“There was no evidence of a multi agency planning meeting prior to Mr Savory’s discharge…”
Dated 11 Aug 2021, from the coroner for North East Kent. Sent to 3 organisations or people.
A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.
The 56-day response deadline
Report put online after its 56 daysOrganisations that receive a report must reply to the coroner within 56 days, saying what they will do or why they will do nothing. We show whether a response is published on judiciary.uk; a reply may have been sent and not yet published.
judiciary.uk put this report online on 19 Dec 2022, after the 56 days for replies had ended (6 Oct 2021). These dates can’t tell us whether a reply was due before it went online. A reply may have been sent and not yet published.
- Report dated11 Aug 2021
- Deadline6 Oct 2021
- Published on judiciary.uk19 Dec 2022
- Today23 Oct 2026
Watch this report
We’ll email you when a response is published on judiciary.uk, or when the 56 days to reply end with none published there yet. Free, and you can stop with one click.
Responses from each recipient
| Sent to | Response |
|---|---|
| The Forward Trust | Report put online after its 56 daysNo response published on judiciary.uk. judiciary.uk put this report online on 19 Dec 2022, after the 56 days for replies had ended (6 Oct 2021). These dates can’t tell us whether a reply was due before it went online. |
| Kent and Medway NHS and Social Care Partnership Trust | Report put online after its 56 daysNo response published on judiciary.uk. judiciary.uk put this report online on 19 Dec 2022, after the 56 days for replies had ended (6 Oct 2021). These dates can’t tell us whether a reply was due before it went online. |
| East Kent Hospitals University NHS Foundation TrustNamed in the report as “East Kent Hospital University NHS Foundation Trust” | Report put online after its 56 daysNo response published on judiciary.uk. judiciary.uk put this report online on 19 Dec 2022, after the 56 days for replies had ended (6 Oct 2021). These dates can’t tell us whether a reply was due before it went online. |
The coroner’s concerns
– (1) There was no evidence of a multi agency planning meeting prior to Mr Savory’s discharge from Queen Elizabeth The Queen Mother Hospital on 25 September 2019. Nor was there evidence of what multi-agency procedures are in place relating to the safe discharge of patients with concurrent, mental health, substance misuse, social care and physical health needs;
An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.
- Source
- judiciary.uk, Prevention of Future Deaths reports, 2022-0402
- Added to Minute Book
- 8 Oct 2026
- Reuse
- We show short extracts and link to the original. We don’t host the full report.
Something wrong, such as a date or who it was sent to? Report a mistake
Is this report about someone close to you? You can ask us to remove names from our pages.
Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0
Ask about this report
AISummaries and questions, with page references. Pro and above.
Sign in to use