“2”
Dated 30 Apr 2024, from the coroner for Berkshire. Sent to 1 organisation or person.
A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.
The 56-day response deadline
All responses publishedReplies were due by 25 Jun 2024.
Organisations 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.
- Report dated30 Apr 2024
- Deadline25 Jun 2024
- Published on judiciary.uk9 May 2024
- Today23 Oct 2026
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Responses from each recipient
| Sent to | Response |
|---|---|
| Berkshire Healthcare NHS Foundation Trust | Response publishedPublished on judiciary.uk in May 2024. |
The coroner’s concerns
1. 2. 3. 4. 5. 6 I am concerned about whether systems are in place for sufficiently robust care coordination for patients who have been discharged from a mental health setting, particularly in the context of detained/recently detained patients. Reliance on telephone rather than face to face appointments. Regularity / thresholds for MDT discussions. Absence of a clear route for family to report concerns, even where a patient does not wish confidential information to be given to their family. Policy / expectation for correspondence with primary care, particularly in the time after discharge from hospital.
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, 2024-0232
- Added to Minute Book
- 8 Oct 2026
- Reuse
- We show short extracts and link to the original. We don’t host the full report.
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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0
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