“6 1”
Dated 8 Nov 2024, from the coroner for Manchester West. Sent to 2 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
All responses publishedReplies were due by 3 Jan 2025.
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 dated8 Nov 2024
- Deadline3 Jan 2025
- Published on judiciary.uk11 Nov 2024
- Today22 Oct 2026
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Responses from each recipient
| Sent to | Response |
|---|---|
| Northern Care Alliance NHS Foundation TrustNamed in the report as “SALFORD ROYAL HOSPITAL FOUNDATION TRUST” | Response publishedPublished on judiciary.uk in November 2024. |
| NHS EnglandNamed in the report as “NHS ENGLAND” | Response publishedPublished on judiciary.uk in November 2024. |
The coroner’s concerns
6 1. During evidence, it was heard that the deceased had elected to leave the Hospital on Friday 19 July because of waiting times, before being clinically assessed. 2. There was no consideration of whether secondary investigations could be undertaken during the waiting time for example CT scan which would likely be required by a clinician in order to make a diagnosis. 3. No evidence was provided that the deceased’s capacity to decide to leave the hospital was assessed given the history of suspected head injury. 4. Reference was made to a new standard operating procedure being developed relating to patients leaving the hospital before a clinical assessment occurs, but it was unclear what this will include.
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, 2024-0614
- 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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