Lack of standard operating procedures for worsening patients in renal unit

Each row is one judged link between an earlier and a later report. Open a row to read both quotes, found word for word in the originals. ?Every quote shown was checked by code to appear word for word in the original report.

• 2025 → 2026Janet Tripp7 months after Jason Clemens · same coronerClosely relatedConfidence 0.85 · high

  Closely relatedConfidence 0.85 · high

  Both reports concern the lack of proper standard operating procedures for managing worsening patients in the renal unit. The later report notes that there is insufficient evidence those procedural shortcomings have been resolved.

  Jason Clemens · 2 Jul 2025

  “There were no applicable standard operating procedures for worsening patients in the renal unit at the date of [the deceased]'s death and none had been implemented by the date of Inquest.”

  Check it in the source

  Janet Tripp · 9 Feb 2026

  “There was insufficient evidence before the court to indicate that the above failings found at Inquest had been addressed by the hospital.”

  Check it in the source

  Stated action in the response to the earlier report

  “Standard Operating Procedure (SOP): This (SOP) is now completed and has been uploaded onto the Trust's intranet page for all staff to have access to. A copy of the SOP is attached to the response as 'Enclosure”

  Earlier report in the app · Later report in the app