Recurance · prevention of future deaths reports
Pre-inquest brief
Lack of VTE risk assessment guidance
The earlier warning
Sophia Ayuk · 20 Jan 2023 · Graeme Irvine, East London
“At no time during the two periods of Ms [name redacted] inpatient care was she assessed for venous thromboembolism (VTE) risk in contravention of trust policy.”
judiciary.uk/…/sophia-ayuk-prevention-of-future-deaths-report
What was promised
A published response was found, but no specific action could be extracted with a verified quote.
What recurred
- 21 Jul 2023 · Corinne Haslam · Chris Morris · Closely related · confidence 0.90 (high)
- 24 Oct 2025 · Sophie Towle · Alexandra Poutney · Closely related · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Sophia Ayuk · 20 Jan 2023
“At no time during the two periods of Ms [name redacted] inpatient care was she assessed for venous thromboembolism (VTE) risk in contravention of trust policy.”
Later · Sophie Towle · 24 Oct 2025
“During the course of [the deceased]'s inquest, I heard evidence which concerns me that there is a lack of clarity in relation to the current local VTE policy.”
What happened next
No web check of the stated actions has been published for this chain.