Recurance · prevention of future deaths reports
Pre-inquest brief
Missing training records and qualifications verification
The earlier warning
Adam Bojelian · 5 Feb 2020 · Kevin McLoughlin, West Yorkshire (East)
“The evidence revealed that in 2015, the Trust did not hold records of the training received by individual nurses. Instead, it was left to each individual nurse to maintain their own training records.”
judiciary.uk/prevention-of-future-death-reports/adam-bojelian
What was promised
No published response from Leeds Teaching Hospitals NHS Trust was found for the earlier reports.
What recurred
- 18 Aug 2022 · John Heffron · Kevin McLoughlin · Closely related · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Adam Bojelian · 5 Feb 2020
“The evidence revealed that in 2015, the Trust did not hold records of the training received by individual nurses. Instead, it was left to each individual nurse to maintain their own training records.”
Later · John Heffron · 18 Aug 2022
“(9) It was unclear whether the Trust's contractual arrangements with nursing agencies stipulate the requirement for those supplied to (a) be professionally qualified (b) have current training to specified standards and (c) have undergone appropriate induction to the ED.”
What happened next
No web check of the stated actions has been published for this chain.