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recurance

Nicola Lawrence

23 Oct 2018 · Coroner Jonathan Leach · West Yorkshire (East)

This report repeats 2 earlier warnings, and was raised again 5 times later. See the linked reports.

The coroner's concerns

  1. 1. prison staff lacking CPR training

    “Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training”

Linked reports

Repeats an earlier warningKeith Murphy25 Mar 2015 · 3 years 7 months earlier
Identical hazardConfidence 0.90 · high

Earlier report

“Action is required to ensure that Prison Officers and Staff with direct access to prisoners have basic first aid training, CPR training and familiarisation with the use of a defibrillator.”
Original on judiciary.uk ↗

This report

“Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”
Full chain: Lack of basic first aid training and CPR among prison officers
Repeats an earlier warningJohn Williams28 Mar 2017 · 1 year 7 months earlier
Identical hazardConfidence 0.90 · high

Earlier report

“. The prison officers did not have even the most basic first aid and cardiopulmonary resuscitation (CPR) training. | am aware from other inquests that this is not provided at a national level.”
Original on judiciary.uk ↗

This report

“(1) Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”
Full chain: Lack of basic first aid training and CPR among prison officers
Raised again laterRyan Trimmer21 Jun 2019 · 8 months later
Closely relatedConfidence 0.90 · high

This report

“Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”

Later report

“One frontline prison staff member gave evidence that he had not received training in 16 years of working for HMPS and felt he needed refresher training.”
Original on judiciary.uk ↗
Full chain: Lack of basic first aid training and CPR among prison officers
Raised again laterLiam Turner5 Feb 2024 · 5 years 3 months later
Closely relatedConfidence 0.90 · high

This report

“Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”

Later report

“It is not mandatory for prison officers to have basic first aid training (which includes the provision of CPR) which is in-date.”
Original on judiciary.uk ↗
Full chain: Lack of basic first aid training and CPR among prison officers
Raised again laterStephen Sleaford14 Oct 2024 · 6 years later
Closely relatedConfidence 0.90 · high

This report

“- (1) Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”

Later report

“Evidence was heard that the majority of those prison officers who had commenced in their roles prior to 2018 had no first aid/basic life-saving skills and no ability/training in undertaking cardiopulmonary resuscitation ('CPR').”
Original on judiciary.uk ↗
Full chain: Lack of basic first aid training and CPR among prison officers
Raised again laterGareth Chumber-Kelly9 Feb 2026 · 7 years 4 months later
Identical hazardConfidence 0.90 · high

This report

“(1) Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”

Later report

“no refresher CPR training had been provided to prison staff since 2023”
Original on judiciary.uk ↗
Full chain: Lack of basic first aid training and CPR among prison officers
Raised again laterGeorge Haldenby21 May 2026 · 7 years 7 months later
Identical hazardConfidence 0.90 · high

This report

“Some Prison staff had not received any cardiopulmonary resuscitation training. Either as part of initial training or any refresher training.”

Later report

“After prison officers and prison staff carry out their induction training which covers basic first aid training including the delivery of cardio pulmonary resuscitation (CPR), there is no further mandatory refresher training on first aid or CPR.”
Original on judiciary.uk ↗
Full chain: Lack of basic first aid training and CPR among prison officers

Responses

2018-0318-Response-by-HM-Prison-Probation-Service.pdf ↗· His Majesty's Prison and Probation Service

Stated action

“The Governor at HMP New Hall has reviewed the band/grade and number of staff who need to be trained in first aid, and the number of such staff required on duty at times throughout the day. The prison currently has 40 staff trained in FAW and 48 in EFAW, and these numbers are considered to be sufficient to ensure that an appropriate response can be provided in any emergency situation that may arise at any time.”
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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person. Methodology and responsible use · Report an error