Olive Nutt
12 Jun 2018 · Coroner Russell Caller · London Inner (West)
A similar concern from this report was raised again 1 time later. See the linked reports.
The coroner's concerns
1. lack of proper symptom documentation
“The LAS failed to make a relevant and proper note of the symptoms of the deceased when these were phoned through to the LAS.and as a result the clinicians at LAS made an incorrect priority decision which caused significant delay ina timely attendance being made on the deceased”
2. failure to return call to home
“The LAS breached.its own pre-set time guidelines in failing to return a call to the deceased's home to take further details of her medical conditions”
Linked reports
Closely relatedConfidence 0.80 · moderate
This report
“The LAS failed to make a relevant and proper note of the symptoms of the deceased when these were phoned through to the LAS.and as a result the clinicians at LAS made an incorrect priority decision”
Later report
“It was apparent that the ambulance crew were not aware that the combination of seizures and cocaine represented a medical emergency”
Responses
2018-0233-Response-by-London-Ambulance-Service-NHS-Trust.pdf ↗· London Ambulance Service NHS Trust
Stated action
“The LAS failed to make a relevant and proper note of the symptoms of the deceased when these were phoned through to the LAS and as a result the clinicians at LAS made an incorrect priority decision which caused significant delay in a timely attendance being made on the deceased.”
Stated action
“During the afternoon of 29" January 2018 demand in the service was above that predicted and staffing levels both operationally and in the Clinical Hub were below the below the planned”
Stated action · September 2018
“The LAS recruitment drive is ongoing for operational staff and a specific recruitment programme for the Clinical Hub is taking place in September 2018 with a view to increasing the pool of staff trained in the Manchester Triage System and with specific Clinical Hub training.”