Warren Sampson
6 Sept 2016 · Coroner Caroline Beasley-Murray · Essex
This report repeats 1 earlier warning, and was raised again 2 times later. See the linked reports.
The coroner's concerns
1. lack of written evidence of contributory input from other agencies
“The lack of written evidence within the ACCT documentation of contributory input from other agencies such as Healthcare”
2. lack of process for following up non-attendance at Reception Healthcare first night screening
“lack of a process for following up non- attendance at the Reception Healthcare first night screening”
3. lack of system for ensuring officers are familiar with local directives and instructions
“lack of a system for ensuring that all officers are familiar with local directives and instructions”
Linked reports
Closely relatedConfidence 0.70 · moderate
Earlier report
“Witnesses confirmed that they often did not read much of the ACCT document prior to the ACCT review and relied more upon input of other attendees”
This report
“The lack of written evidence within the ACCT documentation of contributory input from other agencies such as Healthcare.”
Identical hazardConfidence 0.90 · high
This report
“The lack of a process for following up non- attendance at the Reception Healthcare first night screening”
Later report
“There was no second reception screen conducted. If Mr [name redacted] was not brought to healthcare staff for his second reception screen then healthcare staff needed to follow this up.”
Closely relatedConfidence 0.90 · high
This report
“The lack of a process for following up non- attendance at the Reception Healthcare first night screening”
Later report
“It was clear from evidence from prison and healthcare staff that it was not routine for healthcare to attend ACCT reviews.”
Responses
2016-0320-Response-from-Care-UK.pdf ↗· Care UK
Stated action · within 72 hours
“The process now is that a Second Health Screen is undertaken within 72 hours of an inmate arriving at HMP Chelmsford and at that second health screen there would be a Care UK Cltrncal SeMces llm,ted - Registered ,n England No 3462881 Registered Office Connaught House.”