Tracking preventable deaths in November 2024
Black Friday isn't over yet
Welcome to November’s monthly review of coroner data by the Preventable Deaths Tracker (PDT). Last month, the Lady Chief Justice published her first report. However, the update on coroners features at the end (pages 47-48) as part of “other” judicial activity, with no news to report back on.
The Government announced the 10-Year Plan Working Groups to consider the future vision for the NHS. The PDT is particularly interested in the “Accountability and oversight” group, which is tasked with reviewing “the current approach to accountability and oversight and determining whether it is fit for purpose and can drive improvement in our healthcare system.” After analysing the NHS’s poor responses to coroners' reports for over 11 years, the conclusion is clear - there’s very little accountability and oversight in the NHS. It’s not fit for purpose. Job done.
To some good news: on 19 November, a new All-Party Parliamentary Group (APPG) on Patient Safety was launched. And last week, on 25 November, I hosted Professor Noel Woodford from the Victorian Institute of Forensic Medicine, Australia, at King’s College London. Prof Woodford gave a brilliant overview of how Australia’s death investigation system evolved, as well as its current practices, challenges, and future directions. As one attendee said, “…Australia (and New Zealand) are well ahead of us in England and Wales. [We have] much to learn and adopt.”
A huge thanks to Prof Woodford for taking the time out of his holiday to speak with us and to many of you for your support, including Sir Peter Thornton KC. Sir Peter was the first Chief Coroner of England and Wales and runs the brilliant Death Investigation course at King’s College London. I’m delighted to be delivering a lecture on this course next year, and for those interested, you can find out more online or download the flyer below. If you or your colleagues work in the NHS or want to learn more about the Coroner Service, this course is for you.
And finally, if you haven’t had enough of Black Friday, the PDT has a special offer for those wanting access to the archive, monthly reviews, and today’s analysis.
Now, onto the monthly review of coroner reports published in November.
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