Recurance · prevention of future deaths reports
Pre-inquest brief
The earlier warning
Matthew Faulkner · 29 Mar 2018 · Geoffrey Sullivan, Hertfordshire
“(1) At the time of this incident, demand on the EEAS far outstripped the resources available to them.”
judiciary.uk/prevention-of-future-death-reports/matthew-faulkner
What was promised
Stated action 1 · response to Matthew Faulkner (29 Mar 2018) · stated timescale: March 2017
“In January 2017 we identified ambulance handover times as a key challenge within our performance targets and in order to address this in March 2017 we sought external expertise to reconfigure the handover process, our aim being to reduce handover times to the meet the national standard of 100% within 15 min of arrival, thus releasing ambulance crews in a timelier manner.”
judiciary.uk/…/2018-0097-Response-by-East-North-Hertfordshire-N…
Stated action 2 · response to Matthew Faulkner (29 Mar 2018) · stated timescale: coming months
“We are planning to arrange a further briefing for HM coroners in the coming months”
judiciary.uk/…/2018-0097-Response-by-East-of-England-Ambulance-…
Stated action 3 · response to Matthew Faulkner (29 Mar 2018) · stated timescale: December 2017
“The Trust introduced Patient Safety Intervention Teams (PSIT) across the Trust in December 2017 to support our Acute Trust colleagues throughout the winter”
judiciary.uk/…/2018-0097-Response-by-East-of-England-Ambulance-…
3 further stated actions are listed on the full chain page.
What recurred
- 26 Aug 2022 · Christina Ruse · Jacqueline Lake · Identical hazard · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Matthew Faulkner · 29 Mar 2018
“(1) At the time of this incident, demand on the EEAS far outstripped the resources available to them.”
Later · Christina Ruse · 26 Aug 2022
“2. There were no emergency ambulances available to assign to this call due to high call demand.”
What happened next
No evidence found either way · a stated action in a response
The Trust states it is working with HSIB to escalate concerns but does not specify any completed action or timeline.
No evidence found does not mean the action did not happen.
No evidence found either way · a stated action in a response
“The trust's Patient Plan included that hospitals would no longer be the default destination for patients if it was safe for them to instead receive care closer to home.”
East of England Ambulance to take fewer patients to hospital · bbc.com/news/articles/cy49d8zv4w2o
No evidence found does not mean the action did not happen.