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Recurance · prevention of future deaths reports

Pre-inquest brief

Lack of naloxone availability and training in prisons

Organisation: NHS England · Generated: 26 Oct 2026

Recurance · recurance.com/chains/e704d0d690ae9af5

The earlier warning

Neville McNair · 5 Nov 2019 · Fiona King, East Sussex

“all staff including non-health care staff and operational/security staff should have training in recognising and responding to opiate overdose including using available Naloxone.”

judiciary.uk/prevention-of-future-death-reports/neville-mcnair

What was promised

A published response was found, but no specific action could be extracted with a verified quote.

What recurred

  • 2 Jan 2025 · Joseph Forbes Black · Ian Potter · Closely related · confidence 0.90 (high)

The clearest link, quoted from both reports:

Earlier · Neville McNair · 5 Nov 2019

“all staff including non-health care staff and operational/security staff should have training in recognising and responding to opiate overdose including using available Naloxone.”

Later · Joseph Forbes Black · 2 Jan 2025

“I am concerned that this set of circumstances raises the risk of future deaths occurring because the provision of naloxone kits could be made more widely available to those most likely to need them.”

What happened next

No web check of the stated actions has been published for this chain.

Every quote is verified word for word against the original report on judiciary.uk. A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person.

Source: Courts and Tribunals Judiciary, Open Government Licence v3.0.