Chloe Ellis
13 Jun 2025 · Coroner Oliver Longstaff · West Yorkshire (East)
The coroner's concerns
1. lack of accessibility of NHS 111 assessment outcomes to clinicians
“The inquest was told that it is possible for the outcomes of NHS 111 online assessments to be made accessible to Emergency Department clinicians, and that the decision whether or not to commission that accessibility in a particular hospital rests with the relevant Integrated Care Board.”
2. lack of commissioned accessibility of NHS 111 online assessments
“The inquest was told that the West Yorkshire Integrated Care Board has not commissioned accessibility to NHS 111 online assessments for the Mid Yorkshire Teaching NHS Trust.”
3. inadequate history taking in Emergency Departments
“If the NHS online assessment completed by [the deceased] had been available to the relevant clinicians at Dewsbury District Hospital, her history of oral contraceptive use and the suspicion of a pulmonary embolism would have been visible to them.”
4. inadequate history taking in Emergency Departments
“The availability of NHS 111 online assessments to clinicians in Emergency Departments may assist in the obtaining of a full history and may act as a failsafe against inadequate history taking in Emergency Departments.”