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recurance

Emily Collishaw

27 Jun 2024 · Coroner Andrew Harris · Outer South London

This report repeats 1 earlier warning. See the linked reports.

The coroner's concerns

  1. 1. insufficient support to maintain physical health and promote abstinence

    “the degree of support was insufficient to maintain her physical health or promote abstinence over such a long period of six months before she died”
  2. 2. delayed referral for residential care

    “the referral for residential care should have been made earlier”
  3. 3. prolonged waiting for residential rehabilitation placement

    “the delay in accessing residential care had been progressively getting longer over the last 10 years, which posed risks such as sudden death to patients”

Linked reports

Repeats an earlier warningBenjamin Hazelden26 Sept 2023 · 9 months earlier
Closely relatedConfidence 0.90 · high

Earlier report

“A bespoke placement had been carefully created by those involved in [name redacted]'s care but this had taken several months to arrange.”
Original on judiciary.uk ↗

This report

“the delay in accessing residential care had been progressively getting longer over the last 10 years, which posed risks such as sudden death to patients.”
Full chain: Delayed bespoke care placement arrangements

Responses

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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person. Methodology and responsible use · Report an error