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recurance

Matthew Sargent

7 Apr 2016 · Coroner Geraint Williams · Worcestershire

The coroner's concerns

  1. 1. insufficient systematic information sharing between departments

    “The Personal Officer of Mr [name redacted] appeared to have had lithe to do with him. It was suggested that there should regular meetings between Personal Officers and individual prisoners so that a more indepth knowledge of individual prisoners could be obtained ans shared.”
  2. 2. historical information not reviewed at intake

    “There was a concern that historical information which was available to Officers and Healthcare staff was not reviewed when the prisoner first presented at the prison and it was suggested that it would be beneificial if there was an instruction that any member of staff dealing with a prisoner who had access to historical information should make some enquiry as to that historical information so as to inform them of both the present and past risks.”
  3. 3. lack of awareness of ACCT history

    “There was a concern that Healthcare staff were not made aware of prisoners who arrive with an ACCT history and it was suggested that Healthcare should be informed in all cases where a prisoner arrives at reception with an ACCT history so that there is a continued sharing of pertinant information.”
  4. 4. Prisoner Escort Record not supplied to healthcare staff

    “There was a concern that the Prisoner Escort Record (hightlighting concerns and risks) was not supplied to the Healthcare Department and nurses at reception, It was Suggested that this should be an imperative requirement for the further sharing of relevant information.”

Responses

Matthew-Sargent-Response.pdf ↗· Government Legal Department

Stated action

“plans to review the reception screening process to introduce a standard template for first reception screening across its prison healthcare settings.”

NOMS-Response_Redacted.pdf ↗· Government Legal Department

Stated action

“In response to this concern, a process has been put in place to ensure that staff gain access to historical information where this information is available. Offender Management Unit staff are now responsible for ensuring that historical risk indicators are disseminated to Healthcare, Reception and the Safer Prisons team. This information is drawn from the pre-transfer report (a document which includes all the prisoner's details including ACCT information and case notes), which is sent to the”
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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