Leonard King

Dear Mr Cummings

LEONARD JOMO ISAAC KING (DECEASED)

I am writing in response to the preventing future deaths report we received at the Association of Ambulance Chief Executives (AACE) dated 15th August 2023, and I respond as our Managing Director on behalf of the AACE.

It may be helpful for us to explain that AACE is a private company owned by the English and Welsh Ambulance NHS Trusts. It exists to provide ambulance services with a central organisation that supports, co-ordinates and implements nationally agreed policy. Our primary focus is the ongoing development of the English ambulance services and the improvement of patient care. It is a company owned by NHS organisations and possess the intellectual property rights of the Joint Royal Colleges Ambulance Liaison Committee UK ambulance service clinical practice guidelines (the “JRCALC guidelines”). AACE is not constituted to mandate or instruct ambulance services however it has national influence via the regular meetings of ambulance Chief Executives and Trust Chairs along with a network of national specialist sub- groups.

With regard to your matter of concern relating to ambulance services:

Education and training in the movement of epiglottitis into the adult population may assist in recognition and early treatment.

With regard to the UK ambulance service clinical practice guidelines (the “JRCALC guidelines”). The guidelines are in regular use by ambulance clinicians across the UK and guide decisions on the assessment and management of a wide range of clinical presentations. We currently have guidance for children with suspected epiglottitis but not for adults. We had already started to scope and develop new guidance for ambulance clinicians on rarer and specific conditions that need pre-hospital clinical assessment and management that differs from standard practice. We appreciate the importance of the prompt recognition or suspicion of suspected epiglottitis in adults and that typical symptoms may include a sore throat which becomes more severe with time, difficulty swallowing secretions, pain on swallowing and an alteration in voice. Therefore, as part of this new guidance we will include adult epiglottitis as one of the conditions and include the key assessment and management points and the importance of rapid conveyance to hospital for lifesaving treatment.

AACE are not responsible for the training or education of ambulance staff, however we plan to share and discuss this preventing future death report with ambulance service medical directors at our next meeting. We will suggest that individual ambulance services consider if any education or raising awareness of epiglottitis in adults is required. We will also share the report with education leads of ambulance trusts, via the national education network for ambulance trusts.

On behalf of AACE, I would like to extend our sincere condolences to the family of Leonard Jomo Isaac King.

I hope this response has adequately addressed the concerns that you have raised. If you have any further questions please do not hesitate to get in touch.