Hazel Lewis

On the 7 December 2018, commenced an investigation into the death of Hazel Maureen Lewis. The inquest concluded on 4 November 2019. The medical cause of death is Ia) metastatic cancer of the breast 2) left fractured neck of femur (conservative management): The Conclusion was Natural Causes to which an injury sustained as a result of an unwitnessed fall contributed '

Hazel Lewis had learning and communication difficulties and long history of declining medical investigations and social support: In January 2016, she was noted to have a lump suggestive of breast cancer and declined investigations_ She was deemed to have the requisite mental capacity to decline investigations at that time. On 30 May 2017, Ms Lewis's long-term partner died. Her package of social care support was increased and whilst initially resistant; Ms Lewis was able to fully engage with the care package and carers. She was referred to her GP in relation to the breast lump. On 10 July 2017, the GP undertook a home visit jointly with Care Act Advocate. Ms Lewis was assessed as lacking capacity to make decisions in relation to investigations into the breast lump. best interest decision was made by the GP not to proceed with investigations, prior to consultation with the social worker or community learning disabilities nurse_ When the social worker and community learning disabilities nurse were spoken to about the best interest decision, neither of them appreciated that were consulted for the purpose of best interest decision-making_ Options as to whether it might be possible to encourage Ms Lewis to engage with medical investigations were not explored: Ms Lewis had no family or friends to consult with and an Independent Mental Capacity Act Advocate was not formally instructed as part of the best interest decision-making process. On 14 November 2018, Ms Lewis was found on the floor at her home address by carers She had sustained hip fracture as a result of an unwitnessed fall: She was taken to the Royal Oldham Hospital where she was managed conservatively and died at 16.14 hours on 28 November 2018_ Whilst the hip fracture significantly contributed to her death, the cause of death was metastatic cancer of the breast. they being

In my opinion action should be taken to prevent future deaths and believe each of you respectively have the power to take such action: