Jane Reason

Dear Mrs Hunt, Your ref: 114060 - JANE LOUISE REASON (LH/RP) Thank you for your letter dated 25th October 2016 regarding your Report to Prevent Future Deaths in this sad case. We agree that it is appropriate that further action should be taken to prevent future deaths in relation to the availability of public access defibrillators (PAD), often referred to as an AED (Automated External Defibrillator) , thank you for giving us the opportunity to respond: The Resuscitation Council (UK) (RC (UK)) is a charity established by medical professionals to promote high-quality practice in all aspects of cardiopulmonary resuscitation (CPR) and improve survival rates from cardiac arrest: The charity exists to promote high-quality, scientifically-based resuscitation guidelines that are applicable to everybody, and to contribute to saving life through education; training; research and collaboration; In relation to your requirements, we recognise that immediate access to a defibrillator is to improving the chances of survival from cardiac arrest for many individuals. This can be achieved through greater numbers of PADs in the community, knowledge of the location of these devices and resuscitation training for the public This will help to ensure the public have the knowledge and confidence to give basic life support (BLS) and use a PAD when appropriate This is a message that we have been promoting for some time and continue to do so with enthusiasm: To this end we are engaged in the following activities: Education We recognise education facilitates many of the aims of the RC (UK). We work closely with UK ambulance service, other first aid organisations and the European Resuscitation Council to encourage all members of the public to learn first aid (BLS and AED use)_ In the UK, we have recently organised the annual 'European Restart a Heart which through hundreds of events that took place across the UK, trained over 150,000 children and young people in basic life support: We have been campaigning at all levels to make BLS and AED teaching mandatory for all school children: Although disappointingly we have not managed to make this a mandatory part of the school curriculum, our campaign has undoubtedly raised the need for this training and improved the numbers of school children who are taught these vital life skills. Training The RC (UK) runs a number of immediate and advanced life support courses which help promote the wider need for awareness of defibrillators in public places, training approximately 150, medical professionals each vear: 5th Floor Tavistock House North, Tavistock Square London; WC1H 9HR Telephone (020) 7388 4678 Fax (020) 7383 0773 Email enquiries@resus org uk Website

Registered Charity Number 286360 RECEIVED and key Day'" 000

Resuscitation Council (UK) Guidelines The RC (UK) is a contributor to international and European resuscitation guidelines from which are distilled the UK resuscitation guidelines. We work with key first aid organisations (e:g: ambulance service, RNLI; St John etc ) to ensure that recommendations relating to bystander CPR defibrillation are disseminated as appropriate throughout the entire UK Additionally, in conjunction with the British Heart Foundation, we have recently published 'A to Automated External Defibrillators' which is designed to provide information about AEDs and how they can be deployed in the community to help resuscitate a victim of sudden cardiac arrest; Research The RC (UK) funds a number of research projects relating to resuscitation and in particular defibrillation that contribute to our knowledge and use of AEDs. Improving the availability of AEDs We are currently working with the Department of Health to oversee the distribution of E1,000,000 funding for public access defibrillators across communities in the UK After extensive public consultation, we have redesigned the signage to be used for all PADs in order to improve the visibility of the devices and increase their use at cardiac arrests in areas Collaboration We regularly work with statutory and non-statutory organisations where we share common aims in order to promote the use of PADs_ We have been contributing a major project with the Department of Health to produce a national framework to improve the treatment of patients with cardiac arrest (Resuscitation to Recovery: A National Framework to improve care of people with Out-of-Hospital Cardiac Arrest (OHCA) in England. 2016) This document makes specific recommendations with regards to improving availability of PADs. In summary, whilst being actively engaged with the above requirements, we have no power to mandate these. We would ask that your recommendations are shared with the Department of Education, in particular that all children are trained in BLS and defibrillator awareness as a mandatory part of the curriculum: We hope that this letter clarifies our position with regards to placement of PADs and educating the and hope that it meets your requirements

ETMAH 2016-0059995POSoS FOR Rt Hon Justine Greening MP Secretary of State Sanctuary Buildings Great Smith Street Westminster London SWIP 3BT tel: 0370 000 2288 WWW education gov.uk/help/contactus RECEIVED Mrs Louise Hunt 2 0 FEB 2017 HM Senior Coroner, Birmingham & Solihull Districts BY: Coroner's Court 50 Newton Street Birmingham B4 6NE ref: 14060 February 2017 Uew Mv Iunk Thank you for your letters of 25 October 2016 and 26 January, and for providing me with sight of the Report to Prevent Future Deaths following the inquest of Ms Jane Louise Reason. Unfortunately, your first letter seems to have been lost due to an administration error _ | am terribly for the in my reply. was extremely saddened to about the circumstances of Ms Reason's death. read the Regulation 28 Report with great care. agree that every consideration must be given in order to prevent; so far as we possibly can, tragedies of this nature occurring in our schools, colleges and other education institutions_ assure you that the safety and wellbeing of staff, and of those in their care, is a matter that my department takes very seriously. My department published guide on automated external defibrillators in April 2016, which is available at: tinyurLcom/zn82vva: Since this tragic incident; we have published new guidance that is more relevant to further education colleges. shall be writing to the Association of Colleges to draw this guidance to the attention of their members_ Thank you for writing on this important matter Ucxt Vshs J RT HON JUSTINE GREENING MP EoucaTiON 'ARTMeNT Your delay sorry hear

Dear Mrs Hunt, Your ref: 114060 - JANE LOUISE REASON (LH/RP) Response to the Regulation 28 Report to Prevent Further Deaths issued by the Senior Coroner's Office for the Birmingham and Solihull Areas dated 25 October 2016 Thank you for your letter dated 25th October 2016 enclosing your Report to Prevent Further Deaths in this very unfortunate matter. As Director of the Prevention, Survival and Support Directorate for the British Heart Foundation (BHF) have been asked by our Chief Executive, Simon Gillespie, to respond on behalf of the BHF to the Matters of Concern raised in your report: We acknowledge and fully support that improved awareness and accessibility of public access defibrillators would be of significant benefit preventing similar unnecessary deaths. The importance of the general public having the confidence to deliver cardiopulmonary resuscitation (CPR) and use a defibrillator in an emergency is core to the work of the BHF. We are grateful for the opportunity to respond on this matter as part of your investigation into this issue_ The BHF is a company limited by guarantee, incorporated in England on 28 July 1961, and with registered office at Greater London House, 180 Hampstead Road, London NW1 7AW. It is registered charity in England and Wales (charity number 225971) and in Scotland (charity number SC039426). The purposes for which the BHF is established (i.e: its charitable objectives), as set out in its Articles of Association, are: to attack and defeat diseases and conditions of the heart and circulation and other diseases, illness or conditions, by undertaking and promoting research for the public benefit into their cause, diagnosis, treatment and prevention, promoting their diagnosis, treatment and prevention, educating the public and alleviating suffering and promoting the welfare of persons afflicted and those who care for such persons: FIGHT FOR EVERY HEARTBEAT bhf.org uk Patron HRH The Prince Philip KG KT A Company Limited by Guarantee; Registered in England Number 699547 Head and Registered Office at I80 Hampstead Road, Landon NWI ZAW Chief Executive Simon Gillesple Telephone 020 7554 00O0_ The British Heart Foundation is registered charity In England and Wales (225970) and in Scotland (SC039426)

The BHF can only carry out activities that fall within its charitable objectives, but it is not under a legal duty to carry out any particular activity that may fall within these objectives either by statute Or otherwise, unless it contractually agrees to do so. Like all charities, its overall purposes must be to the benefit of the public: Since it was established in 1961, the BHF has powered critical advances in heart health, from pacemakers to statins Cardiovascular disease kills more people in the UK than all cancers put together and the BHF funds over half of all cardiovascular research in the UK With regards to the Matters of Concern we recognise that immediate access to a defibrillator is a part of the chain of survival in ensuring more people survive out-of-hospital cardiac arrest: There are more than 30,000 out-of-hospital cardiac arrests in the UK each year and currently less than 1 in 10 people survive. This is partly because many people don't have the skills, confidence and ability to step in and help: Around 80% of out-of-hospital cardiac arrests happen in the home which is why CPR skills and defibrillation awareness are SO important In instances of an out-of-hospital cardiac arrest, 999, immediate CPR and access to public access defibrillator (PAD) are essential to maximise the chances of survival indeed, all are essential parts of the chain of survival which are the internationally recognised set of steps to increase the chances of survival for someone who's had a cardiac arrest: Effective CPR means that the casualty is more likely to be kept in & shockable heart rhythm and this coupled with the placement of PADs in public places helps to reduce the time delay between cardiac arrest and shock from the defibrillator and time is an important factor. PADs are specifically designed to be used by members of the public as well as first responders in the event of a cardiac arrest and no training is required as they have spoken instructions and won't deliver a shock unless necessary. The BHF is committed to tackling the low out-of-hospital cardiac arrest survival rates in the UK by: increasing the rate of bystander CPR by providing free CPR training kits to schools and the general public; and increasing the rate of bystander PAD use by increasing awareness, availability and visibility of PADs The BHF has a clear five year strategy to 2021 and we are currently investing time, money and resources in a number of projects to improve survival rates from out-of-hospital cardiac arrest_ Training_resources Making CPR training more accessible, the BHF has a programme called Call Push Rescue which is a unique self-directed learning kit that is free to eligible secondary schools and community groups. There are currently over 2300 secondary schools and over 1800 adult and youth community groups who are part of this programme: We are also working with partners including Scotland and Greater Manchester fire and rescue services to support CPR training in schools and local communities Furthermore the BHF works with a number of corporate partners, BHF retail shops and workplaces to offer CPR training to employees We are continuing to support our 2000 existing Heartstart schemes who teach a more in depth first aid course covering choking, bleeding and CPR skills and this has meant the BHF has helped to train over 1.6 million people since 2014. BHF has been a partner in running national awareness campaigns about the importance of bystander CPR skills on "European Restart a Heart Day" for 3 years and have recently worked with a number of partners including the UK Resuscitation Council, British Red Cross, St John Ambulance and the 14 UK ambulance services to provide resources and support training of 150,000 voung people in one at a number of events across the UK on 18th October 2016_ key from calling The key day

Improving accessibility and availability of PADs The BHF provide part funding to community groups to enable them to purchase a PAD for their local area and have awarded 435 PADs already in 2016 and we are currently managing and distributing the €1,000,000 PAD funding project awarded to the Department of Health from the treasury budget in 2016 which will provide more PADs to local communities in England. The BHF are working closely with the UK Resuscitation Council to redesign the signs for PADs in order to improve visibility increase bystander use in access areas_ There are currently an unknown number of PADs across the UK (the figure is estimated to be 100,000) and importantly there is no central database which captures information regarding the location of these PADs for the UK ambulance services. If emergency call resm ponders at the ambulance service were able to locate the closest defibrillator via a national database then they could direct a bystander to the PAD and this may impact on improving survival rates. The BHF are investing funds to review options to develop a National PAD database, which would be accessible to all ambulance services and make locating the PADs much easier Research The BHF provides grant funding for a UK wide out-of-hospital cardiac arrest registry at Warwick University which will support audit of service improvement. The BHF and its partners have developed series of initiatives to try to improve bystander CPR and PAD use, but how effective these projects are is not known: The Out of Hospital Cardiac Arrest Outcomes project at Warwick will collect information to work out the best ways of improving the bystander response to cardiac arrest We also have links with other countries in Europe and with hospital specialists to further develop our understanding of the best ways to improve survival from cardiac arrest: Key collaborations The BHF are convening expert advisory groups with representation from the four nations to improve out-of-hospital cardiac arrest survival rates through a system wide approach we are part of a number of key collaborations. The BHF are working with the NHS & Welsh Government to develop an out-of-hospital cardiac arrest strategy Wales_ We_have_beensupporting the Community Resuscitation steering group in England chaired by to develop a national framework document "resuscitation to recovery" to improve care of people with out-of-hospital cardiac arrest in England BHF are a member of the Scottish Government Out of Hospital Cardiac Arrest strategy delivery group which aims to improve survival rates in Scotland. In conjunction with the Resuscitation Council we have recently developed 'A guide to Automated External Defibrillators" which provides information about PADs and how they can be deployed in the community to help resuscitate victims of sudden cardiac arrest Genetic Information Service In addition to significant funding in medical research into inherited heart conditions that can cause sudden death; we have also invested in implementing the research finding in clinical practice so that families affected by an inherited heart condition can receive the appropriate care quickly: We also provide a Genetic Information Service for families affected by inherited heart conditions and support families where a diagnosis of an inherited heart condition has been made in a living or a deceased family member: Coroners are also encouraged to call the Genetic Information Service for advice if they suspect an individual has died due to an inherited heart condition and need advice on how to refer the surviving family members for treatment: To date we have had two meetings with the Chief Coroner for England to raise awareness of the service amongst coroners and coroners' officers and public and

In summary we are actively engaged in providing access to training resources to teach CPR skills and PAD familiarisation on a range of programmes and provide access to funding for PADs but we have no authority to carry out these programmes as a matter of public policy as we are not a government institution or authority. However; the BHF recommends that all young people are given access to CPR training and defibrillator awareness while at secondary school and would ask that you support this recommendation by communicating this to the Department for Education. We hope that the information provided above sufficiently clarifies the BHF'$ position with regards to the Matters of Concern raised: Should your office require further explanation the BHF is more than happy to offer its assistance in any way.