North West Ambulance Service NHS Trust
NHS Trust
Noted
AI-generated response summary
• The Concern for Welfare Response Criteria Guidelines Policy was introduced in May 2024, in response to the Right Care, Right Person (RCRP) National Partnership Agreement. • NWAS has communicated its policy on welfare call deployment to local system partners, including police, acute trusts, mental health organisations, and councils. • NWAS met with the Okay Each Day service to advise them on the circumstances for ambulance deployment in welfare calls.
View full response
Dear Ms Devonish
Regulation 28 Report – Inquest Touching the Death of Lesley Katherine Higginson
I write further to your Prevention of Future Deaths Report dated 10th June 2026, which was issued to North West Ambulance Service (“NWAS”) following the conclusion of the inquest touching the death of Lesley Katherine Higginson.
I am aware that you will share my response with Lesley’s family, and I firstly wish to express my sincere condolences to them. NWAS’ core purpose is to save lives, prevent harm and provide services which optimise the likelihood of positive patient outcomes.
Through the Regulation 28 report, you have requested that NWAS considers your matters of concern. By this letter I will address those concerns as far as I am able.
I note that the inquest took place on 4th June 2026 and that NWAS did not have Interested Person (IP) status. NWAS provided witness evidence from Connor Hayes, Paramedic, on 5th February 2026 though he was not called to give evidence. Therefore, no NWAS witnesses or representatives were in attendance at the hearing.
Through the Regulation 28 report, you have requested that NWAS considers your matters of concern and have suggested that action is taken to prevent future deaths occurring in the future. Within this letter, I will address those concerns raised as far as I am able.
Mrs Higginson benefitted from a care package designed for her independence and welfare, engaging a remote means of making daily contact with her in the least intrusive manner. Failed contact was followed up by a call to the ambulance service which indicated that they would not attend. It is important to know whether there is an established policy for declining welfare calls and when it was introduced. It leaves patients in a difficult position when aligned with the constabulary Right Care Right Person (RCRP) policy which was published nationally on 23 June 2023 and implemented in the Cheshire region in January 2024. The RCRP policy states that the police in Cheshire (and in other areas nationally) will not respond to welfare check calls when healthcare are best placed to support those who may be in crisis. It is unclear from the ambulance service response whether a request for a welfare check, in the circumstances of this death, is to be deemed to be healthcare related and whether the ambulance service properly rejected the request, on the grounds stated.
On 17th of January 2026 at 15:16 hrs a call was received from Okay Each Day, a wellbeing check service, in which the caller advised that they had attempted to contact Ms Higginson on their daily call but had not received a response. During this call, they advised that a neighbour of Ms Higginson’s had advised that they had cameras for each other, and she had seen no movement of Ms Higginson on the cameras.
This call elicited an ambulance response, and the caller was advised that there was a 1 hour 20 minute to 1 hour 50 minute response time but they may receive a call back from a Health Care Professional within that timeframe. This was accepted by the caller. An Advanced Paramedic called Okay Each Day back at 15:35hrs and advised that due to the location of Ms Higginson being unknown and a medical need for an ambulance also being unknown, an ambulance would not be deployed.
This advice was in accordance with the NWAS Concern for Welfare policy, which covers the receipt, recording, escalation and NWAS responses in relation to concern for welfare of a patient. Where such calls are received, the guidelines provide that the patient’s location needs to be known and there needs to be a confirmed medical need.
NWAS need a verified location and assurance that a patient is indeed present at the specified location where an ambulance resource is being dispatched to. Additionally, NWAS rely on accurate contact information, ensuring that any provided contact number will connect us directly with the patient. NWAS does not have the legal powers, nor the equipment, to force entry to properties.
As an ambulance service, our primary function is to prioritise and respond to the medical needs of our patients whether this is face-to-face or via other methods. A confirmed physical or mental health complaint means that the caller has evidence or good reason to believe that the patient or service user is currently suffering from a physical or mental health issue that requires either a face-to-face assessment or telephone response. It cannot be assumed that an individual being uncontactable, means that they require medical assistance. Nor do NWAS have the capacity to conduct thorough enquiries, on behalf of other services, to determine whether an individual is experiencing physical or mental health concerns. It is incumbent upon these services to arrange for and execute such inquiries autonomously.
The NWAS Mental Health and Suicide Prevention Lead has listened to the 999 calls made in respect of Ms Higginson and has confirmed that the 999 call from Okay Each Day at 15:16 hrs was handled appropriately and in line with the Concern for Welfare policy. It could not be determined that Ms Higginson was at the specified location nor could it be determined that she had a confirmed physical or mental health complaint. It was therefore correct that NWAS did not deploy an ambulance to Ms Higginson based on the information provided at the time of the call.
A subsequent call was received at 11:49 hrs on 18th January 2026. The caller was a neighbour of Ms Higginson who stated that a foot could be seen on the floor. NWAS then deployed an ambulance which arrived within 54 minutes, at 12:43 hrs. Ms Higginson was sadly declared deceased on scene at 13:03 hrs.
The Concern for Welfare Response Criteria Guidelines Policy was introduced in May 2024, in response to the Right Care, Right Person (RCRP) National Partnership Agreement. NWAS have been clear and transparent with local system partners, including the Police, Acute Trusts, Mental Health Organisations and Councils regarding the deployment of ambulances when concern for welfare calls are made to the service and the circumstances in which an ambulance will and will not be deployed. NWAS and other system partners have previously noted that there is a gap in services for members of the public who may need concern for welfare call outs and this has been discussed in both strategic and tactical RCRP meetings, but not something that NWAS are able to fulfil unilaterally.
NWAS have also met with the Okay Each Day service who have been advised as to the circumstances in which an ambulance will and will not be deployed when concern for welfare calls are received. It was recommended by NWAS that Okay Each Day explore whether they could set up a pathway with other agencies to make initial contact with a patient where their exact location cannot be determined or for them to consider their own response team to conduct these enquiries
I am grateful to you for bringing this matter to my attention and I am sorry that you felt it necessary to issue a Prevention of Future Deaths Report to NWAS. If you require any further clarification or information, please do not hesitate to contact me or the Trust’s Deputy Director of Corporate Affairs, Emma Shiner.
Regulation 28 Report – Inquest Touching the Death of Lesley Katherine Higginson
I write further to your Prevention of Future Deaths Report dated 10th June 2026, which was issued to North West Ambulance Service (“NWAS”) following the conclusion of the inquest touching the death of Lesley Katherine Higginson.
I am aware that you will share my response with Lesley’s family, and I firstly wish to express my sincere condolences to them. NWAS’ core purpose is to save lives, prevent harm and provide services which optimise the likelihood of positive patient outcomes.
Through the Regulation 28 report, you have requested that NWAS considers your matters of concern. By this letter I will address those concerns as far as I am able.
I note that the inquest took place on 4th June 2026 and that NWAS did not have Interested Person (IP) status. NWAS provided witness evidence from Connor Hayes, Paramedic, on 5th February 2026 though he was not called to give evidence. Therefore, no NWAS witnesses or representatives were in attendance at the hearing.
Through the Regulation 28 report, you have requested that NWAS considers your matters of concern and have suggested that action is taken to prevent future deaths occurring in the future. Within this letter, I will address those concerns raised as far as I am able.
Mrs Higginson benefitted from a care package designed for her independence and welfare, engaging a remote means of making daily contact with her in the least intrusive manner. Failed contact was followed up by a call to the ambulance service which indicated that they would not attend. It is important to know whether there is an established policy for declining welfare calls and when it was introduced. It leaves patients in a difficult position when aligned with the constabulary Right Care Right Person (RCRP) policy which was published nationally on 23 June 2023 and implemented in the Cheshire region in January 2024. The RCRP policy states that the police in Cheshire (and in other areas nationally) will not respond to welfare check calls when healthcare are best placed to support those who may be in crisis. It is unclear from the ambulance service response whether a request for a welfare check, in the circumstances of this death, is to be deemed to be healthcare related and whether the ambulance service properly rejected the request, on the grounds stated.
On 17th of January 2026 at 15:16 hrs a call was received from Okay Each Day, a wellbeing check service, in which the caller advised that they had attempted to contact Ms Higginson on their daily call but had not received a response. During this call, they advised that a neighbour of Ms Higginson’s had advised that they had cameras for each other, and she had seen no movement of Ms Higginson on the cameras.
This call elicited an ambulance response, and the caller was advised that there was a 1 hour 20 minute to 1 hour 50 minute response time but they may receive a call back from a Health Care Professional within that timeframe. This was accepted by the caller. An Advanced Paramedic called Okay Each Day back at 15:35hrs and advised that due to the location of Ms Higginson being unknown and a medical need for an ambulance also being unknown, an ambulance would not be deployed.
This advice was in accordance with the NWAS Concern for Welfare policy, which covers the receipt, recording, escalation and NWAS responses in relation to concern for welfare of a patient. Where such calls are received, the guidelines provide that the patient’s location needs to be known and there needs to be a confirmed medical need.
NWAS need a verified location and assurance that a patient is indeed present at the specified location where an ambulance resource is being dispatched to. Additionally, NWAS rely on accurate contact information, ensuring that any provided contact number will connect us directly with the patient. NWAS does not have the legal powers, nor the equipment, to force entry to properties.
As an ambulance service, our primary function is to prioritise and respond to the medical needs of our patients whether this is face-to-face or via other methods. A confirmed physical or mental health complaint means that the caller has evidence or good reason to believe that the patient or service user is currently suffering from a physical or mental health issue that requires either a face-to-face assessment or telephone response. It cannot be assumed that an individual being uncontactable, means that they require medical assistance. Nor do NWAS have the capacity to conduct thorough enquiries, on behalf of other services, to determine whether an individual is experiencing physical or mental health concerns. It is incumbent upon these services to arrange for and execute such inquiries autonomously.
The NWAS Mental Health and Suicide Prevention Lead has listened to the 999 calls made in respect of Ms Higginson and has confirmed that the 999 call from Okay Each Day at 15:16 hrs was handled appropriately and in line with the Concern for Welfare policy. It could not be determined that Ms Higginson was at the specified location nor could it be determined that she had a confirmed physical or mental health complaint. It was therefore correct that NWAS did not deploy an ambulance to Ms Higginson based on the information provided at the time of the call.
A subsequent call was received at 11:49 hrs on 18th January 2026. The caller was a neighbour of Ms Higginson who stated that a foot could be seen on the floor. NWAS then deployed an ambulance which arrived within 54 minutes, at 12:43 hrs. Ms Higginson was sadly declared deceased on scene at 13:03 hrs.
The Concern for Welfare Response Criteria Guidelines Policy was introduced in May 2024, in response to the Right Care, Right Person (RCRP) National Partnership Agreement. NWAS have been clear and transparent with local system partners, including the Police, Acute Trusts, Mental Health Organisations and Councils regarding the deployment of ambulances when concern for welfare calls are made to the service and the circumstances in which an ambulance will and will not be deployed. NWAS and other system partners have previously noted that there is a gap in services for members of the public who may need concern for welfare call outs and this has been discussed in both strategic and tactical RCRP meetings, but not something that NWAS are able to fulfil unilaterally.
NWAS have also met with the Okay Each Day service who have been advised as to the circumstances in which an ambulance will and will not be deployed when concern for welfare calls are received. It was recommended by NWAS that Okay Each Day explore whether they could set up a pathway with other agencies to make initial contact with a patient where their exact location cannot be determined or for them to consider their own response team to conduct these enquiries
I am grateful to you for bringing this matter to my attention and I am sorry that you felt it necessary to issue a Prevention of Future Deaths Report to NWAS. If you require any further clarification or information, please do not hesitate to contact me or the Trust’s Deputy Director of Corporate Affairs, Emma Shiner.