Paula Ivers
Addressed to: NHS England; Tameside and Glossop Integrated Care NHS Trust
PFD · Response tracker
PFD Response Tracker
5,058 total
5,058 with responses identified
0 with 0 responses identified (past 2 years)
0 response window open
Live tracking of every Prevention of Future Deaths report and the published responses identified for them under Regulation 28's 56-day deadline.
How response counts are interpreted — 56-day deadline, Judiciary.UK data
Recipients have 56 days to respond under Regulation 28. We use the deadline stated in the report where available, otherwise we calculate it from the report date.
We rely on Judiciary.UK for response data, so this tracker shows published responses we have identified there.
A report with at least one published response is counted as having a response identified, even if not every listed addressee has a separate published response. Reports with 0 responses identified are split by whether the response window is still open, within the last two years after that window, or older than two years. This is because addressee data from Judiciary.UK can be unreliable: address fragments, job titles, and redacted names are sometimes parsed as separate addressees, and a single response PDF may cover multiple parties.
Historic reports with 0 responses identified are more than two years old. Older reports may have received a response that was never made public. Treat these counts as a neutral data-coverage signal, not confirmed non-compliance.
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5,058 reports · Page 1 of 102
| Date ↓ | Deceased | Addressee(s) | Responses identified |
|---|---|---|---|
| 26 Aug 2026 | Paula Ivers | NHS England Tameside and Glossop Integrated Care NHS Trust | 3 responses · 2 indexed addressees |
| 17 Aug 2026 | Gloria Monte | Nottingham University Hospital NHS Trust | 1 responses · 1 indexed addressees |
| 14 Aug 2026 | Samuel Hand | Department of Health and Social Care East Midlands Ambulance Service NHS England | 1 responses · 3 indexed addressees |
| 12 Aug 2026 |
Erika Francis
AI-generated concerns summaryDevon Partnership NHS Trust staff lacked comprehensive and accessible training on domestic abuse, particularly concerning its identification in patients with mental ill health and its links to increased risks of …
|
Devon Partnership NHS Trust | 1 responses · 1 indexed addressees |
| 12 Aug 2026 | Mathew Bailey | Worcestershire Acute Hospitals NHS Trust | 1 responses · 1 indexed addressees |
| 11 Aug 2026 | Sohaib Ahmed and Manahal Ahmed | Haier Smart Home UK & I Limited Office fr Product Safety & Standards | 2 responses · 2 indexed addressees |
| 5 Aug 2026 | Richard Laversuch | Hampshire and Isle of Wight Healthcare Foundation NHS Trust | 1 responses · 1 indexed addressees |
| 4 Aug 2026 | Benjamin Pesian | Black Country Healthcare NHS Foundation Trust | 1 responses · 1 indexed addressees |
| 4 Aug 2026 | Martin Poole | Royal Wolverhampton Trust Walsall Healthcare NHS Trust | 1 responses · 2 indexed addressees |
| 3 Aug 2026 | Richard Preece | Adult Social Service for Kent Kent and Medway Safeguarding Adults Board | 1 responses · 2 indexed addressees |
| 3 Aug 2026 | Stephen Nuth | North London NHS Foundation Trust | 1 responses · 1 indexed addressees |
| 31 Jul 2026 | Karen Graham | Royal College of Emergency Medicine | 1 responses · 1 indexed addressees |
| 31 Jul 2026 | Rhoda Freedman | AquaCert Swiftclean Wensley House Care Home | 3 responses · 3 indexed addressees |
| 31 Jul 2026 | Alexander McDonald | Department of Health and Social Care | 1 responses · 1 indexed addressees |
| 30 Jul 2026 | William Keary | Manchester University NHS Foundation Trust | 1 responses · 1 indexed addressees |
| 29 Jul 2026 | Alan Rees | Cardiff and Vale University Health Board Welsh Government | 1 responses · 2 indexed addressees |
| 28 Jul 2026 | Rodney Foster | Worcestershire Acute Hospitals NHS Trust | 1 responses · 1 indexed addressees |
| 27 Jul 2026 |
Adam Clark
AI-generated concerns summaryA prison maths tutor and her line manager had not received training on suicide/self-harm risk or the ACCT process, and this training deficit persists among other staff at HMP Hewell.
|
HMP Hewell | 1 responses · 1 indexed addressees |
| 27 Jul 2026 | Amelia Nasiadka | National Institute for Health and Care Excellence Royal College of Obstetricians and Gynaecologists | 2 responses · 2 indexed addressees |
| 27 Jul 2026 | Adam Clark | Practice Plus Group | 1 responses · 1 indexed addressees |
| 24 Jul 2026 |
Andrew Watson
AI-generated concerns summaryThe coroner raised concerns that the ambulance service's pathway algorithm categorised a life-threatening natural cause of choking as Category 2, unlike choking from a foreign object. It was also noted …
|
NHS England | 1 responses · 1 indexed addressees |
| 24 Jul 2026 | Isla McVeigh | Cumberland Council Cumberland Safeguarding Children Partnership North Cumbria Integrated Care | 2 responses · 3 indexed addressees |
| 23 Jul 2026 | Roland Michaud | Chief Medical Officer, Blackpool Teaching Hospital NHS Trust | 1 responses · 1 indexed addressees |
| 23 Jul 2026 |
Monica Wood
AI-generated concerns summaryThe coroner identified a lack of provision to review a patient's fitness for travel when hospital transfers were delayed, and no mechanism to reassess transport or crew suitability when a …
|
Barts Health NHS Trust | 1 responses · 1 indexed addressees |
| 21 Jul 2026 |
Malcolm Budd
AI-generated concerns summaryThe coroner highlights that a comprehensive regional Standard Operating Procedure for managing acute aortic dissection has not been formally implemented in the East Midlands. This absence has led to delays …
|
NHS England | 1 responses · 1 indexed addressees |
| 21 Jul 2026 | Margaret Murphy: Prevention of future deaths report | Greater Manchester Integrated Care Partnership Department of Health and Social Care Tameside and Glossop Integrated Care NHS Foundation Trust | 3 responses · 3 indexed addressees |
| 20 Jul 2026 | Alan Hirst | College of Policing National Police Chief’s Council | 2 responses · 2 indexed addressees |
| 20 Jul 2026 | Margaret Templeman | Mid and South Essex NHS Foundation Trust | 1 responses · 1 indexed addressees |
| 17 Jul 2026 | Glyn Pressley | Chief Medical Officer for Welsh Government | 1 responses · 1 indexed addressees |
| 16 Jul 2026 | Sandra Moon | Portsmouth County Council | 1 responses · 1 indexed addressees |
| 16 Jul 2026 | Gareth Williams | Chief Executive officers of the College of Policing | 1 responses · 1 indexed addressees |
| 16 Jul 2026 | Jane Lawrence | Association of Ambulance Chief Executives | 1 responses · 1 indexed addressees |
| 15 Jul 2026 | Millie Hook | Basildon University Hospital Trust | 1 responses · 1 indexed addressees |
| 15 Jul 2026 | Cody Stock | National Highways North Northamptonshire West Northamptonshire | 1 responses · 3 indexed addressees |
| 15 Jul 2026 | Tia Birkitt | EPUT INQUESTS [REDACTED] and [REDACTED] | 1 responses · 2 indexed addressees |
| 10 Jul 2026 | Joan Murphy | Aria Care | 1 responses · 1 indexed addressees |
| 9 Jul 2026 | Tung Tran | British Association for the study of the Liver NHS England UK Health Security Agency | 3 responses · 3 indexed addressees |
| 8 Jul 2026 | June Turner | Chief Medical Officer Department of Health and Social Care President Resuscitation Council UK | 2 responses · 2 indexed addressees |
| 8 Jul 2026 | Alison Thomas | Grove Surgery | 1 responses · 1 indexed addressees |
| 8 Jul 2026 | Marie Bell | NHS England | 1 responses · 1 indexed addressees |
| 7 Jul 2026 | Philip Quelch | Care Quality Commission Crouched Friars Residential Home Essex Adult Social Care | 3 responses · 3 indexed addressees |
| 7 Jul 2026 |
Gemma Robins
AI-generated concerns summaryThe coroner noted communication challenges and risks of miscommunication among multiple specialist clinicians across different NHS Trusts using text, email, and telephone. A need for a centralised system or platform …
|
Foundation Trust Chief Executive Royal Surrey NHS Foundation Trust Chief Executive, University Hospitals Sussex NHS | 3 responses · 3 indexed addressees |
| 6 Jul 2026 | Indy Mason-Kidd | Ashford and St Peter’s and Royal Surrey NHS Foundation Trust Cambridge University Hospitals NHS Foundation Trust East of England Ambulance Service NHS England | 4 responses · 4 indexed addressees |
| 6 Jul 2026 | Eden Henry | Department of Health and Social Care London Association of Directors of Public Health | 2 responses · 2 indexed addressees |
| 6 Jul 2026 |
Scott Taylor
AI-generated concerns summaryThere are a limited number of tertiary centres for treatment-resistant OCD in the UK, predominantly in London and the South East, which limits access for complex cases due to capacity, …
|
Department of Health and Social Care | 2 responses · 1 indexed addressees |
| 6 Jul 2026 |
Aylina Akhmadova
AI-generated concerns summaryThe coroner noted that safety netting advice for 999 calls needs to clarify interpreter availability for ambulance triage. Concerns were raised about the risks of using informal interpreters in primary …
|
Institute of Health Visiting Royal College of General Practitioners Royal College of Midwives | 3 responses · 3 indexed addressees |
| 6 Jul 2026 |
Eleisha Skinner
AI-generated concerns summaryThe coroner identified issues with the driveway's safety, including the absence of a protective barrier at a sheer drop and a lack of clear procedures for managing icy conditions. Concerns …
|
Howarth Properties LTD | 1 responses · 1 indexed addressees |
| 6 Jul 2026 | Indy Mason-Kidd | Chief Executive Officer Cambridge University Hospitals NHS Foundation Trust (CUH) Chief Executive Officer NHS England Group Chief Executive Ashford and St Peter’s and Royal Surrey NHS Foundation Trusts (RSCH) | 4 responses · 3 indexed addressees |
| 3 Jul 2026 | Bernadette Rosario | Chief Constable, Devon & Cornwall Police Head of Operations south- | 1 responses · 2 indexed addressees |
| 3 Jul 2026 | John Wetton | Alexander House Care Home Department of Health and Social Care Valorum Care Group | 1 responses · 3 indexed addressees |
Gloria Monte
Addressed to: Nottingham University Hospital NHS Trust
Samuel Hand
Addressed to: Department of Health and Social Care; East Midlands Ambulance Service; NHS England
Erika Francis
AI-generated concerns summaryDevon Partnership NHS Trust staff lacked comprehensive and accessible training on domestic abuse, particularly concerning its identification in patients with mental ill health and its links to increased risks of self-harm and suicide. Existing training did not sufficiently address these particular challenges.
Addressed to: Devon Partnership NHS Trust
Mathew Bailey
Addressed to: Worcestershire Acute Hospitals NHS Trust
Sohaib Ahmed and Manahal Ahmed
Addressed to: Haier Smart Home UK & I Limited; Office fr Product Safety & Standards
Richard Laversuch
Addressed to: Hampshire and Isle of Wight Healthcare Foundation NHS Trust
Benjamin Pesian
Addressed to: Black Country Healthcare NHS Foundation Trust
Martin Poole
Addressed to: Royal Wolverhampton Trust; Walsall Healthcare NHS Trust
Richard Preece
Addressed to: Adult Social Service for Kent; Kent and Medway Safeguarding Adults Board
Stephen Nuth
Addressed to: North London NHS Foundation Trust
Karen Graham
Addressed to: Royal College of Emergency Medicine
Rhoda Freedman
Addressed to: AquaCert; Swiftclean; Wensley House Care Home
Alexander McDonald
Addressed to: Department of Health and Social Care
William Keary
Addressed to: Manchester University NHS Foundation Trust
Alan Rees
Addressed to: Cardiff and Vale University Health Board; Welsh Government
Rodney Foster
Addressed to: Worcestershire Acute Hospitals NHS Trust
Adam Clark
AI-generated concerns summaryA prison maths tutor and her line manager had not received training on suicide/self-harm risk or the ACCT process, and this training deficit persists among other staff at HMP Hewell.
Addressed to: HMP Hewell
Amelia Nasiadka
Addressed to: National Institute for Health and Care Excellence; Royal College of Obstetricians and Gynaecologists
Adam Clark
Addressed to: Practice Plus Group
Andrew Watson
AI-generated concerns summaryThe coroner raised concerns that the ambulance service's pathway algorithm categorised a life-threatening natural cause of choking as Category 2, unlike choking from a foreign object. It was also noted that self-reporting of the emergency led to a lower prioritisation.
Addressed to: NHS England
Isla McVeigh
Addressed to: Cumberland Council; Cumberland Safeguarding Children Partnership; North Cumbria Integrated Care
Roland Michaud
Addressed to: Chief Medical Officer, Blackpool Teaching Hospital NHS Trust
Monica Wood
AI-generated concerns summaryThe coroner identified a lack of provision to review a patient's fitness for travel when hospital transfers were delayed, and no mechanism to reassess transport or crew suitability when a patient's condition changed prior to transfer.
Addressed to: Barts Health NHS Trust
Malcolm Budd
AI-generated concerns summaryThe coroner highlights that a comprehensive regional Standard Operating Procedure for managing acute aortic dissection has not been formally implemented in the East Midlands. This absence has led to delays in transferring patients to specialist hospitals for potentially life-saving surgical treatment.
Addressed to: NHS England
Margaret Murphy: Prevention of future deaths report
Addressed to: Greater Manchester Integrated Care Partnership; Department of Health and Social Care; Tameside and Glossop Integrated Care NHS Foundation Trust
Alan Hirst
Addressed to: College of Policing; National Police Chief’s Council
Margaret Templeman
Addressed to: Mid and South Essex NHS Foundation Trust
Glyn Pressley
Addressed to: Chief Medical Officer for Welsh Government
Sandra Moon
Addressed to: Portsmouth County Council
Gareth Williams
Addressed to: Chief Executive officers of the College of Policing
Jane Lawrence
Addressed to: Association of Ambulance Chief Executives
Millie Hook
Addressed to: Basildon University Hospital Trust
Cody Stock
Addressed to: National Highways; North Northamptonshire; West Northamptonshire
Tia Birkitt
Addressed to: EPUT INQUESTS; [REDACTED] and [REDACTED]
Joan Murphy
Addressed to: Aria Care
Tung Tran
Addressed to: British Association for the study of the Liver; NHS England; UK Health Security Agency
June Turner
Addressed to: Chief Medical Officer Department of Health and Social Care; President Resuscitation Council UK
Alison Thomas
Addressed to: Grove Surgery
Marie Bell
Addressed to: NHS England
Philip Quelch
Addressed to: Care Quality Commission; Crouched Friars Residential Home; Essex Adult Social Care
Gemma Robins
AI-generated concerns summaryThe coroner noted communication challenges and risks of miscommunication among multiple specialist clinicians across different NHS Trusts using text, email, and telephone. A need for a centralised system or platform for real-time recording of communications was identified to improve this.
Addressed to: Foundation Trust; Chief Executive Royal Surrey NHS Foundation Trust; Chief Executive, University Hospitals Sussex NHS
Indy Mason-Kidd
Addressed to: Ashford and St Peter’s and Royal Surrey NHS Foundation Trust; Cambridge University Hospitals NHS Foundation Trust; East of England Ambulance Service; NHS England
Eden Henry
Addressed to: Department of Health and Social Care; London Association of Directors of Public Health
Scott Taylor
AI-generated concerns summaryThere are a limited number of tertiary centres for treatment-resistant OCD in the UK, predominantly in London and the South East, which limits access for complex cases due to capacity, criteria, and geographical distribution.
Addressed to: Department of Health and Social Care
Aylina Akhmadova
AI-generated concerns summaryThe coroner noted that safety netting advice for 999 calls needs to clarify interpreter availability for ambulance triage. Concerns were raised about the risks of using informal interpreters in primary care, which can lead to misunderstandings about accessing emergency assistance.
Addressed to: Institute of Health Visiting; Royal College of General Practitioners; Royal College of Midwives
Eleisha Skinner
AI-generated concerns summaryThe coroner identified issues with the driveway's safety, including the absence of a protective barrier at a sheer drop and a lack of clear procedures for managing icy conditions. Concerns were also raised regarding the absence of instructions for safe vehicle unloading to prevent run-away incidents.
Addressed to: Howarth Properties LTD
Indy Mason-Kidd
Addressed to: Chief Executive Officer Cambridge University Hospitals NHS Foundation Trust (CUH); Chief Executive Officer NHS England; Group Chief Executive Ashford and St Peter’s and Royal Surrey NHS Foundation Trusts (RSCH)
Bernadette Rosario
Addressed to: Chief Constable, Devon & Cornwall Police; Head of Operations south-
John Wetton
Addressed to: Alexander House Care Home; Department of Health and Social Care; Valorum Care Group