Source · Scotland · Fatal Accident Inquiry
Angela Smith
Scotland · FAI
Reference: 2B/1481/08
Published: 22 Dec 2009
Sheriff: Sheriff F.R. Crowe
Sheriffdom: Lothian and Borders
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Court recommendations
Identified
Responses identified
0
8-week deadline
16 Feb 2010
Section 28 status
Response pending
Recommendations
[51] Although I do not find established that system failures contributed to Angela Smith’s death, I consider the evidence which emerged in this long inquiry should be examined by the police service and NHS to ensure at-risk prisoners are flagged up with all relevant information known about the risk.
Where a nursing assessment is indicated this should be carried out promptly and the results assessed by the duty sergeant to determine whether the risk level has increased or not.
The frequency of observations may need to be increased and the quality of these observations should be such that they are of assistance to the nursing staff in determining whether a re-assessment is required.
[52] Nurses and doctors operating from custody suites are welcome steps forward but consideration should be given to joint training and co-location of staff to improve the flow of information on the condition of at-risk prisoners.
Where a nursing assessment is indicated this should be carried out promptly and the results assessed by the duty sergeant to determine whether the risk level has increased or not.
The frequency of observations may need to be increased and the quality of these observations should be such that they are of assistance to the nursing staff in determining whether a re-assessment is required.
[52] Nurses and doctors operating from custody suites are welcome steps forward but consideration should be given to joint training and co-location of staff to improve the flow of information on the condition of at-risk prisoners.
Under section 28 of the 2016 Act, each recipient of a recommendation must respond within 8 weeks.
The window from publication ran to 16 February 2010.
See how we track responses.
Section 28 responses
Response pendingNo response has been identified on the case landing page yet. The 8-week window has closed without a published response or non-response notice.
Determination details
- Reference
- 2B/1481/08
- Published
- 22 December 2009
- Sheriff
- Sheriff F.R. Crowe
- Sheriffdom
- Lothian and Borders
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About FAIs
Fatal Accident Inquiries are held under the
2016 Act
before a sheriff. They are mandatory for deaths in custody and at work.
The sheriff may make recommendations under s.26(1)(b); recipients must respond within 8 weeks under
s.28. See the methodology page for detail.