Chief Executive Officer Tameside and Glossop Integrated Care NHS Foundation Trust Silver Springs Fountain Street Ashton under Lyne Lancashire OL6 9RW 4th April 2025

FAO Mr Morris HM Coroner Coroner’s Court 1 Mount Tabor Street Stockport Cheshire SK1 3AG

FURTHER INFORMATION, FOLLOWING THE INQUEST TOUCHING ON THE DEATH OF MRS SUZANNE ECCLES

Reference: 35766784

I am writing to you following the inquest touching on the death of Mrs Suzanne Eccles, which concluded on 13th September 2024.

Firstly, please accept my apologies for the delay in providing this response. The letter will explain the Trusts’ immediate work undertaken following the inquest, however, the wider work has taken longer than originally anticipated to review, approve and implement.

Following the inquest, you raised some concerns that no system currently operates whereby clinicians working in the Emergency Department can easily access records made by colleagues working on the virtual ward. The Trust have reviewed this process, what is currently in place and what we plan to do to enable records to be shared.

Health and social care organisations in Greater Manchester have established the GM Care Record (GMCR) and is operated by Graphnet. It is an evolution of locality-based care records already live in Greater Manchester (e.g. Manchester Care Record, Bolton Care Record etc). However, it collates patient information from across Greater Manchester into one place, making it easily accessible for health and care professionals to inform direct care from across geographies and organisations.

The record brings together data from:
• Primary/Secondary Care (GPs/Hospitals)
• Mental Health
• Community
• Specialist Trusts (including the Christie)
• Social Care

GMCR provides real-time access to a single, secure shared care record, and allows care professionals to communicate and collaborate safely and effectively across disciplines and organisations. Professionals working in hospital, community, primary care and social care services have immediate access to the same up-to-date patient information. The user should then click through to access more detailed information for that patient from that organisation. It will not replace the Trusts’ existing care records system, but it will connect it to the GMCR.

Whilst Tameside and Glossop Integrated Care NHS Foundation Trust have access to this care record over the last few years, as a Trust we have reviewed this and consider we can, and will, utilise this more.

The Trusts’ Neighbourhood Clinical Lead has engaged in multiple discussions with the GMCR Team and the Chief Digital Office for Greater Manchester Integrated Care Partnerships (GMICB) who have confirmed that the Trust can have access to the system. The Change Control Notice (CCN) was sent to be switched on circa 16th October 2024 and we were informed it would take 3-4 weeks but this was subject to delay from the provider. It was hoped that this would have been completed sooner but was subsequently delayed due to a financial barrier. This has now been resolved.

There is now a draft contract in place with Docobo which we anticipate will be sign off by 7th April 2025 meaning the CNN can then be enacted. We have also had to collaborate with the Information Governance Lead at the ICB in relation to matters concerning GDPR so that we can ensure there will be no issues with this moving forward.

Subject to the above all being signed off, the Docobo icon on the GMCR is intended to go live on 16th April 2025. Clinical safety has been carried out by the Trusts’ Chief Clinical Information Officer so that all ED staff can see the virtual ward patient observation, then the Trust will commence the training of all ED and Digital Health staff on the GMCR which we anticipate will take 3-6 weeks to implement, from 16th April 2025.

Until the GMCR goes live, all patients admitted to the virtual ward have an alert added to community EMIS informing that the patient is on the virtual ward. EMIS is a clinical software system used in primary care, acute care and community pharmacy. Following the period of care, this alert is removed. Once the GMCR is operational, the alert process will remain on EMIS but will be changed to prompt clinicians to review the GMCR record/care plans. This will be led by Digital Health.

A hard copy of the virtual ward is being printed off daily by Digital Health and a copy is provided to the reception team in the Emergency Department (ED), so that out of hours and ED are aware of who is being monitored.

In addition to the above, an electronic Virtual Ward Patient Management Board has been created and is available across the acute organisation, with live and current patient updates across all departments. Bed managers are able to see and access this Ward Board. It is just out of development and is being moved to the Emergency Departments Clinical Portal System, so that it will make it easier to see the list of patients currently under the care of the Virtual Ward. The board provides information about the level of risk that a patient is at whilst on Virtual Ward and the number of contacts that they have had each day and what condition they are being monitored/supported at home for. This board enables ED Teams to have full access to patients twenty-four hours each day, seven days a week.

Once the GMCR record is operational, ED will have their own direct access to the GMCR through the icon. Until this is launched on 16th April 2025, there is an alert process on Lorenzo that will prompt staff to review the position on Virtual Ward which has been in place since the inquest in September 2024.

I do hope that this letter provides you with further reassurance following the inquest, however, should you have any queries arising from the content of this letter or require further information or clarification, please do not hesitate to contact Legal Services on or