Noura Hardy
PFD Report
All Responded
Ref: 2024-0400
Coroner's Concerns (AI summary)
Excessively long national waiting lists for heart treatment, particularly for patients with weakened heart muscles due to long-term steroid use, pose a fatal risk despite local improvements.
View full coroner's concerns
In addition to her heart difficulties, Ms. Hardy had taken steroids for a long period of time for temporal arteritis. She was put on a waiting list for her heart treatment in June 2022 but not treated until March 2023, nine months later. The evidence of the Cardiac Surgeon who gave evidence at the Inquest was that the long term steroid use significantly weakened her heart muscles such that she suffered a perforation which subsequently led to her death. If she had been treated earlier, the muscles may not have been weakened to such an extent that she died. The local Trust (UHS Foundation Trust) assures me that waiting lists for heart treatment are now between 9 and 22 weeks which is reassuring. However I am still concerned about waiting lists for heart treatment being too long and consider this a national problem. Excessive waiting lists for heart treatment can be fatal.
Responses
Noted
The Department of Health and Social Care acknowledges concerns about waiting times for heart treatment and highlights commitment to reducing waiting lists, but notes the Trust believed the patient's complication would have happened regardless of waiting times. (AI summary)
The Department of Health and Social Care acknowledges concerns about waiting times for heart treatment and highlights commitment to reducing waiting lists, but notes the Trust believed the patient's complication would have happened regardless of waiting times. (AI summary)
View full response
Dear Gareth,
Thank you for the Regulation 28 report of 18 July sent to the Department of Health and Social Care about the death of Ms Noura Hardy. I am replying as the Minister of State for Health with responsibility for elective care.
Firstly, I would like to say how saddened I was to read of the circumstances of Ms Hardy’s death, and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are very concerning and I am grateful to you for bringing these matters to my attention.
The report raises concerns over the length of time Ms Hardy was on a waiting list for heart treatment - for nine months from June 2022 until her untimely death in March 2023. Clinical evidence given at the inquest states that the long term interim steroid use, whilst on the waiting list, significantly weakened Ms Hardy’s heart muscles such that she suffered a perforation which subsequently led to her death.
I want to assure you that tackling waiting lists is a key part of our Health Mission and a top priority for this government, as we get the NHS back on its feet. We have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment (RTT), by the end of this parliament.
We recognise that it is unacceptable that some patients are waiting 9 months for definitive cardiology treatment. The NHS and Department are providing additional regional and national support and scrutiny to the most challenged trusts with the largest backlogs of long waiters and will continue to work towards the target in NHSE’s 24/25 planning guidance to eliminate waits of over 65 weeks by September 2024.
Furthermore, this government is committed to change the NHS so that it becomes not just a sickness service, but able to prevent ill health in the first place. A focus will be on ensuring fewer lives are lost to the biggest killers and reducing deaths from heart disease and stroke by a quarter within ten years.
From
Minister of State for Health
39 Victoria Street London SW1H 0EU
In preparing this response, Departmental officials made enquiries with NHS England (NHSE) in order to gain a more detailed response at local level and received the below information: With regard to reviewing the long-term use of steroids, University Hospitals Sussex NHS Foundation Trust confirmed that the patient was noted to be significantly breathless and had steroid-dependent arteritis, and reviews were part of her ongoing care and treatment for her conditions.
The consultant explained in his evidence that cardiology waiting times were longer due to the hangover effect of covid, and that Ms. Hardy suffered a complication which would happen regardless of the waiting list times. Waiting time information on the NHS My Planned Care website states the current waiting times are:
- First outpatient appointment – 24 weeks.
- Waiting time for treatment (outpatient or inpatient) – 23 weeks.
I hope this response is helpful. Thank you for bringing these concerns to my attention.
Thank you for the Regulation 28 report of 18 July sent to the Department of Health and Social Care about the death of Ms Noura Hardy. I am replying as the Minister of State for Health with responsibility for elective care.
Firstly, I would like to say how saddened I was to read of the circumstances of Ms Hardy’s death, and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are very concerning and I am grateful to you for bringing these matters to my attention.
The report raises concerns over the length of time Ms Hardy was on a waiting list for heart treatment - for nine months from June 2022 until her untimely death in March 2023. Clinical evidence given at the inquest states that the long term interim steroid use, whilst on the waiting list, significantly weakened Ms Hardy’s heart muscles such that she suffered a perforation which subsequently led to her death.
I want to assure you that tackling waiting lists is a key part of our Health Mission and a top priority for this government, as we get the NHS back on its feet. We have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from Referral to Treatment (RTT), by the end of this parliament.
We recognise that it is unacceptable that some patients are waiting 9 months for definitive cardiology treatment. The NHS and Department are providing additional regional and national support and scrutiny to the most challenged trusts with the largest backlogs of long waiters and will continue to work towards the target in NHSE’s 24/25 planning guidance to eliminate waits of over 65 weeks by September 2024.
Furthermore, this government is committed to change the NHS so that it becomes not just a sickness service, but able to prevent ill health in the first place. A focus will be on ensuring fewer lives are lost to the biggest killers and reducing deaths from heart disease and stroke by a quarter within ten years.
From
Minister of State for Health
39 Victoria Street London SW1H 0EU
In preparing this response, Departmental officials made enquiries with NHS England (NHSE) in order to gain a more detailed response at local level and received the below information: With regard to reviewing the long-term use of steroids, University Hospitals Sussex NHS Foundation Trust confirmed that the patient was noted to be significantly breathless and had steroid-dependent arteritis, and reviews were part of her ongoing care and treatment for her conditions.
The consultant explained in his evidence that cardiology waiting times were longer due to the hangover effect of covid, and that Ms. Hardy suffered a complication which would happen regardless of the waiting list times. Waiting time information on the NHS My Planned Care website states the current waiting times are:
- First outpatient appointment – 24 weeks.
- Waiting time for treatment (outpatient or inpatient) – 23 weeks.
I hope this response is helpful. Thank you for bringing these concerns to my attention.
Response Status
Linked responses
1
56-Day Deadline
12 Sep 2024
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Report Sections
Investigation and Inquest
On 21 March 2023 I commenced an investigation into the death of Noura HARDY aged 73. The investigation concluded at the end of the inquest on 18 June 2024. The conclusion of the inquest was that: Noura Hardy died on the 14th of March 2023 at Royal Sussex County Hospital in Brighton of a cardiac arrest following a septal ablation procedure complicated by perforation of a coronary artery.
Circumstances of the Death
Ms. Hardy suffered from severe left ventricular hypertrophy. She was admitted to hospital in March 2023 for a septal ablation procedure. Her coronary artery was perforated before the procedure. She subsequently died of a cardiac arrest.
Copies Sent To
University Hospitals Sussex NHS Foundation Trust
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.