Dear Ms Saunders Re: Aneurin Bevan University (Health Board response to Regulation 28 Report received following the inquest touching upon the death of Mrs Valmai Ann West, DOB 05/10/1939 Thank you for your report dated 13th July 2021, which was received by the Health Board on the 14th July 2021. The information within the response letter has been compiled by , Executive Director of Nursing. In response to your report, the information provided is intended to address the concerns raised by Dr s during the course of the inquest. It was acknowledged that staff had not followed hospital protocol or NICE guidelines in relation to the frequency of which observations should be performed. Dr assessment of the situation was this was probably due to inadequate nurse staffing levels within the Emergency Department. Following receipt of the Regulation 28 Report a review of the nurse staffing levels was undertaken by the Senior Nurse Manager of the Emergency Department. I can confirm nurse staffing levels at the index time were appropriate and adequate and as per the roster for the area the patient was cared for. The staffing levels would not have impacted on the ability to undertake neurological observations. I thought it would be helpful to share that an in-depth review of nurse staffing levels for the Emergency Department (ED) at the Grange University Hospital was commissioned as a result of the early opening of the hospital and in light of increased patient demand. This has been undertaken by the Bwrdd lechyd Prifysgol Aneurin Bevan Aneurin Bevan University Health Board Pencadlys, Headquarters Ysbyty Sant Cadog St Cadoc's Hospital Ffordd Y Lodj Lodge Road Caerilion Caerleon Casnewydd Newport De Cymru NP15 3XQ South Wales NP18 3XQ Ff6n: 01633 436700 Tel No: 01633 436700 E-best: abhb.enquiries@wales.nhs.uk Email: abhb.enquiries@wales.nhs.uk Bwrdd Iechyd Prifysgol Aneurin Bevan yw envy gweithredol Bwrdd Iechyd Lleol Prifysgol Aneurin Bevan Aneurin Bevan University Health Board is the operational name of Aneurin Bevan University Local Health Board

-2- Senior Nurse Manager for ED and the Assistant Head of Nursing, supported by the Deputy Director of Nursing. The assessment is based on RCN Guidance, RCEM Guidance, Nurse Staffing Levels (Wales) Act 2016 and, importantly, professional judgement. A similar review of medical staffing is also being undertaken. I hope this additional information in relation to the matters raised is helpful in terms of clarification but also as an update on progress and assurance in relation to nurse staffing levels within the Emergency Department at the Grange University Hospital and those raised in regards nurse staffing levels at the time of the incident. Do not hesitate to contact me should you require any further information.