Warren Sampson

PFD Report Partially Responded Ref: 2016-0320
Date of Report 6 September 2016
Coroner Caroline Beasley-Murray
Coroner Area Essex
Response Deadline ✓ from report 31 October 2016
Coroner's Concerns (AI summary)
Prison healthcare lacked consistent input in ACCT reviews and a follow-up process for missed screenings. Officers were also not adequately familiar with local directives.
View full coroner's concerns
(1) The “ad hoc” attendance at ACCT reviews of representatives from all disciplines especially Healthcare. The lack of written evidence within the ACCT documentation of contributory input from other agencies such as Healthcare.

(2) The lack of a process for following up non-attendance at the Reception Healthcare first night screening (3) The lack of a system for ensuring that all officers are familiar with local directives and instructions
Responses
Care UK Private Sector
4 Oct 2016
Action Taken
Discipline staff now email healthcare each day with the ACCT reviews they are intending to hold and invite the appropriate healthcare professional to input into the process. A Second Health Screen is undertaken within 72 hours of an inmate arriving to ensure matters such as consent for obtaining GP records has been sought. (AI summary)
View full response
Dear Madam, Regulation 28: Prevention of Future Deaths report The inquest touching the death of Warren Sampson Deceased HMP Chelmsford Date of death: 4th September 2015 Thank you for your Regulation 28 Prevention of Future Deaths Report issued to Care UK following the inquest into the death of Mr Warren Sampson. Care UK is the provider of primary healthcare services at HMP Chelmsford. North Essex Partnership Foundation NHS Trust provide mental health services. This response addresses the matters of concern in so far as they relate to Care UK. The matters of concern to you are highlighted in bold with the response set out below each concern (1) The "ad hoc" attendance at ACCT reviews of representatives from all disciplines especially Healthcare. The lack of written evidence within the ACCT documentation of contributory input from other agencies such as Healthcare. It is the process now that discipline staff each day will email healthcare with the ACCT reviews they are intending to hold that day and invite the appropriate healthcare professional to input into the process, whether it be primary healthcare, mental health or a member of the substance misuse team. Attendance will be in person where possible but where a healthcare professional is unable to attend, the input of healthcare, for example, by telephone, must be recorded on the ACCT document and in SystmOne. This has been reaffirmed to healthcare staff. (2) The lack of a process for following up non- attendance at the Reception Healthcare first night screening The process now is that a Second Health Screen is undertaken within 72 hours of an inmate arriving at HMP Chelmsford and at that second health screen there would be a Care UK Cltrncal SeMces llm,ted - Registered ,n England No 3462881 Registered Office Connaught House. 850 The Crescent Colchester Bus,ness Park, Cotcheste< Essex C04 908

check to ensure matters such as consent for obtaining GP records has been sought. On occasions where an inmate refuses to provide consent, that will be recorded in SystmOne. We trust that the above response provides the information that you require but please do not hesitate to contact us if Care UK can be of any further assistance. Yo1,1._rs faithfully

Head of Healthcare, HMP Chelmsford Care UK
Sent To
  • Care UK
  • Family Solicitors
  • HMP
Response Status
Linked responses 1 of 3
56-Day Deadline 31 Oct 2016
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 7 September 2015 I commenced an investigation into the death of Warren Martin Sampson. The investigation concluded at the end of the inquest on 2 September 2016. The conclusion of the inquest was that Warren Sampson killed himself. The cause of death was 1a) Suspension
Circumstances of the Death
Mr Sampson had been remanded to HM Prison Chelmsford on 3 August 2015. At the time of his death, he was subject to an ACCT – Assessment, care in custody and teamwork. He was found hanging in his cell.
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.