Dear Mr Hatvany Thank you for your letter to our Chief Executive regarding Mr Andrew Farrow deceased and the attached Prevention of Future Death (PFD) report: When there is a bed pressure in a locality, clinical staff may take a number of different actions depending upon the requirements of the individual patient. These actions may include seeking alternatives to admission such as intensive home treatment, seeking a bed in another part of the Trust; making a bed available by seeing if there are patients well enough to be discharged, or sending patient out of the Trust's area. The decision is always risk based, and takes account as far as is possible the wishes of the patient and their family: When patient is sent out of area, every effort is made to repatriate them locally as soon as it is possible and in their best interests to do so. The Trust Board closely monitors bed pressures and out of area placements and is continually working with its Commissioners and NHS England to manage the situation optimally_ hope that this information is helpful but please let me know if you require anything further: Whilst writing, would to comment at how surprised was to receive a PFD report for an inquest that we were not a properly interested person in and would like to understand on what basis it was felt necessary to issue a PFD report in this case, given that you found that the patient did not require hospital admission. have recently taken up appointment at Avon and Wiltshire Mental Health Trust and it is important for me to understand how local Coroners work. look forward to hearing from you.