Bedfordshire and Luton
Coroner Area
Reports: 79
Earliest: Jan 2014
Latest: 10 Mar 2026
73% response rate (above 62% average).
Gianna Khan
All Responded
2014-0219
9 May 2014
Bedfordshire Clinical Commissioning Gro…
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
A patient with a head injury was inappropriately streamed to a GP clinic instead of the Emergency Department, indicating a critical failure in triage protocols, which was impeded by the CCG.
Ernest Harper
All Responded
2014-0223
9 May 2014
Bedford Borough Council
Other related deaths
Concerns summary
Design flaws allowed falling between the safety barrier and vehicle, compounded by the lack of formal assessment for passenger health and mobility for safe access.
Sari Keen
All Responded
2014-0180
16 Apr 2014
Luton and Dunstable University Hospital
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
Insufficient staffing levels overwhelmed healthcare professionals, and a lack of awareness among staff regarding 'un-recordable blood pressure' as a medical emergency led to delayed resuscitation.
Albert James Hand
All Responded
2014-0010
9 Jan 2014
East of England Ambulance Service
Community health care and emergency services related deaths
Concerns summary
Insufficient ambulance crews in the Luton and Bedfordshire area caused dangerously long wait times for head injury patients, and current emergency call protocols are putting patients at risk.
Action taken summary
The Trust has reviewed and implemented an updated Demand Management Plan, recruited 100 new frontline clinicians, and commenced issuing a clinical manual. They are also commissioning an upgrade to the