Greater Manchester Police

PFD Addressee
Reports: 36 Earliest: Jan 2014 Latest: 15 Mar 2026

83% 2-year response rate (matches average). 46% of classified responses show concrete action taken.

PFD Reports
36 results
Christopher Fields
All Responded
2016-0194 18 May 2016 Manchester South
Police related deaths
Concerns summary (AI summary) Police left a vulnerable, injured person in an unsafe situation without awaiting an ambulance, leading to further assault. Ambulance dispatch algorithms are inaccurate, causing critical delays in response times for seriously injured patients.
Disputed (AI summary) North West Ambulance Service is exploring ways to minimise lengthy waits during high demand periods and has secured funding for additional frontline staff and new vehicles. It defends its coding system and response, citing pressures and circumstances at the time. The Department of Health disagrees with the coroner's concern, stating the call was correctly coded based on the information available at the time and the algorithm used is appropriate. They suggest the coroner contact the Priority Dispatch Corporation directly with concerns about the algorithm's design. Greater Manchester Police gave management action to an officer for lack of documentation, and addressed errors in recording inaccurate information. They propose to report back on wider work around vulnerability in October 2016. NHS England is conducting a review of ambulance coding systems and trialling a new system, taking into account previous similar calls and coroner's reports. Recommendations are expected in autumn 2016.
Adele Blakeman
All Responded
2016-0145-wp25219 15 Apr 2016 Manchester South
Police related deaths
Concerns summary (AI summary) The antiquated GMP computer system hinders officers' access to critical information, preventing adequate situation assessment. Officers also failed to consistently record pertinent intelligence on individual profiles.
Action Planned (AI summary) • GMP is investing significantly in the replacement of technology through the IS Transformation Programme to replace existing separate command and control, custody, intelligence, work allocation, and property systems with one user experience and more intelligence information management process that enables partner agency information sharing (iOPS). • Mobile technology is distributed to operational staff which is already demonstrating through pilot site a significant forwards steps in information access, input, and decision-making. • GMP is undertaking comprehensive procurement, design and testing process before implementation which is currently scheduled for late 2017.
Joyce Carney
All Responded
2016-0140 7 Apr 2016 Manchester West
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary (AI summary) Fragmented risk assessments and a lack of communication between police and hospital staff led to a misunderstanding of the ward layout, inadequate patient supervision, and a failure to assess risks to other patients and staff. There were no agreed protocols or senior oversight.
Action Planned (AI summary) The Trust has been working with Greater Manchester Police to learn lessons and address concerns including the security of patients under arrest and the protection of other patients. A final draft of the 'Patient Under Escort Record' is to be agreed and training on its use will be rolled out. The Department of Health has shared a report with NHS Protect to support a joint DH Home Office initiative to develop protocols, policies and procedures, to provide a national framework for joint risk assessments between police and NHS staff for patients detained at a hospital under arrest. The Minister for Policing will write to the National Policing Lead for Custody, Chief Constable to raise the matter with Chief Constables across England and Wales. The College of Policing is leading a programme of work aiming to set a national framework clarifying the roles and responsibilities of health and policing partners to maintain safety in mental health settings.
Christopher Smith
Historic (No Identified Response)
2015-0455 28 Oct 2015 Manchester (West)
Other related deaths
Concerns summary (AI summary) A 12-minute ambulance call delay resulted from communication breakdown between police control rooms regarding responsibility. A clear procedure is required to prevent future delays, especially when timely medical intervention is crucial.
Ronald Laidiar
Historic (No Identified Response)
2015-0270 8 Jul 2015 Manchester (South)
Other related deaths
Concerns summary (AI summary) The police investigation was severely inadequate, failing to secure the scene, account for missing items, properly investigate the source of blood, or identify a key head injury, significantly raising the risk of undetected violent crime.
Yvonne Davies and Andrew Davies
Historic (No Identified Response)
2015-0261 7 Jul 2015 Manchester (South)
Other related deaths
Concerns summary (AI summary) An off-duty police officer, personally involved with the deceased, compromised the crime scene by breaking in and contaminating evidence before and after on-duty officers arrived, who then failed to secure the scene.
Michael Thorley
All Responded
2015-0260 7 Jul 2015 Manchester (South)
Community health care and emergency services related deaths
Concerns summary (AI summary) There was an inexcusable delay in emergency entry and a lack of clear policy for forced entry. Police failed to thoroughly investigate the scene, overlooked crucial evidence, and did not consider potential third-party involvement, compromising the investigation.
Action Taken (AI summary) Greater Manchester Police has provided feedback and management advice to the officers concerned. The officer who attended is to remain on an action development plan to be managed by their line manager, and Detective Inspector Stainton is to remain on an action development plan which will continue to be managed by his immediate line manager.
Paul McGuigan
All Responded
2015-0185 12 May 2015 Manchester (South)
Other related deaths
Concerns summary (AI summary) General concerns were raised across relevant agencies about risks that could lead to future deaths, requiring action.
Action Planned (AI summary) The Home Office states that the Notifiable Occupations Scheme (NOS) was withdrawn and replaced with a new police-led scheme, the Common Law Police Disclosure (CLPD) scheme, which provides greater consistency across forces in the disclosure of information. The Trust states that following the Bradley Report (2009), the MDO teams transferred into single line management and implemented operational policy and approved documentation for assessment of needs and risks. They are rolling out an electronic clinical record (PARIS) and clinical staff have adequate time to access information from case notes. GMP will train officers in understanding their responsibilities under the pressing social need test, including classroom and NCALT training. They will be entering and holding notifications on the intelligence file of offenders. The SIA offered training and guidance to all UK police forces.
Kesia Leatherbarrow
Partially Responded
2015-0143 16 Apr 2015 Manchester (South)
Child Death Other related deaths
Concerns summary (AI summary) Critical communication failures and incomplete information sharing between Children's Services and CAMHS across different regions, along with a failure to transfer the Youth Offending Team case, led to a lack of support for a high-risk young person.
Action Planned (AI summary) The Department of Health has shared the report with NHS England, who are working to develop Liaison and Diversion services in Greater Manchester. NHS England is also reshaping mental health services commissioning and delivery and will prioritize investment in areas with Local Transformation Plans. The government has already made a partial change to PACE via the Criminal Justice and Courts Act to require 17 year olds to be treated as 10-16 year olds for detention after charge. Planning is underway to amend the remaining PACE provisions, and the Secretary of State for Education wrote to local authorities reminding them of their duty to provide accommodation for children denied bail. A multi-agency working group has been commissioned to understand issues and develop solutions. The CPS has modified CPS training so advocates conducting youth court cases are reminded that a youth can always be remanded for their "own welfare". The Chief Crown Prosecutor for Greater Manchester is discussing wider issues and lessons learned with the Assistant Chief Constable for GMP. Pennine Care NHS Foundation Trust has completed an investigation, requesting written clinical summaries and risk assessments when young people transfer from other mental health services. The health diversion pathway has been re-published and re-promoted, and a multi-agency panel now has the capacity to deal with children and young people.
Lucasz Lewandowski
Partially Responded
2014-0445 15 Oct 2014 Manchester (North)
Community health care and emergency services related deaths
Concerns summary (AI summary) The report identifies concerns regarding the timeliness of the police response, communication gaps between agencies, use of the Mental Health Act due to resource constraints, and a lack of correspondence from a psychiatric practice with the patient's GP.
Action Taken (AI summary) A protocol is being implemented for psychiatric practice, including risk assessment and communication with healthcare professionals, to be reviewed regularly. The referral system is being improved to flag occurrences like missed appointments, and the surgery will encourage a more inclusive approach from clinicians in patient care. The Operational Communications Branch (OCB) has reviewed its Escalation Policy, issued individual management advice to staff involved in the incident, and recirculated the policy with emphasis on accurate recording. The Custody Branch has circulated the MEDACs Escalation Policy to all staff and included it in its October 2014 Custody Branch Orders.
Billy Paul Thomas Salton
Partially Responded
2014-0002 6 Jan 2014 Manchester (South)
State Custody related deaths
Concerns summary (AI summary) GMP policy of not staffing the Prisoner Processing Unit overnight leads to unnecessary and prolonged custody times for individuals awaiting interview.
Action Planned (AI summary) Medacs Healthcare has implemented measures to ensure staff are aware of and have access to Medacs policies and procedures. They are also reviewing the electronic MedacsFME system to include screening tools and dropdown boxes that will prevent sections from being completed. Greater Manchester Police acknowledge delays in processing detainees due to staffing limitations. They are currently reviewing roles in custody and looking for a system that matches or improves coverage of CCTV and also provides greater accountability.