Other related deaths

Noted (AI summary) Oldham Council has amended the wording on licenses, added blind cord safety as a license condition (checked at every property visit), briefed enforcement officers on blind cord safety, and added related information to the Council's website. A new selective licensing scheme was also reintroduced in July 2022. The Department acknowledges the coroner's concerns but believes awareness campaigns are key. They support RoSPA's 'Make It Safe' campaign and will consider how to strengthen its reach.

Noted (AI summary) Cumbria, Northumberland, Tyne and Wear Foundation Trust has implemented several measures to proactively engage families, including integrating family support as a core offer, providing family therapist assessments, and reviewing and implementing systems to ensure carers are offered intervention. The Trust also plans further improvement work in 2022/23 to increase staff time with service users and carers. The Department of Health and Social Care acknowledged concerns about mental health workforce capacity. It noted an increase in the mental health workforce and highlighted ongoing national plans to expand the workforce by an additional 27,000 professionals by 2023/24 through significant investment.

Noted (AI summary) Sheffield Health & Social Care NHS Foundation Trust outlines a plan to develop a protocol for working with older adults with a forensic history, ensure thorough risk assessments when removing a service user from detention, improve communication with service users and families, ensure complex clinical decisions are multidisciplinary, and deliver online training on the Mental Health Act. The Government Legal Department, on behalf of the Probation Service, acknowledges the concerns but states it's a matter for the sentencing Judge to determine Restriction Orders. They will obtain the Court transcript of Mrs Grayson's sentencing hearing and share concerns with the Ministry of Justice colleagues in the Mental Health Caseworker team.

Noted (AI summary) The organisation states that it had received public health advice about how to manage the pandemic and balanced obligations to licensees and employees, and maintenance staff were not put on furlough because of income streams. It has undertaken PAT tests and the organisation will be guided by advice received from several agencies including Public Health England and the Fire and Rescue Service to determine its plan on managing any increased risks posed by the absence of PAT testing.

Noted (AI summary) The Home Office acknowledges the concerns raised, explains the existing legislative framework, and states that it prefers to encourage sensible planning rather than mandating every element of it through legislation, pointing to guidance from the Cabinet Office.

Noted (AI summary) CHEM notes the concerns raised regarding public entry into containers and will welcome suggestions for additional warnings for operators. Biffa is reviewing operating instructions to ensure clarity on the use of viewing windows, reminding customers about using locks effectively, and continuing to develop relationships with charities supporting rough sleepers. Dennis Eagle explains the design intent of the side window on their refuse vehicles, stating it's for viewing the discharge of container contents and not for viewing the floor of the tailgate. BSI consulted experts and will raise the issue of bin locks when the committee next meets to discuss if changes to existing standards are appropriate.

Noted (AI summary) The Department of Health and Social Care outlines existing NHS services and policies related to electronic health record transfer and access.

Noted (AI summary) The RFU cascaded the findings in the Regulation 28 Report to all clubs involved in the Premiership. The RFU also raised this subject at the June meeting of the Professional Game Board. The ECB intends to circulate communications to appropriate representatives, including a list of steps from the CAA, within one month and emphasize the need to share the information directly with players. All corporate travel for ECB employees and representatives must be booked through the ECB's travel management company Ventur. The EFL reissued guidance to all Clubs, which was received in March 2021. The EFL will reissue a link to the guidance in advance of each transfer window. The British Horseracing Authority briefed its Board and prepared a draft guidance note to send to its member bodies and engaged with the Civil Aviation Authority (CAA). The Department for Transport and the CAA are reviewing the powers available to them in investigating breaches of aviation regulations and what powers they would find of assistance in their investigative and enforcement role. The FA states they were not aware of the coroner's report until it was provided by the English Football League. The FA relayed CAA guidance on illegal flights to clubs and Registered Intermediaries in March 2021. The Jockey Club requires aircraft operating at its racecourses to obtain prior permission, demonstrate pilot licensing, provide aircraft registration and insurance, and confirm whether flights are private or commercial. The Jockey Club and Helicopter & Aviation Services Ltd provide records of aircraft activities to authorities when requested. The organisation circulated a note to its members recommending that they do not pay for or use unlicensed commercial flights, sharing the concerns of the Dorset Coroner. The Professional Footballers Association has written to its current members and put information on its website to raise awareness on the issue of unlicensed aircraft, and attached the guidance issued by the CAA. UK Athletics has distributed information regarding private flights to World Class Programme athletes, coaches, support staff, and known agents, emphasizing the need to check the legality of flights. The Institute of Directors included a statement in its 'Influence' email to 20,000 members and posted a notice on its website warning of the dangers of unauthorised flights, following a request from the Civil Aviation Authority. The LTA sent a communication to relevant players on 9 August 2022 regarding commercial flights from unlicensed operators, including a link to CAA guidance. The Premier League will send correspondence to the Legal, Club Secretarial, and Football departments at each of the Clubs. The Premier League met with Clubs at the Annual General Meeting on 9 June 2022 and raised the issue to the Chairs/Chief Executives/Owners attending. The Confederation of British Industry plans to publish an article on employee wellbeing and safety linking to the Sala case, use social media to amplify the importance of employee well-being and safety, and flag the case to its account managers who manage the CBI's aerospace members. The Rugby Football League wrote to all member clubs advising them of the situation regarding private flights and asking them to ensure they do not use such flights. The Department for Digital, Culture, Media and Sport shared CAA guidance with sports organisations, Live music Industry Venues & Entertainment (LIVE), the Music Venues Trust (MVT), and the Musicians' Union. UK Sport asserts that the use of illegal private plane journeys is not permitted with their funding and that the risk of government funded sports using them is minimal. The British Chambers of Commerce circulated briefing materials to its Chamber of Commerce members, raised the issue in a call with Chamber of Commerce CEOs, and highlighted the importance of taking action at the BCC Board. The RFU requested Premiership clubs review the PFD report on commercial flight chartering and ensure flights are legal and have required authorisations, certifications and permissions, and pass the information to relevant employees. Motorsport UK will publish advice to its license holders on its website and in its monthly ezine regarding air-worthiness of chartered aircraft and pilot qualifications. The EFL circulated a CAA notice to club secretaries raising awareness of the risks of illegal public transport using unlicensed aircraft. The Executive Association of Great Britain stated that the report and concerns are not applicable to their particular circumstances as they do not arrange travel for members, and members do not travel by air to attend meetings.