South East
NHS Region83 health investigations in the South East region.
Root Cause Analysis Investigation Report into the Death ofDr Julien Warshafsky
Mental Health Investigation
NHS England has published aRoot Cause Analysis Investigation Report into the Death of Dr Julien Warshafsky. The focus of this case review is to explore opportunities for collective learning and identify actions that could be either considered or taken to minimise the risk of recurrence.
1 recommendation
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Independent investigation: Alan Creasey, Lancing (2017)
Mental Health Investigation
Mentally disordered man fatally batters and stamps on man. Convicted of Murder
6 recommendations
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Independent investigation: Alison Gable, Theale (2003)
Mental Health Investigation
Sectioned MH patient on day release kills girlfriend. Ind Rev 2004 – originally unpubl. Not in public interest
-1 recommendations
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Independent investigation: Amaaar Khan, Slough (2014)
Mental Health Investigation
Depressed and anxious woman jumped in front of a high speed train holding her young son. Family said there had been ‘shortfalls’ in her mental health treatment
17 recommendations
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Independent investigation: Angela Titley, Private Psych hospital, Redhill, Surrey (2004)
Mental Health Investigation
Psychotic MH patient fatally and repeatedly stabbed lover with Swiss Army Knife. Ind Inq 2009. May have missed meds
-1 recommendations
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Independent investigation: Anita Bawtree, Southampton (2011)
Mental Health Investigation
Psychotic man fatally and repeatedly stabbed partner. Extensive Drug history. Recently released from MHA
28 recommendations
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Independent investigation: Annette Sturt, Dover (2012)
Mental Health Investigation
Paranoid schizophrenic fatally batters and strangles his mother. Heavy drug abuse
3 recommendations
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Independent investigation: Anthony Harrison, Andover (1998)
Mental Health Investigation
Detained MH patient leaves hospital and fatally stabs man. Ind Inq 2001. Later hanged himself at Broadmoor
16 recommendations
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Independent investigation: Anthony Radford, Pewley Down, Guildford (2005)
Mental Health Investigation
Paranoid schizophrenic fatally and repaetedly batters man with log. MH History. (Ind Inq 2013, Verita)
-1 recommendations
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Independent investigation: Anthony Wakeford, Effingham (2010)
Mental Health Investigation
Mentally ill woman fatally stabs husband. Released at trial
8 recommendations
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Independent investigation: Avril Hollens, Tonbridge, Kent (1999)
Mental Health Investigation
MH patient fatally stabs girlfriend. Ind Inq 2003
-1 recommendations
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Independent investigation: Ben Cargill (Mr D), Chesham, Bucks (2004)
Mental Health Investigation
Mentally ill man repeatedly and fatally stabbed former flatmate. Ind Inq 2006
14 recommendations
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Independent investigation: Brenda Lindley, Northfleet (2007)
Mental Health Investigation
Mentally ill man fatally batters wife then kills himself
6 recommendations
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Independent investigation: Carl Scott, Winchester
Mental Health Investigation
Schizophrenic man fatally battered and stabbed man
11 recommendations
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Independent investigation: Catherine Ogram, Aldershot (2002)
Mental Health Investigation
Schizophrenic fatally punched and stabbed his girlfriend. Long history of MI – clear warning signs beforehand
14 recommendations
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Independent investigation: Chris Poole, Eastbourne (2012)
Mental Health Investigation
Mentally ill man fatally punches and kicks man
6 recommendations
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Independent investigation: Chris Stones, Worthing (2005)
Mental Health Investigation
Paranoid Schizophrenic stabs father of two. Long MH history
-1 recommendations
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Independent investigation: Daniel Quelch, Maidenhead, Berks (2007)
Mental Health Investigation
Paranoid Schizophrenic breaks into house and fatally and repeatedly stab stranger in front of his children. Long MH history – sectioned 2001 – not taking meds
9 recommendations
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Independent investigation: Darren Lock, Newbury (2012)
Mental Health Investigation
Mentally ill man fatally stabs man
9 recommendations
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Independent investigation: David Ford, Margate (2011)
Mental Health Investigation
Man with schizophrenia fatally attacks fellow hostel resident
4 recommendations
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Independent investigation: Derek Saxby, Folkestone (2004)
Mental Health Investigation
MH Patient with schizophrenia kills fellow hostel resident. Long MH history. (Ind Inq 2013, Verita)
2 recommendations
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Independent investigation: Donald Lock, Findon (2015)
Mental Health Investigation
Paranoid schizophrenic repeatedly and fatally stabs stranger. MH history, some previous violence, family not listened to
21 recommendations
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Independent investigation: Eileen Cameron, Reading, Berks (1997)
Mental Health Investigation
MH homicide of mother. Ind Inq 2000
-1 recommendations
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Independent investigation: Elizabeth Cook, Langley, Berks (2006)
Mental Health Investigation
Paranoid schizophrenic fatally stabs mother. Ind Inq 2006
4 recommendations
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Independent investigation: Elizabeth Thomas, Oxted (2014)
Mental Health Investigation
Mentally disordered teenager fatally stabbed young friend. Convicted of murder
11 recommendations
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