Recurring concern

Unreliable pre-activity safety information for organised water activities

First to latest report 28 Feb 2018 — 10 Apr 2025

Reports that mention this concern
5
Times this concern has been raised
7
Stated actions linked to this concern
9

What this concern includes

Includes failures of pre-booking or pre-session safety information and briefings for organised water activities, including disclosure of activity demands, health advice, hazard warnings, participant-suitability information and essential safety arrangements.

What is not included
  • Excludes failures in the operation, supervision, rescue or emergency response of a water activity after participation has begun when pre-activity safety information is not deficient.
  • Excludes generic communication, training or risk-assessment deficiencies without a direct participant-facing pre-activity information or briefing failure.
  • Excludes ordinary swimming, boating or water-safety information that is not connected to an organised activity or a participant-safety decision.
  • Excludes information failures concerning unrelated travel, accommodation or non-water activities.

Reports and published responses 5 reports

See individual reports that have raised this concern, and the actions taken in response

  1. Sunderland

    AI-generated summary

    Mr Joel Kenneth Ineson · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Joel Kenneth Ineson died by drowning at Hetton Lyons County Park on 1 June 2023 after participating in an open water swimming event and suffering an unexpected cardiac event. The principal concerns were uncertainty about responsibility for safety measures, inadequate or absent safety briefings, lack of knowledge about participants and numbers in the water, and the absence of specific regulation, oversight and safety requirements for such events.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to provide specific pre-session safety briefings

    Wider context from the report

    “Open Water Swimming is becoming a popular way of keeping fit. Mr Ineson was a keen participant in organised open water swimming events with safety at the forefront of his mind with a reasonable expectation that appropriate safety measures would be in place for an organised event. He attended such an event on 31st May 2023 which was well attended, and the organisers indicated that this had been a popular event when it had taken place. This event, like many similar events, charged participants a small fee for the session. The matters of concern were not found to be causative of Mr Ineson’s death but were such that there is a risk that future deaths could occur unless action is taken. I was concerned that the evidence highlighted uncertainty and confusion with regard to responsibility for aspects of safety measures leading to some participants not receiving a specific safety briefing, a lack of knowledge of the competency/capability of each and every participant and no understanding as to who was in the water and how many people were in the water at any one time. It became clear in evidence that the activity does not require a licence from the Adventure Activities Licensing Authority and can be undertaken and/or organised by anyone without regulation. Some organisations provide guidance on safety when organising such events, but there is no established UK body that provides regulation for this activity. It was confirmed there is no specific health and safety guidance, nor is there a regulatory compliance requirement regarding pre-session safety briefing, risk assessments, signing in and out of the water systems, emergency plans and/or training for organisers. The evidence indicated there is no oversight of these events which, by definition, take place in outdoor locations that may pose a risk. I shall be glad to be told of any learning arising from this death and timescales and results of your review. ”

    Source location

    Mr Joel Kenneth Ineson · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

  2. Dorset

    AI-generated summary

    Iain Richard Farrell · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Iain Richard Farrell became breathless and exhausted during a led coasteering activity on 26 May 2019, was swept back into the sea by a large wave after reaching a ledge, and was later confirmed deceased despite resuscitation efforts. The principal concerns were the risks of lone guiding, the delayed access to the sole means of communication, and the absence of assessment of participants’ swimming ability and physical fitness during booking.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to assess prospective participants’ swimming ability and physical fitness during coasteering booking

    Wider context from the report

    “iv. At the time of booking a coasteering experience, the nature and potential physical demands of the experience at the coasteering location proposed should be made clear and a prospective participant should be asked about their swimming ability and physical fitness. ”

    Source location

    Iain Richard Farrell · Prevention of Future Deaths report
    Page 4 · concerns

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    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to disclose the nature and potential physical demands of the proposed coasteering experience at booking

    Wider context from the report

    “iv. At the time of booking a coasteering experience, the nature and potential physical demands of the experience at the coasteering location proposed should be made clear and a prospective participant should be asked about their swimming ability and physical fitness. ”

    Source location

    Iain Richard Farrell · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Produce a final updated Safety Advice for Coasteering Providers document incorporating consultation responses and advice.

    Verbatim wording from the response

    “The current NCC document, ‘Safety Advice for Coasteering Providers 2015 Version 3’ will be updated to address the 4 points raised as concerns by the Coroner in Section 5.2 i-iv in the Prevention of Future Deaths report. The rewrite will also update the 2015 version with other practices and advice that may have changed since the writing of the original advice with an aim of continuing to promote safe coasteering.”

    Source location

    Response from National Coasteering Charter
    Page 1 · response
    Published 1 November 2023

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consult NCC members by email and through a committee-led working group on updates to the Safety Advice for Coasteering Providers document.

    Verbatim wording from the response

    “The current NCC document, ‘Safety Advice for Coasteering Providers 2015 Version 3’ will be updated to address the 4 points raised as concerns by the Coroner in Section 5.2 i-iv in the Prevention of Future Deaths report. The rewrite will also update the 2015 version with other practices and advice that may have changed since the writing of the original advice with an aim of continuing to promote safe coasteering.”

    Source location

    Response from NCC
    Page 1 · response
    Published 1 November 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Produce a final updated Safety Advice for Coasteering Providers document incorporating member consultation responses and advice.

    Verbatim wording from the response

    “The current NCC document, ‘Safety Advice for Coasteering Providers 2015 Version 3’ will be updated to address the 4 points raised as concerns by the Coroner in Section 5.2 i-iv in the Prevention of Future Deaths report. The rewrite will also update the 2015 version with other practices and advice that may have changed since the writing of the original advice with an aim of continuing to promote safe coasteering.”

    Source location

    Response from NCC
    Page 1 · response
    Published 1 November 2023

    Open published response

  3. Manchester South

    AI-generated summary

    Sandra Curran · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Sandra Curran died after becoming unresponsive while snorkelling in the sea off Bugibba Saint Paul's, Malta, on 4 July 2022; an investigation found that she died from asphyxia as a consequence of drowning. The principal concern was that UK tour operator welcome information did not warn about the risks and challenges of sea swimming or snorkelling in Malta, particularly for weak swimmers.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of warnings about local sea conditions, swimming risks and risk mitigation for weak swimmers

    Wider context from the report

    “The inquest heard the Mrs Curran had booked her holiday through a UK Tour operator. Mrs Curran was not a strong swimmer and that she was unaware of the risks that swimming/snorkelling in the sea off the coast of Malta could present. No warnings were given in the welcome information/briefing about the challenge the sea around the coast in Malta could present to a weak swimmer. Previously when she had snorkelled it had been in far easier conditions where the risks of strong currents had not been present. The evidence given by her family at the inquest was that had her tour operator highlighted the need for caution Mrs Curran would not have snorkelled alone in the area where she drowned. A more proactive approach by UK tour operators highlighting the risk of getting into difficulties and how to mitigate them would reduce the risk of further deaths in circumstances such as Mrs Curran’s. ”

    Source location

    Sandra Curran · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Enhance Travel Advice on swimming safety by linking to the Royal Life Saving Society’s Water Safety on Holiday guidance.

    Verbatim wording from the response

    “In light of your report, we have considered further our advice on water risks in Malta:”

    Source location

    Response from Foreign, Commonwealth and Development Office
    Page 2 · response
    Published 30 October 2023

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue the Travel Aware campaign prompting British nationals to read destination advice and subscribe to travel alerts.

    Verbatim wording from the response

    “The FCDO’s established public-facing Travel Aware communications campaign will continue to prompt British nationals who are planning to travel abroad to read the latest FCDO travel advice for their destination and to sign up for e-mail alerts.”

    Source location

    Response from Foreign, Commonwealth and Development Office
    Page 2 · response
    Published 30 October 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Enhance cooperation with the Royal Life Saving Society and support water-safety information on its website during the summer holiday season.

    Verbatim wording from the response

    “We work closely with foreign governments, partners in the travel industry and others to reduce the risks to British people when they travel abroad. This year we enhanced our cooperation with the Royal Life Saving Society and worked with them on the water safety information appearing on their website during the summer holiday season. We will continue to work with ABTA and the travel industry and fully endorse efforts to make their customers aware of the risks they may face during travel.”

    Source location

    Response from Foreign, Commonwealth and Development Office
    Page 3 · response
    Published 30 October 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue disseminating swim-safety guidance through ABTA websites, social-media campaigns, and member and stakeholder channels.

    Verbatim wording from the response

    “ABTA runs a number of consumer campaigns where evidence from our members has highlighted that increased awareness on particular issues is important. We have been raising the importance of swim safety to consumers for over 20 years, and have been running a dedicated campaign on swim safety for around 10 years.”

    Source location

    Response from ABTA
    Page 2 · response
    Published 30 October 2023

    Open published response

  4. Derby and Derbyshire

    AI-generated summary

    Kellie Jean POOLE · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Kellie Jean POOLE died on 25 April 2022 after collapsing during a led cold water immersion session in the River Goyt. The report states that cold water likely triggered a heart rhythm disturbance and that she had an abnormal heart. The principal concerns were the limited oversight and regulation of cold water immersion providers, including health warnings, safety measures, leader training, first aid provision, insurance, risk assessments and guidance from relevant authorities.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Lack of pre-session health advice or warnings for cold water immersion participants

    Wider context from the report

    “There seems to be very little oversight of these businesses in their provision of cold water immersion covering matters such as pre-session health advice or warnings, public liability insurance, training and experience of the session leader, first aid training and equipment, or written risk assessments. I am not aware of the issuing of specific health and safety guidance. ”

    Source location

    Kellie Jean POOLE · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

  5. Northamptonshire

    AI-generated summary

    Andrea McHugh · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Andrea McHugh, who had epilepsy and continued to experience seizures after brain surgery, died after being found floating in the sea while snorkelling during a boat trip in Cuba on 17 June 2016. The report raised concerns that the participant waiver did not mention the dangers of swimming in the sea for people with epilepsy and did not request participants’ past medical history.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of participant waivers to mention the dangers of sea swimming for participants with epilepsy

    Wider context from the report

    “1) Marinas Gaviota S.A allegedly require participants in the boat and snorkelling trip to sign a waiver. (copy attached). The waiver does not mention the dangers of swimming in the sea if a participant suffers from epilepsy. 2) Additionally the waiver does not request details of participants past medical history. ”

    Source location

    Andrea McHugh · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of participant waivers to request participants' past medical history

    Wider context from the report

    “1) Marinas Gaviota S.A allegedly require participants in the boat and snorkelling trip to sign a waiver. (copy attached). The waiver does not mention the dangers of swimming in the sea if a participant suffers from epilepsy. 2) Additionally the waiver does not request details of participants past medical history. ”

    Source location

    Andrea McHugh · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Engage Gaviota to request adding epilepsy as a relevant medical condition to the Sunrise excursion waiver.

    Verbatim wording from the response

    “Thomas Cook has assessed the position carefully and has decided to immediately engage with Grupo Turismo Gavíota S.A. (“Gaviota”) to request that they amend their waiver form for the Sunrise excursion to include reference to epilepsy as a relevant medical condition which may make it dangerous for our customers to go in to the sea due to the increased risk of injury.”

    Source location

    2018-0060-Response-by-Thomas-Cook
    Page 1 · response
    Published 8 June 2018

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review whether to request further waiver amendments covering medical history that may make sea excursions dangerous.

    Verbatim wording from the response

    “Thomas Cook then intends to review whether we request Gaviota make further amendment to their waiver to include reference to any medical history that may make it dangerous for our customers to go in to the sea and therefore should be included in the waiver. If further amendment is required it is envisaged that it will be necessary for Thomas Cook to obtain expert medical advice in respect of this to ensure appropriate relevant medical history is included.”

    Source location

    2018-0060-Response-by-Thomas-Cook
    Page 1 · response
    Published 8 June 2018

    Open published response

Actions and positions describe what organisations say in published responses. Implementation is not independently verified.

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Data last updated 7 September 2026