Brema Elizabeth VIRGO · Prevention of Future Deaths report

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Issued 27 Feb 2026•Gwent

Published report and response evidence

This report’s concerns and statements found in recipients’ published responses. Statements are included even where no link to an individual concern is recorded. A link shows an evidence connection; it does not assign responsibility.

View original report
Concerns
2

Raised in this report

Recipients
1

Named on the report

Responses found
1

Of 1 recipient

Stated actions
1

Described in responses

Recipients and published responses

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

Select any concern, action or position to view the source wording.

Concerns raised2

  1. Failure to properly identify relevant pavement defects
    Part of recurring concern: Unreliable highway-defect investigation and prioritisation
  2. Inadequate methods for assessing and interpreting pavement defect height
    Part of recurring concern: Unreliable highway-defect investigation and prioritisation

Stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.1

  1. Newport City Council

    Review the Highway Maintenance Manual to consider whether alterations are necessary in response to the reported concern.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.1

  1. Newport City Council

    No immediate or short-term changes are considered necessary because existing highway inspection, risk-assessment, and defect-recording arrangements address the concern.

    Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure to properly identify relevant pavement defects

Wider context from the report

“The methods used for assessing and interpreting height of the defects in pavements allows for circumstances to occur whereby the actual height of the entire defect may not be reflected. Relevant defects may not be properly identified resulting in preventative remedial action not being taken, which presents a risk of future deaths. ”

Is this part of a recurring concern?

Yes — Unreliable highway-defect investigation and prioritisation.

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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. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Inadequate methods for assessing and interpreting pavement defect height

Wider context from the report

“The methods used for assessing and interpreting height of the defects in pavements allows for circumstances to occur whereby the actual height of the entire defect may not be reflected. Relevant defects may not be properly identified resulting in preventative remedial action not being taken, which presents a risk of future deaths. ”

Is this part of a recurring concern?

Yes — Unreliable highway-defect investigation and prioritisation.

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

Review the Highway Maintenance Manual to consider whether alterations are necessary in response to the reported concern.

Verbatim wording from the response

“Whilst we consider that no immediate or short term changes need to be made, in view of the serious nature of the incident in question, Highways intend to undertake a review of the Highway Maintenance Manual to consider whether any alterations to this may be necessary in view of your comments. Should any changes be identified, these would need to be reviewed by senior managers and proceed through a cabinet approval process, before being ratified and implemented.”

Source location

Response from Newport City Council
Page 2 · response
Published 9 March 2026

Open published response

Source evidence

How this respondent position was interpreted

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

PFD Monitor interpretation

No immediate or short-term changes are considered necessary because existing highway inspection, risk-assessment, and defect-recording arrangements address the concern.

Verbatim wording from the response

“I and other senior members of the Council’s highways department have given detailed consideration to the report and reviewed the Council’s Manual and methods with reference to the specific concern raised. We have concluded that we do not consider that any immediate or short term changes need to be made.”

Source location

Response from Newport City Council
Page 1 · response
Published 9 March 2026

Open published response
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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026