PFD report

Ellie Jessalyn Isaacs · Prevention of Future Deaths report

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Issued 4 Sep 2020•East London

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

View original report
Concerns
4

Raised in this report

Recipients
1

Named on the report

Responses found
2

Of 1 recipient

Stated actions
6

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

Open published report

Concerns and recipient responses

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

Report evidence summary

Concerns raised4

  1. Risk of future deaths from the combined crossing hazards
    Part of recurring concern: Inadequate control of pedestrian crossing risks
  2. Obstruction of drivers' view of pedestrians waiting at the crossing
    Part of recurring concern: Inadequate control of pedestrian crossing risks
  3. Failure of vehicles to comply with automated traffic signals
    Part of recurring concern: Inadequate control of pedestrian crossing risks
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

Actions described in response An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.5

  1. Action

    Renew the 30mph signs so the central-reservation and farside signs match the nearside sign size.

    Stated by Transport for LondonStated completedThe respondent said that this action was complete when they made their response on 10 November 2020.
  2. Action

    Undertake a further safety review, including reassessing street-furniture positioning, by the end of November 2020.

    Stated by Transport for LondonStated plannedThe respondent said that this action was planned when they made their response on 10 November 2020.
  3. Action

    Conduct fatal-collision site visits with multidisciplinary staff to identify and address road-safety issues.

    Stated by Transport for LondonStated completedThe respondent said that this action was complete when they made their response on 10 November 2020.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.8

  1. Position

    The pelican crossing’s design, operation and signal timings comply with current TfL standards and provide adequate opportunity for pedestrians to cross safely.

    Stated by Transport for LondonExisting 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

Risk of future deaths from the combined crossing hazards

Wider context from the report

“4. The combination of the above factors, raises a risk of future deaths. ”

Is this part of a recurring concern?

Yes — Inadequate control of pedestrian crossing risks.

Open source report

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

Obstruction of drivers' view of pedestrians waiting at the crossing

Wider context from the report

“1. The Inquest heard that there are a number of items of street furniture that obstruct the view that drivers should have of pedestrians waiting at the Pelicon crossing (signage, bus stand, safety camera and overhanging foliage/tree branches). ”

Is this part of a recurring concern?

Yes — Inadequate control of pedestrian crossing risks.

Open source report

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 of vehicles to comply with automated traffic signals

Wider context from the report

“3. A recent site visit noted a very high level of non-compliance with the automated traffic signals. Vehicles were noted not to be stopping at the amber traffic light phase. ”

Is this part of a recurring concern?

Yes — Inadequate control of pedestrian crossing risks.

Open source report

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

Hazardous crossing approach following a bend with a higher preceding speed limit

Wider context from the report

“2. The Pelicon crossing is sited shortly following a bend in the road and the immediate speed limit approaching the crossing is 30 miles per hour. Very shortly before the Pelicon crossing, the speed limit is 50mph. ”

Is this part of a recurring concern?

Yes — Inadequate control of pedestrian crossing risks; Inadequate speed control at hazardous road locations; Unsafe road design and layout.

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

Renew the 30mph signs so the central-reservation and farside signs match the nearside sign size.

Verbatim wording from the response

“Work undertaken”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

Undertake a further safety review, including reassessing street-furniture positioning, by the end of November 2020.

Verbatim wording from the response

“Conclusion”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 6 · response
Published 10 November 2020

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

Conduct fatal-collision site visits with multidisciplinary staff to identify and address road-safety issues.

Verbatim wording from the response

“It is our standard practice and part of our wider commitment to Vision Zero to organise a visit to the site of every fatal incident that occurs on TfL’s road network. This is to identify any issues and actions that can be taken immediately to prevent future loss of life.”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 2 · response
Published 10 November 2020

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

Resurface the Gallows Corner roundabout and A12 approaches, renewing white lines, markings, bus-stop cage lining and red surfacing.

Verbatim wording from the response

“Work undertaken”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

Liaise with the retail park to request regular maintenance and cutting of vegetation and trees within its property boundary.

Verbatim wording from the response

“Work undertaken”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

The pelican crossing’s design, operation and signal timings comply with current TfL standards and provide adequate opportunity for pedestrians to cross safely.

Verbatim wording from the response

“A further site inspection was undertaken by TfL Engineering’s Traffic Control team on 29 August 2019 following an enquiry from Ms Isaac’s family which was forwarded to us by the MPS regarding the location of the crossing facility. This inspection determined that the design and operation of the pelican crossing met TfL’s current design standards and this finding was communicated to the MPS. It additionally determined that there was good visibility of the traffic signals which have five signal heads on both approaches (with two positioned at 6m high and three at 4m high as illustrated in the photos below).”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 2 · response
Published 10 November 2020

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

The 30 mph speed limit and its location relative to the pedestrian crossing comply with relevant highway regulations.

Verbatim wording from the response

“Below is an aerial photo of the crossing. The speed limit for the Gallows Corner roundabout is 30mph and remains so through the pedestrian crossing location for traffic exiting the roundabout to travel north-east along the A12.”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 5 · response
Published 10 November 2020

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 road bend causing driver sightline problems was apparent near the crossing during inspection.

Verbatim wording from the response

“While on site there was no visible bend apparent in the carriageway along this length of the road that would cause any sight line issues for drivers what so ever.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

The Metropolitan Police is responsible for investigating and enforcing traffic-light and speed offences at the crossing.

Verbatim wording from the response

“During the site visit on 17th September the non-compliance witnessed above was not seen. This may well be down to the fact that someone standing near the crossing point dressed in black wearing a high-viz jacket may have given the impression of a police presence in which case any comment here is possibly flawed. In London it is the Metropolitan Polices role to enforce traffic light control contraventions/speed offences etc. so it would fall to them to carry out any further necessary investigation at this particular site.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

Highway safety actions at the location fall outside Havering Council’s authority because Transport for London is the highway authority.

Verbatim wording from the response

“While Colchester Road is part of the adopted highway network, Havering Council are not the Highway Authority for this road, this responsibility falls to Transport for London (TfL). The plan shown below shows the boundary of TfL’s responsibility around Gallows Corner roundabout and also the section of Colchester Road where the crossing point is situated.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 1 · response
Published 10 November 2020

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

Transport for London must investigate and determine any action concerning the highway network at the location.

Verbatim wording from the response

“A site inspection was undertaken on Thursday 17th September to look at the incident site so that Havering could give responses to the points raised in the coroner’s report. While these comments are made by a Senior Engineer at Havering it must be stressed that TfL would need to carry out their own investigation as they would be ultimately responsible for any action (or inaction) carried out to the highway network at this location.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 2 · response
Published 10 November 2020

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

The reported high non-compliance with traffic signals was not observed during the Council’s site visit, although the observation may have been unreliable.

Verbatim wording from the response

“3. A recent site visit noted a very high level of non-compliance with the automated traffic signals. Vehicles were noted not to be stopping at the amber traffic light phase.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

The inspected camera, vegetation, bus stand and signage did not obstruct drivers’ sightlines to the controlled crossing.

Verbatim wording from the response

“The footway at this location is split into a cycle way at the rear of the footway with the pedestrian side adjacent to the carriageway. The safety camera is located at the rear of the footway approximately 25 metres before the crossing, within the cycle way section, and would not cause any sight line issues for car drivers approaching the controlled crossing point.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 2 · response
Published 10 November 2020

Open published response

Other statements in published responses

These actions and other statements could not be clearly connected to one concern in this report.

Recipient-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. 1

    Prepare and submit a Department for Transport bid for Major Roads Network funding to support further A12/A127 Gallows Corner junction improvements.

    Stated by Transport for LondonStated plannedThe respondent said that this action was planned when they made their response on 10 November 2020.

Recipient positions A position is what a recipient says about a concern when they do not describe a specific action.1

  1. 1

    The area was clean, with no highway litter or detritus considered relevant to the incident.

    Stated by London Borough of HaveringDisputes the concernThe respondent disagreed with part of the concern or the basis for it.

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

Prepare and submit a Department for Transport bid for Major Roads Network funding to support further A12/A127 Gallows Corner junction improvements.

Verbatim wording from the response

“In addition to the measures outlined above, TfL is preparing to submit a bid to the Department for Transport (DfT) in late 2020 for Major Roads Network (MRN) funding to deliver further improvements to the A12/A127 Gallows Corner junction.”

Source location

2020-0169-Response-from-TFL_Redacted.pdf
Page 6 · response
Published 10 November 2020

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

The area was clean, with no highway litter or detritus considered relevant to the incident.

Verbatim wording from the response

“While Havering Council are not the Highway Authority for this location they are responsible for the cleanliness of the area as the Litter Authority. On inspection there area was clean, there was no build-up of litter or detritus on the highway that would have had any input into this incident.”

Source location

2020-0169-Response-from-Havering-Council-_Redacted.pdf
Page 5 · response
Published 10 November 2020

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

Official responses located
2/1

Data last updated 7 September 2026