PFD report

Karen Lesley Day · Prevention of Future Deaths report

Pin Get email alerts Request correction

Issued 10 Dec 2024•West Yorkshire Eastern

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
5

Raised in this report

Recipients
1

Named on the report

Responses found
1

Of 1 recipient

Stated actions
20

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 raised5

  1. Failure to follow the lower limb framework
  2. Failure to make appropriate tissue viability referrals
    Part of recurring concern: Unreliable referrals to tissue viability services
  3. Failure to support patients with wound self-management or regular appointment attendance
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.8

  1. Action

    Audit patients receiving regular practice wound care monthly, moving to three-monthly audits once the system is assured.

    Stated by Meanwood Group PracticeStated completedThe respondent said that this action was complete when they made their response on 11 December 2024.
  2. Action

    Hold regular multidisciplinary discussions for complex or non-healing wounds and record outcomes in patient records.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  3. Action

    Adopt four-week escalation triggers for non-improving foot and leg wounds, including podiatry or Tissue Viability referral consideration.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.

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

  1. Position

    Long-term wound care will be referred to specialist services, with the ICB expected to commission the necessary service.

    Stated by Meanwood Group PracticeRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.

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 follow the lower limb framework

Wider context from the report

“(1) During the course of the inquest I heard evidence that the GP practice did not follow the lower limb framework, failed to refer to tissue viability appropriately, and failed to escalate concerns around the deteriorating wound or consider appropriate measures to support the deceased to either self-manage her wound with an at home compression bandaging kit, or to support her to attend appointments on a more regular basis. I am concerned that the practice was unable to provide assurance that the same situation could not occur again. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

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 to make appropriate tissue viability referrals

Wider context from the report

“(1) During the course of the inquest I heard evidence that the GP practice did not follow the lower limb framework, failed to refer to tissue viability appropriately, and failed to escalate concerns around the deteriorating wound or consider appropriate measures to support the deceased to either self-manage her wound with an at home compression bandaging kit, or to support her to attend appointments on a more regular basis. I am concerned that the practice was unable to provide assurance that the same situation could not occur again. ”

Is this part of a recurring concern?

Yes — Unreliable referrals to tissue viability services.

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 to support patients with wound self-management or regular appointment attendance

Wider context from the report

“(1) During the course of the inquest I heard evidence that the GP practice did not follow the lower limb framework, failed to refer to tissue viability appropriately, and failed to escalate concerns around the deteriorating wound or consider appropriate measures to support the deceased to either self-manage her wound with an at home compression bandaging kit, or to support her to attend appointments on a more regular basis. I am concerned that the practice was unable to provide assurance that the same situation could not occur again. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

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

Inadequate systems for timely review of patient safety incidents and learning from findings

Wider context from the report

“(2) During the inquest I received evidence that the practice had not carried out any internal investigation in relation to this death and the practice accepted it should have done. I am concerned that the practice does not have adequate systems in place to ensure that patient safety incidents are reviewed in a timely way to allow lessons to be drawn from the findings. ”

Is this part of a recurring concern?

Yes — Inadequate safety incident investigations.

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 to escalate concerns about deteriorating wounds

Wider context from the report

“(1) During the course of the inquest I heard evidence that the GP practice did not follow the lower limb framework, failed to refer to tissue viability appropriately, and failed to escalate concerns around the deteriorating wound or consider appropriate measures to support the deceased to either self-manage her wound with an at home compression bandaging kit, or to support her to attend appointments on a more regular basis. I am concerned that the practice was unable to provide assurance that the same situation could not occur again. ”

Is this part of a recurring concern?

Yes — Inadequate wound management for deteriorating wounds.

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

Audit patients receiving regular practice wound care monthly, moving to three-monthly audits once the system is assured.

Verbatim wording from the response

“• To audit all patients receiving regular wound care within the practice every month, and once the system is assured every 3 months.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Hold regular multidisciplinary discussions for complex or non-healing wounds and record outcomes in patient records.

Verbatim wording from the response

“• We will hold regular multi-disciplinary team discussions for patients with complex or wounds that are failing to heal. The lead nurse to bring forward patients the nurses are concerned about. The result of the MDT will be recorded in the patient’s record.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Adopt four-week escalation triggers for non-improving foot and leg wounds, including podiatry or Tissue Viability referral consideration.

Verbatim wording from the response

“• The practice will adopt a process that all foot wounds that have shown no improvement or are static within four weeks would trigger a review and referral to podiatry and all leg wounds that have shown no improvement should be reviewed and considered for referral to the Tissue Viability service.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Update GP and practice nursing knowledge, training and wound-care processes in line with Leeds guidelines.

Verbatim wording from the response

“Following the inquest the case was discussed again at a practice meeting on 2nd December 2024 with all partners, salaried GPs and GP registrars, practice manager and deputy, practice nurse lead and reception manager and a full significant event analysis was presented and discussed. This led to the use of a detailed wound care template for all relevant wound management consultations, a review of the use of Tissue Viability Team referral process to ensure no other referrals are rejected, and GPs and the practice nursing team updating their knowledge, training and processes for wound care, in line with Leeds guidelines.”

Source location

Response from Meanwood Group Practice
Page 1 · response
Published 11 December 2024

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

Complete and discuss a full significant event analysis of the case.

Verbatim wording from the response

“The case had previously been discussed at a practice meeting on 25th July 2022 following the death of Ms Day. This is done for all patient deaths, and includes GPs, practice manager, practice pharmacist, and lead practice nurse. As with other case reviews it provided an opportunity to review and learn from the case.”

Source location

Response from Meanwood Group Practice
Page 1 · response
Published 11 December 2024

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

Use a detailed wound-care template for relevant consultations, including four-week completion and photographic documentation.

Verbatim wording from the response

“Following the inquest the case was discussed again at a practice meeting on 2nd December 2024 with all partners, salaried GPs and GP registrars, practice manager and deputy, practice nurse lead and reception manager and a full significant event analysis was presented and discussed. This led to the use of a detailed wound care template for all relevant wound management consultations, a review of the use of Tissue Viability Team referral process to ensure no other referrals are rejected, and GPs and the practice nursing team updating their knowledge, training and processes for wound care, in line with Leeds guidelines.”

Source location

Response from Meanwood Group Practice
Page 1 · response
Published 11 December 2024

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

Review the Tissue Viability referral process to prevent inappropriate rejection of referrals.

Verbatim wording from the response

“Following the inquest the case was discussed again at a practice meeting on 2nd December 2024 with all partners, salaried GPs and GP registrars, practice manager and deputy, practice nurse lead and reception manager and a full significant event analysis was presented and discussed. This led to the use of a detailed wound care template for all relevant wound management consultations, a review of the use of Tissue Viability Team referral process to ensure no other referrals are rejected, and GPs and the practice nursing team updating their knowledge, training and processes for wound care, in line with Leeds guidelines.”

Source location

Response from Meanwood Group Practice
Page 1 · response
Published 11 December 2024

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

Apply a lower threshold for completing significant event analyses, discussing them weekly and recording and acting on lessons.

Verbatim wording from the response

“• The practice will have a lower threshold to complete a full significant event analysis. These will be discussed in the weekly practice clinical meeting and any lessons learnt recorded and acted on.”

Source location

Response from Meanwood Group Practice
Page 3 · response
Published 11 December 2024

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

Long-term wound care will be referred to specialist services, with the ICB expected to commission the necessary service.

Verbatim wording from the response

“• The practice will inform the ICB in Leeds of its intention to no longer provide long-term wound care management and would refer all relevant patients to a specialist service for wound care management. The practice would expect the ICB to commission the necessary service.”

Source location

Response from Meanwood Group Practice
Page 3 · response
Published 11 December 2024

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.12

  1. 1

    Review dependent-oedema management to document investigation plans for heart failure and other causes.

    Stated by Meanwood Group PracticeStated completedThe respondent said that this action was complete when they made their response on 11 December 2024.
  2. 2

    Appoint a practice Wound Care Lead alongside the practice nurse lead.

    Stated by Meanwood Group PracticeStated completedThe respondent said that this action was complete when they made their response on 11 December 2024.
  3. 3

    Request an urgent multi-organisation meeting to learn from the case and seek improvement in community wound services.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  4. 4

    Inform the Leeds ICB that the practice intends to stop providing long-term wound-care management.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  5. 5

    Organise wound-management training for GPs and practice nurses with the Lead Vascular Nurse Specialist.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  6. 6

    Request legal representation at subsequent inquests.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  7. 7

    Make wound care and management a standing item on weekly practice meeting agendas.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  8. 8

    File Datix incident reports when risks are identified, including the community wound-care funding risk.

    Stated by Meanwood Group PracticeStated completedThe respondent said that this action was complete when they made their response on 11 December 2024.
  9. 9

    Improve duty-doctor recording systems by adding nurse-requested patient reviews to the duty list and clinical notes.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  10. 10

    Invite a District Nurse representative to quarterly practice meetings to review cases and strengthen collaboration with community healthcare colleagues.

    Stated by Meanwood Group PracticeStated completedThe respondent said that this action was complete when they made their response on 11 December 2024.
  11. 11

    Discuss the case with Primary Care Network practices to share learning and improve local care quality.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.
  12. 12

    Review all current wound-care patients in a clinician-attended practice meeting using full clinical-record review.

    Stated by Meanwood Group PracticeStated plannedThe respondent said that this action was planned when they made their response on 11 December 2024.

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 dependent-oedema management to document investigation plans for heart failure and other causes.

Verbatim wording from the response

“• We have reviewed our clinical management of dependent oedema to ensure in all cases a clear plan for investigating heart failure and other causes is documented in the clinical record, in line with Leeds guidelines.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Appoint a practice Wound Care Lead alongside the practice nurse lead.

Verbatim wording from the response

“As a result of the significant event analysis and practice team discussion the following action plan was agreed and implemented:”

Source location

Response from Meanwood Group Practice
Page 1 · response
Published 11 December 2024

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

Request an urgent multi-organisation meeting to learn from the case and seek improvement in community wound services.

Verbatim wording from the response

“• To write to the ICB, LCH, LITH and CQC, sharing the Section 28 report, and to request an urgent meeting to learn lessons from this case and seek improvement to the community wound service. Other areas within West Yorkshire and elsewhere in the country have greater access to specialist wound care services and yet in Leeds the limited wound clinics have recently been discontinued. The practice should not be expected to care for patients with chronic wounds that are not healing and will work to ensure all relevant patients are referred.”

Source location

Response from Meanwood Group Practice
Page 3 · response
Published 11 December 2024

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

Inform the Leeds ICB that the practice intends to stop providing long-term wound-care management.

Verbatim wording from the response

“• The practice will inform the ICB in Leeds of its intention to no longer provide long-term wound care management and would refer all relevant patients to a specialist service for wound care management. The practice would expect the ICB to commission the necessary service.”

Source location

Response from Meanwood Group Practice
Page 3 · response
Published 11 December 2024

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

Organise wound-management training for GPs and practice nurses with the Lead Vascular Nurse Specialist.

Verbatim wording from the response

“• Wound management training to be organised for the practice nursing team and GPs with the Lead Vascular Nurse Specialist, LGI, on 24th February 2025.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Request legal representation at subsequent inquests.

Verbatim wording from the response

“• To request legal representation at any subsequent inquests. In this case, MPS supported the preparation of an initial statement but advised that legal representation wasn’t necessary. However, Leeds Community Healthcare and Leeds Teaching Hospital Trust had legal representation present. The inquest caused significant distress for those attending and the practice has a duty of care to support them.”

Source location

Response from Meanwood Group Practice
Page 3 · response
Published 11 December 2024

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

Make wound care and management a standing item on weekly practice meeting agendas.

Verbatim wording from the response

“• Wound care and management will be made a standing item as part of the weekly practice meeting agenda with contributions from partners/GP Registrars/Nursing/ Pharmacy teams.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

File Datix incident reports when risks are identified, including the community wound-care funding risk.

Verbatim wording from the response

“• Datix Incident reports will be filed in the event of risks being identified. A Datix incident form has been filed because of this inquest regarding the risk associated with the withdrawal of funding for the community wound care clinic and the pressures being placed on General Practice nursing services because of this.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Improve duty-doctor recording systems by adding nurse-requested patient reviews to the duty list and clinical notes.

Verbatim wording from the response

“• Systems will be improved within the daily duty doctor arrangements to ensure all clinical contact related to a patient is appropriately recorded. As part of this whenever a GP is asked to review a patient by a nurse the patient’s name should be added to the duty-list as a prompt for the duty GP to record their review, in addition to the practice nurse’s consultation, in the notes.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Invite a District Nurse representative to quarterly practice meetings to review cases and strengthen collaboration with community healthcare colleagues.

Verbatim wording from the response

“• We have invited a District Nurse representative to attend a practice meeting once every three months to review cases they are dealing with and facilitate a closer working relationship with our Leeds Community Healthcare colleagues.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Discuss the case with Primary Care Network practices to share learning and improve local care quality.

Verbatim wording from the response

“• To discuss the case with other practices within our Primary Care Network at the next meeting on 28 January 2025, to share learning and improve quality of care across the area.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

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

Review all current wound-care patients in a clinician-attended practice meeting using full clinical-record review.

Verbatim wording from the response

“• To review all current patients in a practice meeting with all clinicians present in the first instance, using a large screen monitor to enable full review of the patient’s clinical record.”

Source location

Response from Meanwood Group Practice
Page 2 · response
Published 11 December 2024

Open published response
Back to top

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

Official responses located
1/1

Data last updated 7 September 2026