Jessica Mary BIRKHEAD · Prevention of Future Deaths report

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Issued 2 Jun 2017•Exeter and Greater Devon

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.

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Concerns
2

Raised in this report

Recipients
2

Named on the report

Responses found
2

Of 2 recipients

Stated actions
8

Described in 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.

Report evidence summary

Concerns raised2

  1. Lack of an appropriate care pathway for people with learning difficulties and associated medical problems
  2. Failure of mainstream adult support services to provide care for people with intellectual disabilities

Stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.8

  1. Seaton and Colyton Medical Practice

    Forward the results of the Significant Event Audit after it has taken place.

  2. Seaton and Colyton Medical Practice

    Hold a formal Significant Event Audit to discuss the case and consider appropriate future care pathways for people with similar learning difficulties and medical problems.

  3. NHS Devon Integrated Care Board

    Provide acute-care liaison nurses in all large Devon general hospitals, supplemented by additional learning-disability liaison nurses.

  4. NHS Devon Integrated Care Board

    Maintain extended annual health checks in primary care for people with learning disabilities.

  5. NHS Devon Integrated Care Board

    Assess with provider organisations whether the 1Green Light audit tool can be applied to community services and agree its appropriate deployment.

  6. NHS Devon Integrated Care Board

    Work with screening and immunisation teams to increase uptake among people with learning disabilities.

  7. NHS Devon Integrated Care Board

    Provide approximately 20 primary-care learning-disability nurses across Devon to support access to primary-care services.

  8. NHS Devon Integrated Care Board

    Commission learning-disability support services to improve access to mainstream healthcare.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.3

  1. Seaton and Colyton Medical Practice

    The support services were equipped to care for someone with Jessica’s intellectual disabilities and were not inadequate as suggested.

    Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
  2. NHS Devon Integrated Care Board

    Parallel healthcare services for people with learning disabilities are not practical or clinically desirable; access should remain through mainstream services with reasonable adjustments.

    Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
  3. NHS Devon Integrated Care Board

    Mental health, physical and social care crises should be managed through normal services rather than the learning disability intensive assessment and treatment team.

    Redirects 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

Lack of an appropriate care pathway for people with learning difficulties and associated medical problems

Wider context from the report

“1. Although Jessica had been referred to a Consultant Psychiatrist in learning disability, the other support services offered to Jessica were main stream adult services, Jessica’s mother, a GP, is of the view that they were not equipped to deal with someone of Jessica’s intellectual disabilities. 2. Perhaps Jessica’s case could be looked at to consider the appropriate pathway for others in the future in a similar situation to Jessica to give appropriate support and care at a level appropriate taking into account any learning difficulties and associated medical problems. ”

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 of mainstream adult support services to provide care for people with intellectual disabilities

Wider context from the report

“1. Although Jessica had been referred to a Consultant Psychiatrist in learning disability, the other support services offered to Jessica were main stream adult services, Jessica’s mother, a GP, is of the view that they were not equipped to deal with someone of Jessica’s intellectual disabilities. 2. Perhaps Jessica’s case could be looked at to consider the appropriate pathway for others in the future in a similar situation to Jessica to give appropriate support and care at a level appropriate taking into account any learning difficulties and associated medical problems. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

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

Forward the results of the Significant Event Audit after it has taken place.

Verbatim wording from the response

“I trust that this reply is satisfactory and we will forward the results of our Significant Event Audit when it has taken place.”

Source location

2016-0208-Response-by-The-Seaton-and-Colyton-Medical-Practice
Page 2 · response
Published 2 June 2016

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 a formal Significant Event Audit to discuss the case and consider appropriate future care pathways for people with similar learning difficulties and medical problems.

Verbatim wording from the response

“The Seaton & Colyton Medical Practice held an informal Significant Event Audit Meeting following Jessica’s death, following which ████████ provided a report to the Coroner as requested. Following receipt of the Record of Inquest and taking particular regard to the Regulation 28: Report to Prevent Future Deaths, the practice will hold a formal Significant Event Audit Meeting in which we will discuss Jessica’s case and consider appropriate pathways for others in the future in a similar situation to Jessica to take into account any learning difficulties and associated medical problems.”

Source location

2016-0208-Response-by-The-Seaton-and-Colyton-Medical-Practice
Page 2 · response
Published 2 June 2016

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

Provide acute-care liaison nurses in all large Devon general hospitals, supplemented by additional learning-disability liaison nurses.

Verbatim wording from the response

“In secondary care there is an Acute Care Liaison nurse in all of the large general hospitals in Devon and additional liaison learning disability nurses offering support. The specification for this service is explicit stating it is there ‘to provide a link between social care/community learning disability services/primary care and facilitate health promotion supporting people to access other health services i.e. chiropody, dentistry, mental health services district nurses etc.’ In addition the specification states that this service will “support good mental health outcomes and access to all universal mental health services”.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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

Maintain extended annual health checks in primary care for people with learning disabilities.

Verbatim wording from the response

“In primary care there are approximately 20 nurses operating across Devon to ensure that individuals have good support in primary care services. This is a significantly higher level of service than other CCG’s. The Extended Service provision of Annual Health Checks in Primary Care for people with learning disabilities has been maintained. In addition work has taken place with the locality screening teams (Cervical cancer, Bowel Cancer, Abdominal Aortic Aneurysm, Breast cancer and Diabetic Retinopathy) and immunisation teams (influenza) to increase uptake of these services by people with learning disabilities.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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

Assess with provider organisations whether the 1Green Light audit tool can be applied to community services and agree its appropriate deployment.

Verbatim wording from the response

“The “1Green Light” audit tool (NDTi, 2013) has previously been deployed to review and benchmark inpatient services response to people who have mental health needs and also a learning disability and/or autism. The CCG clinical and quality leads will assess with the leads of relevant provider organisations whether this tool could appropriately be applied to other community services to provide a review of access of mental health services to individuals and to identify what further reasonable adjustments are needed in services to enable service improvement. Assessment and agreement as to how this tool can be appropriately deployed will be completed in 2016/17 in order to inform any quality improvement initiatives to be undertaken in 2017/18.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 3 · response
Published 2 June 2016

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

Work with screening and immunisation teams to increase uptake among people with learning disabilities.

Verbatim wording from the response

“In primary care there are approximately 20 nurses operating across Devon to ensure that individuals have good support in primary care services. This is a significantly higher level of service than other CCG’s. The Extended Service provision of Annual Health Checks in Primary Care for people with learning disabilities has been maintained. In addition work has taken place with the locality screening teams (Cervical cancer, Bowel Cancer, Abdominal Aortic Aneurysm, Breast cancer and Diabetic Retinopathy) and immunisation teams (influenza) to increase uptake of these services by people with learning disabilities.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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

Provide approximately 20 primary-care learning-disability nurses across Devon to support access to primary-care services.

Verbatim wording from the response

“In primary care there are approximately 20 nurses operating across Devon to ensure that individuals have good support in primary care services. This is a significantly higher level of service than other CCG’s. The Extended Service provision of Annual Health Checks in Primary Care for people with learning disabilities has been maintained. In addition work has taken place with the locality screening teams (Cervical cancer, Bowel Cancer, Abdominal Aortic Aneurysm, Breast cancer and Diabetic Retinopathy) and immunisation teams (influenza) to increase uptake of these services by people with learning disabilities.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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

Commission learning-disability support services to improve access to mainstream healthcare.

Verbatim wording from the response

“The CCG has specifically commissioned services with Devon Partnership NHS Trust (DPT) to support the access of people who have a learning disability to mainstream services.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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 support services were equipped to care for someone with Jessica’s intellectual disabilities and were not inadequate as suggested.

Verbatim wording from the response

“Jessica sadly died on 28 July 2015 having taken an overdose. There is no reference in her primary care records that she expressed to her GP any thoughts of deliberate self-harm. I take note with regards to the “Matters of Concern” raised under Regulation 28. However, it is my opinion that Jessica was under the care of a consultant psychiatrist specialising in learning disabilities, the Devon Learning Disability Team and also the Depression and Anxiety Service, as had previously been arranged by two consultant psychiatrists. It is not, therefore, my view that the support services were not equipped to deal with someone of Jessica’s intellectual disabilities.”

Source location

2016-0208-Response-by-The-Seaton-and-Colyton-Medical-Practice
Page 2 · response
Published 2 June 2016

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

Parallel healthcare services for people with learning disabilities are not practical or clinically desirable; access should remain through mainstream services with reasonable adjustments.

Verbatim wording from the response

“In terms of context, the CCG’s approach to commissioning access to mainstream healthcare services for people with a learning disability is in accordance with national policy. People who have a learning disability should have access to the same specialists as the general population, whilst recognising that reasonable adjustments may need to be made in services to enable this access. It is not practical or indeed clinically desirable to run a host of parallel health services for people who have a learning disability as they should always be able to access the expert input they need as patients, for example in primary care, physical acute medical and surgical services or mental health services.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 1 · response
Published 2 June 2016

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

Mental health, physical and social care crises should be managed through normal services rather than the learning disability intensive assessment and treatment team.

Verbatim wording from the response

“The intensive assessment and treatment team (IATT) in learning disabilities also offered support in this case and is there to support direct input to the person if they are experiencing behavioural problems. The current service specification states that ‘…therefore a key function of the team is to enable advice and support to those agencies to make sure those reasonable adjustments happen in those other services. …’ and ‘IATT is not a crisis intervention service’. Mental health, physical or social care crisis should be dealt with through the normal services.”

Source location

2016-0208-Response-by-Northern-Eastern-and-Western-Devon-Clinical-Commissioning-Group
Page 2 · response
Published 2 June 2016

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
2/2

Data last updated 7 September 2026