PFD report

Stephanie Louise Augusta Marks · Prevention of Future Deaths report

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Issued 20 Jun 2016•Avon

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.

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Concerns
1

Raised in this report

Recipients
1

Named on the report

Responses found
0

Of 1 recipient

Stated actions
0

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

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Concerns raised1

  1. Lack of daily staff checks that all GP messages have been countersigned as received or acted on
    Part of recurring concern: Unreliable review and action on clinically significant incoming correspondence
Responses linked to these concerns

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

No linked response statements

No respondent-stated action or position is clearly linked to these concerns.

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 daily staff checks that all GP messages have been countersigned as received or acted on

Wider context from the report

“1. There was no evidence that staff check at 6.30pm each day that all GP messages have been countersigned as received/acted on by the GP’s, for that day. ”

Is this part of a recurring concern?

Yes — Unreliable review and action on clinically significant incoming correspondence.

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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