PFD report

Lesley Katherine HIGGINSON · Prevention of Future Deaths report

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Issued 10 Jun 2026•Cheshire

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
2

Raised in this report

Recipients
1

Named on the report

Responses found
1

Of 1 recipient

Stated actions
3

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

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

Concerns raised2

  1. Lack of clarity about the policy for declining welfare calls
    Part of recurring concern: Unreliable welfare-check processes for people whose health is of concern
  2. Failure to apply clear criteria for determining whether welfare checks are healthcare related and should be accepted or rejected
    Part of recurring concern: Unreliable welfare-check processes for people whose health is of concernPart of recurring concern: Unreliable welfare-check request handling and follow-up
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.3

  1. Action

    Meet with Okay Each Day and explain when ambulances will and will not be deployed for concern-for-welfare calls.

    Stated by North West Ambulance Service NHS TrustStated completedThe respondent said that this action was complete when they made their response on 13 August 2026.
  2. Action

    Introduce and implement Concern for Welfare Response Criteria Guidelines governing receipt, recording, escalation and ambulance responses.

    Stated by North West Ambulance Service NHS TrustStated completedThe respondent said that this action was complete when they made their response on 13 August 2026.
  3. Action

    Communicate concern-for-welfare ambulance deployment criteria and limitations to police, acute trusts, mental health organisations and councils through system-partner engagement.

    Stated by North West Ambulance Service NHS TrustStated completedThe respondent said that this action was complete when they made their response on 13 August 2026.

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

  1. Position

    NWAS cannot unilaterally provide welfare callouts for people whose needs or locations cannot be established.

    Stated by North West Ambulance Service NHS TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant 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 clarity about the policy for declining welfare calls

Wider context from the report

“It is important to know whether there is an established policy for declining welfare calls, and if so, when it was introduced. It leaves patients in a difficult position when aligned with the constabulary Right Care Right Person (RCRP) policy which was published nationally on 23 June 2023 and implemented in the Cheshire region in January 2024. The RCRP policy states that the police in Cheshire (and in other areas nationally) will not respond to welfare check calls when healthcare are best placed to support those who may be in crisis. It is unclear from the ambulance service response whether a request for a welfare check, in the circumstances of this death, is to be deemed to be healthcare related and whether the ambulance service properly rejected the request, on the grounds stated. ”

Is this part of a recurring concern?

Yes — Unreliable welfare-check processes for people whose health is of concern.

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 apply clear criteria for determining whether welfare checks are healthcare related and should be accepted or rejected

Wider context from the report

“It is important to know whether there is an established policy for declining welfare calls, and if so, when it was introduced. It leaves patients in a difficult position when aligned with the constabulary Right Care Right Person (RCRP) policy which was published nationally on 23 June 2023 and implemented in the Cheshire region in January 2024. The RCRP policy states that the police in Cheshire (and in other areas nationally) will not respond to welfare check calls when healthcare are best placed to support those who may be in crisis. It is unclear from the ambulance service response whether a request for a welfare check, in the circumstances of this death, is to be deemed to be healthcare related and whether the ambulance service properly rejected the request, on the grounds stated. ”

Is this part of a recurring concern?

Yes — Unreliable welfare-check processes for people whose health is of concern; Unreliable welfare-check request handling and follow-up.

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

Meet with Okay Each Day and explain when ambulances will and will not be deployed for concern-for-welfare calls.

Verbatim wording from the response

“NWAS have also met with the Okay Each Day service who have been advised as to the circumstances in which an ambulance will and will not be deployed when concern for welfare calls are received. It was recommended by NWAS that Okay Each Day explore whether they could set up a pathway with other agencies to make initial contact with a patient where their exact location cannot be determined or for them to consider their own response team to conduct these enquiries.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 2026

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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

Introduce and implement Concern for Welfare Response Criteria Guidelines governing receipt, recording, escalation and ambulance responses.

Verbatim wording from the response

“This advice was in accordance with the NWAS Concern for Welfare policy, which covers the receipt, recording, escalation and NWAS responses in relation to concern for welfare of a patient. Where such calls are received, the guidelines provide that the patient’s location needs to be known and there needs to be a confirmed medical need.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 2026

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

Communicate concern-for-welfare ambulance deployment criteria and limitations to police, acute trusts, mental health organisations and councils through system-partner engagement.

Verbatim wording from the response

“The Concern for Welfare Response Criteria Guidelines Policy was introduced in May 2024, in response to the Right Care, Right Person (RCRP) National Partnership Agreement. NWAS have been clear and transparent with local system partners, including the Police, Acute Trusts, Mental Health Organisations and Councils regarding the deployment of ambulances when concern for welfare calls are made to the service and the circumstances in which an ambulance will and will not be deployed. NWAS and other system partners have previously noted that there is a gap in services for members of the public who may need concern for welfare call outs and this has been discussed in both strategic and tactical RCRP meetings, but not something that NWAS are able to fulfil unilaterally.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 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

NWAS cannot unilaterally provide welfare callouts for people whose needs or locations cannot be established.

Verbatim wording from the response

“The Concern for Welfare Response Criteria Guidelines Policy was introduced in May 2024, in response to the Right Care, Right Person (RCRP) National Partnership Agreement. NWAS have been clear and transparent with local system partners, including the Police, Acute Trusts, Mental Health Organisations and Councils regarding the deployment of ambulances when concern for welfare calls are made to the service and the circumstances in which an ambulance will and will not be deployed. NWAS and other system partners have previously noted that there is a gap in services for members of the public who may need concern for welfare call outs and this has been discussed in both strategic and tactical RCRP meetings, but not something that NWAS are able to fulfil unilaterally.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 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

Other services must independently investigate whether an uncontactable person requires physical or mental healthcare.

Verbatim wording from the response

“As an ambulance service, our primary function is to prioritise and respond to the medical needs of our patients whether this is face-to-face or via other methods. A confirmed physical or mental health complaint means that the caller has evidence or good reason to believe that the patient or service user is currently suffering from a physical or mental health issue that requires either a face-to-face assessment or telephone response. It cannot be assumed that an individual being uncontactable, means that they require medical assistance. Nor do NWAS have the capacity to conduct thorough enquiries, on behalf of other services, to determine whether an individual is experiencing physical or mental health concerns. It is incumbent upon these services to arrange for and execute such inquiries autonomously.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 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

The Concern for Welfare policy was sufficient because the call lacked a verified location and confirmed physical or mental health need.

Verbatim wording from the response

“The NWAS Mental Health and Suicide Prevention Lead has listened to the 999 calls made in respect of Ms Higginson and has confirmed that the 999 call from Okay Each Day at 15:16 hrs was handled appropriately and in line with the concern for welfare policy. It could not be determined that Ms Higginson was at the specified location nor could it be determined that she had a confirmed physical or mental health complaint. It was therefore correct that NWAS did not deploy an ambulance to Ms Higginson based on the information provided at the time of the call.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 2026

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 positions A position is what a recipient says about a concern when they do not describe a specific action.2

  1. 1

    Okay Each Day should establish another-agency contact pathways or provide its own response team for welfare enquiries.

    Stated by North West Ambulance Service NHS TrustRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
  2. 2

    NWAS cannot force entry because it lacks the legal powers and equipment to do so.

    Stated by North West Ambulance Service NHS TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.

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

Okay Each Day should establish another-agency contact pathways or provide its own response team for welfare enquiries.

Verbatim wording from the response

“NWAS have also met with the Okay Each Day service who have been advised as to the circumstances in which an ambulance will and will not be deployed when concern for welfare calls are received. It was recommended by NWAS that Okay Each Day explore whether they could set up a pathway with other agencies to make initial contact with a patient where their exact location cannot be determined or for them to consider their own response team to conduct these enquiries.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 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

NWAS cannot force entry because it lacks the legal powers and equipment to do so.

Verbatim wording from the response

“NWAS need a verified location and assurance that a patient is indeed present at the specified location where an ambulance resource is being dispatched to. Additionally, NWAS rely on accurate contact information, ensuring that any provided contact number will connect us directly with the patient. NWAS does not have the legal powers, nor the equipment, to force entry to properties.”

Source location

Response from North West Ambulance Service
Page 2 · response
Published 13 August 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