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Hospital trust neglect contributed to mental health patient's suicide, coroner says​.


A patient who took his own life on a mental health ward died after "neglect" from a hospital trust, a coroner has said.

Mick Woods, 66, of Walton-on-the-Naze, died on Christmas Day in 2020 at the King's Wood Centre, Colchester.

Essex area coroner, Sean Horstead, concluded the death was "suicide contributed to by neglect.”

The trust has previously been fined £1.5m following a prosecution brought by the Health and Safety Executive (HSE) for failings relating to the deaths of 11 patients between 2004 and 2015.

Mr Woods died a month after the trust pleaded guilty to those charges.

A narrative verdict concluded there had been "inadequate" risk assessments of Mr Woods upon his arrival on 10 December, 2020, and when he was on the ward, meaning there were repeated "missed opportunities" to recognise there was a high risk of self-harm.

A chance to remove items, which could have been used by Mr Woods to self-harm, was also missed.

The trust also failed to give proper resuscitation with an "unacceptable delay" in getting oxygen to Mr Woods after he was found on the ward.

Mr Horstead concluded the failure to provide a resuscitation mask was a "gross failure" to provide basic medical care and amounted to neglect.

Following six days of evidence in May 2020, Mr Horstead concluded Mr Woods died by suicide contributed to by neglect.

Afterwards Mr Woods' family said there had been a "complete failure in providing Mick with even the most basic of care at a time when he was at his most vulnerable."

Chief executive of Essex Partnership University NHS Foundation Trust, Paul Scott, said: "Patient safety is our absolute priority and is at the forefront of everything we do at EPUT.

"Since 2020 we have continued to take action to ensure the safe staffing of our wards, improve patient observation practices, increase staff training and strengthen communication between wards."