South London and Maudsley NHS Foundation Trust

37 Prevention of Future Deaths reports name this organisation, 2013–2026. Every report below links to the original on judiciary.uk.

Reports per year

20131
20142
20151
20163
20174
20184
20193
20202
2021
20221
20233
20245
20254
20262

Responses published

29 of 37 reports (78%) have at least one response published on judiciary.uk.

For reports written in the same years, 77% of all PFD reports in the corpus have a published response — so this page is in line with the corpus rate — the difference is within what chance alone would produce for this few reports.

This is not a reply rate. It counts responses published against the report by anyone — the organisation named here, a government department, a regulator or another body — because most response letters do not identify their author in a form that can be resolved reliably. A report with no response listed does not mean nobody replied: publication is at the discretion of the Chief Coroner's office, is often delayed, and was far less consistent in the corpus's early years. Treat a low figure as a prompt to read the reports, not as a finding about this organisation.

Coroner categories

Suicide (from 2015) 5Hospital Death (Clinical Procedures and medical management) related deaths 4Mental Health related deaths 3Community health care and emergency services related deaths | Hospital Death (Clinical Procedures and medical management) related deaths 1Mental Health related deaths; Suicide (from 2015) 1Child Death (from 2015); Hospital Death (Clinical Procedures and medical management) related deaths 1Emergency Services related deaths | Mental Health related deaths 1State Custody related deaths 1Hospital Death (Clinical Procedures and medical management) related deaths; Police related deaths 1Suicide (from 2015); State Custody related deaths | Mental Health related deaths | Hospital Death (Clinical Procedures and medical management) related deaths 1Hospital Death (Clinical Procedures and medical management) related deaths; Child Death (from 2015) 1Alcohol, drug and medication related deaths; Hospital Death (Clinical Procedures and medical management) related deaths 1

Coroners who wrote them

All reports

DateDeceasedCategoryCoronerResponse
24 Mar 2026Robert DaySuicide (from 2015)Ian PotterHome Office, DHSC Department for Womens Health and Mental Health, Kent and Medway Mental Health NHS Trustsource
1 Feb 2026Simon MossSuicide (from 2015)Xavier MooyaartNHS Englandsource
25 Nov 2025Andrew McClearyAlcohol, drug and medication relation death | Police related death | Community health care and emergency services related deathsEmma WhittingBedfordshire Policesource
15 Oct 2025Tony DuncanSuicide (from 2015) | Mental Health related deathsAlison HewittSouth London and Maudsley NHS Foundation Trustsource
19 Sep 2025Luke ChattertonAlcohol, drug and medication related deathAndrew Harrisnone publishedsource
7 Apr 2025Christopher McDonaldMental Health related deaths | Suicide (from 2015)Sian ReevesSouth London and Maudsley NHS Foundation Trustsource
25 Oct 2024Michael CranePolice related deaths | Mental Health related deaths | Care Home Health related deathsIan PotterMetropolitan Police Service, Prime Lifesource
27 Jun 2024Emily CollishawAlcohol, drug and medication related deathsAndrew HarrisNHS England, Ministry of Housing Communities Local Governments, DHSCsource
10 Jun 2024Sailor CourtSuicide (from 2015) | Child Death (from 2015)Sebastian NaughtonNHS England, DHSCsource
17 May 2024Jada MonojaSuicide (from 2015)Xavier MooyaartDHSC, NHS England, South London and Maudsley NHS Trustsource
25 Mar 2024Jacqueline CobainRailway related deaths | Suicide (from 2015)Michelle HasteSouth London and Maudsley NHS Foundation Trustsource
26 May 2023Conrad ColsonSuicide (from 2015)Nadia PersaudNHS England, South London and Maudsley NHS Foundation Trust, Aesthetic Dermatology, NELFTsource
24 Apr 2023Samuel HowesChild Death (from 2015) | Suicide (from 2015) | Railway related deathsJohn TaylorDepartment of Health and Social Care, NHS England 1source
18 Apr 2023Patrick SoamesSuicide (from 2015)Edmund Grittnone publishedsource
28 May 2022Hayley SmithOther related deathsCatherine Woodnone publishedsource
18 Aug 2020Viktor Scott-BrownSuicide; Community healthcare related deathsOliver LongstaffOxleas NHS Foundation Trust, Tees Esk and Wear Valleys NHS Foundation Trust Redacted 1, BNF Publications, NICEsource
10 Feb 2020Kerry AldridgeRailway related deaths; Suicide (from 2015); Mental Health related deathsAndrew HarrisSouth London and Maudsley NHS Foundationsource
24 Sep 2019Rebecca MarshallHospital Death (Clinical Procedures and medical management) related deaths; Suicide (from 2015)Briony BallardKent and Medway NHS Trustsource
29 Jul 2019Alex BlakeAlcohol, drug and medication related deaths; Hospital Death (Clinical Procedures and medical management) related deathsAndrew HarrisNHS Professionals Redacted 1, NMCsource
15 Jan 2019Catherine HortonMental Health related deathsSarah Ormond-WalsheMetropolitan Policesource
5 Nov 2018REDACTEDCommunity health care | Suicide (from 2015)Henrietta Hill QCGMC to Prevention of future deaths reportsource
24 May 2018Rosalind FlettMental Health related deathsSelena Lynchnone publishedsource
8 May 2018William DickensHospital Death (Clinical Procedures and medical management) related deathsHenrietta Hill QCSouth London Maudsley NHS Trustsource
27 Apr 2018Katy RobertsHospital Death (Clinical Procedures and medical management) related deaths; Child Death (from 2015)L TagliaviniSouth London and Maudsleysource
28 Jul 2017Sarah ReedSuicide (from 2015); State Custody related deaths | Mental Health related deaths | Hospital Death (Clinical Procedures and medical management) related deathsSir Peter Thornton QCCNWL NHS Trust, NOMSsource
28 Jun 2017Olaseni LewisHospital Death (Clinical Procedures and medical management) related deaths; Police related deathsSelena LynchMetropolitan Police, South London and Maudsley NHS Trustsource
31 May 2017Jonathan PalmerState Custody related deathsKevin McLoughlinHM Prison Probation Servicesource
28 May 2017Jamie PashleyHospital Death (Clinical Procedures and medical management) related deathsJulian MorrisKings College Hospital NHS Trustsource
5 Dec 2016Christopher BrennanChild Death (from 2015); Hospital Death (Clinical Procedures and medical management) related deathsSelena Lynchnone publishedsource
14 Jun 2016Christina O’BrienMental Health related deaths; Suicide (from 2015)Christopher Williamsnone publishedsource
20 Jan 2016Faiza AhmedEmergency Services related deaths | Mental Health related deathsMary Hassellthe Department of work and Pensions, the Metropolitan Police, the London Ambulance Servicesource
9 Jul 2015Michael GeorgeHospital Death (Clinical Procedures and medical management) related deathsAndrew HarrisSouth London and Maudsley NHS Trustsource
31 Oct 2014Christopher AjayiCommunity health care and emergency services related deaths | Hospital Death (Clinical Procedures and medical management) related deathsSarah Ormond-WalsheSunrise Senior Living, South London and Maudsley NHS Trustsource
6 Mar 2014Natasha RaghooHospital Death (Clinical Procedures and medical management) related deathsDavid SkippPartnership in Caresource
20 Aug 2013Nicola MatthewsMental Health related deathsDr R N Palmernone publishedsource
date unknownMina Topley-BirdHospital Death (Clinical Procedures and medical management) related deaths | Mental Health related deaths | Suicide (from 2015)James ThompsonWest Park Hospital, Dept. of Health and Social Caresource
24/04/26Edward MuwangaPaul Rogersnone publishedsource

These counts are a floor, not a total. A report is listed here only when it names the organisation in text our pipeline could read; scanned reports with poor OCR, and reports that name only a hospital site or an individual, are missed. Always check the source report.

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