Lack of NHS information sharing contributed to woman’s death

Chloe Ellis died after vital information about her condition was not shared between NHS 111 and the A&E department at Dewsbury and District Hospital.

Chloe, 29, experienced breathlessness and pain in her chest and back, and an NHS 111 assessment identified a suspected pulmonary embolism blood clot.

While she was advised to go to A&E, this risk assessment was not communicated to Chloe, nor was it made available to medics at the hospital.

She was misdiagnosed with a respiratory infection and was discharged – but three days later collapsed at home and died only hours later.

Her cause of death was pulmonary embolism, with the underlying cause linked to endometriosis treated with an oral contraceptive pill – information which was shared in her initial NHS 111 assessment.

At her inquest, Coroner Oliver Longstaff concluded that failure to obtain Chloe’s full medical history when she went to A&E, as well as the inaccessibility of her 111 assessment, contributed to her death.

He has written to West Yorkshire Integrated Care Board (ICB) with a Prevention of Future Deaths Report, raising concerns over the lack of accessibility of 111 assessments, something which varies between NHS Trusts nationally.

Chloe’s family are now campaigning for it to be standard practice throughout the NHS for such assessments to be routinely shared when someone attends A&E.

Law firm Slater and Gordon supports families nationally who have suffered as a result of poor standards of care and medical negligence.

“This is absolutely tragic and the fact that Chloe’s medical information and assessment carried out by telephone was not relayed to the treating team has led to the most devastating consequences,” says Jodie Cook, senior associate at Slater and Gordon in Yorkshire.

“It appears nonsensical that information gathered through 111 would not be shared and cannot be accessed in some NHS Trust areas, and this could lead to further avoidable tragedies. We would echo Chloe’s family’s call for NHS 111 assessments to be shared with A&E routinely throughout the country, in a move that would undoubtedly help save lives.”