If the Coroner feels that evidence gives rise to a concern that circumstances creating a risk of other deaths will occur or continue to exist, he/she may make a Rule 43 report which is sent to the organisation that has responsibility for the circumstances.
A recipient of a Rule 43 report must send a written response within 56 days to the Ministry of Justice.
The Coroner has sent a Rule 43 to the following organisation/s ...
MENTAL HEALTH RELATED DEATHS
DORSET PRIMARY CARE TRUST
Recommendation - Published May 2012
To consider a review of risk assessments: the adequacy of treatment when there is a failure to improve: the need for an assessment by a psychiatrist: the failure to take account of concerns expressed by the GP: and the adequacy of 'improving access to psychiatric therapy'.