Inquest GP’s faith in NHS ‘shattered’ by daughter’s death
AYOUNG woman was found dead in her home after taking heroin while on “a period of short leave” from hospital. Evangeline Wilson was last seen alive on the evening of Saturday, July 9, 2022, but was found dead by police carrying out a welfare check in her living room the following day.
An inquest at Ashton Court ruled that the 24-year-old – who had a long history of issues with her mental health – died of the toxic effects of morphine after taking heroin, but that her intention at the time of taking the drugs was not known. Inquest records show she was admitted to Cassel Hospital on June 21, 2022, as a voluntary patient for a residential programme of therapy.
However, she was sent home on a “short period of leave” on July 8 after consuming alcohol at the hospital, according to the inquest records. Ms Wilson - who was living in the Greenbank area of Bristol at the time of her death - has been described by her family as joyful, mischievous and exuberant, as well as a talented artist who had accepted a place to study fine art at a prestigious art school in London.
Dr Nick Wilson, Evie’s father, a GP, said: “We wholeheartedly believe that Evie’s death was entirely avoidable.
“Her family and friends are left wondering how this could have been allowed to happen. The annual report on UK deaths of in-patient psychiatry patients tells us that half of these deaths occur when patients are on agreed leave and that day three of leave is the day of highest risk.
“Avon and Wiltshire Mental Health Trust NHS Trust (AWP) were supposed to call her over that weekend on both her second and third day of leave. These phone calls never happened. There was therefore nothing in place to protect her from that risk over that weekend. Her in-patient unit, Cassel Hospital part of West London NHS Trust, chose not to offer any support whatsoever over that weekend.
“There is an enormous amount of information that has been made available to us, only now because Evie is dead. Our faith in a professional, caring and effective healthcare system has been shattered and we both speak as people who have worked for the NHS. I continue to work for the NHS as a GP. There is much more to be said in another forum.”
A spokesperson for Avon and Wiltshire Mental Health Partnership NHS Trust said: “This is a tragic case and we offer our deepest condolences to Evangeline’s family and friends. We are committed to learning the lessons from Evangeline’s death and addressing the issues raised during the inquest and following our own internal investigations.”
A statement from West London NHS Trust added: “We strive to give the best possible care to all our patients and have completed a serious incident review jointly with mental health services in the patient’s local area. In this review we have identified areas to improve our care and treatment and are implementing these to reduce the risk of tragic incidents like this happening again.”