A New Year and a new “Badge of Dishonour”.

From 1 January 2025, the Chief Coroner for England and Wales, Her Honour Judge Alexia Durran has introduced a new policy aimed at increasing accountability for organisations that fail to respond to Prevention of Future Death (PFD) reports. These reports are issued, pursuant to Regulation 28 of the Coroners (Investigations) Rules 2013, to organisations who have the “power” to take remedial action when a Coroner identifies concerns during an inquest that could lead to future deaths.

Under the new policy, the Chief Coroner will publicly list organisations on the Judiciary website that do not respond to PFD reports within the required 56-day period. As Coroners lack legal powers to enforce a response, the aim of the policy is to impose a “Badge of Dishonour” to organisations that fail to respond. This could indicate that an organisation is not taking the Coroner’s concerns seriously and a lack of engagement carries a reputational risk. It may also lead to a loss of public confidence particularly if there becomes a pattern of the same organisations not responding.

Although this is far from enforcement powers, clearly the Chief Coroner is keen to strengthen the PFD regime which Coroners have been seeking for some time. It also echoes one of the House of Lords recommendations on Public Inquiries (see our article here) which suggested a formation of a new, joint select committee to monitor the publication of Public Inquiry recommendations and hold relevant organisations to account to check implementation. 

If your organisation would like to discuss the content of this article or requires assistance in responding to a PFD report please do not hesitate to contact our Charlotte Whittaker or Jordan Coulton.