Menu & Search

A young woman with serious mental health problems died of suicide after a series of major errors by the NHS trust that was looking after her, a jury at an inquest into her death has found.

Sophie Payne, 22, died in July 2017 at the Rose ward of Queen Mary hospital in Roehampton, south-west London.

The jury highlighted how, despite the fact Payne had apparently tried to take her own life earlier that day, staff did not remove from her room an item she had used in that suicide attempt and went on to use that evening.

“[The item] not being removed from Sophie’s room was a contributing factor or cause of Sophie’s death,” the jury said in a seven-page record of the inquest at Westminster coroner’s court in central London.

The jury argued the item should also have been removed because Payne had used it in four previous apparent suicide attempts during her 24 days in the unit. Staff did not file an incident report about any of those four episodes.

The jury said: “There were failing[s] in incident reporting which contributed to Sophie’s death. There were four incidents in which [the item] was found … in Sophie’s mouth. No incident report was generated.

“[The item in her] mouth posed a ‘significant risk’, yet on four occasions [was] not reported to risk assessment.”

The jury said this led to a failure in risk assessment that separately contributed to Payne’s death.

It also found that her care plan was not updated properly after the suicide attempts, a breach of the guidelines drawn up by the South West London and St George’s mental health NHS trust (SWLSTG), which runs the hospital.

The jury said the trust’s failure to hold a multi-professional review meeting after Payne’s persistent self-harm was the fifth mistake that contributed to her death.

Deborah Coles, the director of the charity Inquest, which supported Payne’s family, said: “We are increasingly concerned about the repeated patterns of failure of vulnerable women like Sophie in secure mental health care. All the warning signs were there but yet again she was failed by the very systems that were meant to keep her safe.”

Start Your Claim Today Call 01904 556600
Tell us about your case

Just send us a little bit about yourself and your claim and we will respond within 24 hours.


Get In Touch
Latest News

Citizens Have Voiced Concern Over Insufficient Bed Numbers At York’s New Mental Health Hospital

A new mental health hospital is being built in York after the loss of Bootham Park Hospital in 2015. However, concerns have emerged that […]

Read More

Former Nurse Calls For Wider Inquiry At Southmead Hospital After Fears Of Huge Cervical Cancer Misdiagnosis Scandal

A terminally-ill patient suffering from cervical cancer recorded a video calling for better cervical screening at Southmead Hospital after doctors failed to diagnose her […]

Read More

Bursary Changes Result In Huge Nursing Degree Application Fall Of 15,000

Despite a small increase from last year, the latest UCAS figures show nursing degree applications in England have fallen over 30% since 2016, the […]

Read More

Take a look back through our complete news archive

Follow us on Twitter

UCAS figures have shown a huge downfall in nursing degree applications after controversial bursary changes.
https://t.co/9sz6qWlc36

Who are we? Get to know our CEO, Neil Fearn, on our handy website guide. Neil has been working in the clinical negligence industry for 25 years and specialises in claims involving complex and serious injuries mainly arising out of Obstetric Care
https://t.co/FFy5JDIhPF

Load More...