Woman died after she ran from Tesco on 'accompanied' leave from hospital

A vulnerable woman suffering from mental health issues died after she 'absconded' from a supermarket while on 'accompanied leave' with a support worker.

Hayley Cowan, 29, who was detained under the Mental Health Act, fled when both she and her support worker went to the toilet at a nearby Tesco store in Prestwich, Bury in Greate Manchester. She was found dead the next day after using drugs at a friend's house, according to a report.

A coroner has highlighted a 'lack of consistency' in how 'accompanied leave' and 'escorted leave' are defined. Consequently, she has written to the Department of Health and Social Care and Home Secretary James Cleverly to 'prevent future deaths'.

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Ms Cowan died on June 4, 2022. An inquest jury at Rochdale Coroner's Court ruled that she died as a result of misadventure, with the medical cause of death confirmed as an 'adverse event arising out of mixed drug use'.

The recently published Prevention of Future Deaths report by Manchester North coroner Joanne Kearsley revealed that Ms Cowan had been detained under the Mental Health Act since July 2021, following an incident where she set fire to her flat. She had a 'long history of involvement with mental health services' and had previously been detained, reports the MEN.

Diagnosed with paranoid schizophrenia and ADHD, Ms Cowan was described in the report as a risk to herself and others, and also had a 'long history of illicit drug use'.

She was detained at the Edenfield unit within Prestwich Hospital, run by Greater Manchester Mental Health and Social Care Trust. After responding well to anti-psychotic medication, the report reveals Ms Cowan was granted leave.

"There were times when her leave was escorted and following progress it was, on occasions, unescorted," Ms Kearsley said.

"Her leave also progressed from being on the hospital grounds to the local Tesco store opposite and at times, into the local village. There had been at least two occasions when Hayley had absconded and run off from the staff with her. She had taken drugs and then returned to the hospital."

"At all times she was considered to be at risk of absconding, which was driven by her urge to use drugs. On the June 3, 2022, Hayley was granted accompanied leave with a support worker to the local Tesco store. Both Hayley and the support worker needed to use the bathroom and during this time Hayley absconded. She was found deceased the following day, having used drugs at a friend's house where she had gone to."

The inquest heard: "There was no guidance to staff as to what to do should they need to use the bathroom. There was guidance given as to what to do should a patient need to use the bathroom, therefore being out of sight."

The coroner raised serious concerns during the inquest, as Ms Kearsley highlighted in her report: "The court heard evidence as to the lack of consistency and clarity for mental health trusts in understanding and defining how section 17 leave should be conducted."

"Guidance as to whether a patient should remain in 'eye-line' or at a 'reasonable distance' is inconsistent. The Mental Health Act Codes of Practice, guidance from the Ministry of Justice to forensic providers and trust policy are inconsistent. This is particularly the case in considering whether a patient needs to be within 'eyeline' or a 'reasonable distance' when on leave."

"There is also no guidance as to how trusts instruct staff on practical matters such as what to do if the staff member needs the bathroom whilst out with a patient."

Expressing condolences to Ms Cowan's loved ones, the Department of Health and Social Care stated it takes every Prevention of Future Death Report seriously and aims to learn from them. The MEN has reached out to Greater Manchester Mental Health and Social Care Trust for a statement.

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