Hospital 'deeply sorry' after 12-year-old's death

A hospital boss has apologised "unreservedly" after the death of a 12-year-old girl which led a coroner to raise concerns about the "discrimination of disabled children".

Rose Harfleet died at Royal Surrey County Hospital, in Guildford, on 30 January 2024, having attended its emergency department the day before with abdominal pain and vomiting.

Assistant coroner for Surrey, Karen Henderson, said in a recent report that there was a failure of the medical and nursing staff to appreciate Rose was clinically deteriorating.

Louise Stead, chief executive of Royal Surrey NHS Foundation Trust, apologised to the family for the "failures in her care" and said she was "deeply sorry for their devastating experience".

She added: "I appreciate that no words or actions can bring Rose back or reduce the grief felt by her loved ones."

She said the trust had carried out a thorough investigation into the case, implemented several areas of learning and that practices would be further reviewed in light of the coroner's recommendations.

The coroner said Rose, who from birth was diagnosed with mosaic trisomy 17 with global developmental delay, was "wholly reliant on her mother to advocate on her behalf".

But she said at the hospital no history was taken from Rose's mother and that the severity of her signs and symptoms were underestimated.

She said poor clinical decisions contributed to Rose's death.

"This gives rise to a concern that by not listening to parents or guardians as a matter of course leads to discrimination of disabled children," she added.

Her report also raised concerns about a lack of national or local guidance to assist hospital staff to "appropriately manage patients such as Rose".

Other bodies also sent the report were NHS England, the Department of Health and Social Care (DHSC), the Care Quality Commission, the Royal College of Paediatrics and the Royal College of Emergency Medicine (RCEM).

President of the RCEM, Dr Adrian Boyle, said the report was "heartbreaking to read" but that it was "vital" to examine what happened, "learn from it, and do all we can to prevent anything similar happening in the future".

He added: "Everyone at RCEM extends our deepest sympathies and condolences to Rose's family and friends."

He said patients with learning disabilities – especially children – were a group at high risk of missed diagnosis and treatment.

The college had been working to raise awareness, and to improve the quality of care patients with learning disabilities received while in the emergency department, he added.

A DHSC spokesperson said: "Our deepest sympathies are with Rose's family and friends."

They added that parents' voices "must be heard when it comes to their children" and that under the NHS constitution parents have a right to be involved in the planning and decision-making around care.

An NHS spokesperson said it was "carefully considering" the coroner's report.

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