Action urged after murder accused starved to death

Officials need to take more action when prisoners refuse food and drink, a coroner has concluded, after a 78-year-old man who was charged with murder starved himself and died.

Surendra Patel, of Aqua Place, Rugby, Warwickshire, died at the Alexandra Hospital, Redditch, on 31 October 2024, while he was on remand at HMP Hewell after suffering an acute kidney injury.

A prevention of future deaths report detailed how he stopped eating between 21 and 26 October and lost a fifth of his body weight, following his arrest.

The assistant coroner for Worcestershire, James Puzey, wrote in his report that prison and healthcare staff at Hewell lacked awareness of a food refusal policy.

He recorded Patel's death as being from natural causes, contributed to by self-neglect through malnutrition.

The 78-year-old was arrested after a woman, also in her 70s, was found dead at a home in Aqua Place on 8 October 2024.

Following the 78-year-old's death, a prevention of future deaths report was commissioned after the inquest concluded on 10 March.

The document is issued by a coroner in England and Wales when an investigation reveals that action should be taken to prevent further, avoidable deaths.

Practice Plus Group is the health provider at the prison while the Midlands Partnership NHS Foundation Trust (MPFT) handles mental health and psychosocial substance misuse provisions.

In his report, Puzey said healthcare staff from both organisations had failed to:

• Recognise that a mental capacity assessment was required as soon as food refusal began
• Consider hospital transfer for prisoners severely weakened by weight loss
• Expedite full medical assessment by a senior healthcare professional
• Consider and advocate for family contact

He added prison staff at HMP Hewell, near Redditch, also failed to inform the next of kin of the prisoner's decision to refuse food or fluids and did not ask the prisoner whether such information should be shared

The report was sent to the Practice Plus Group, the Midlands Partnership NHS Foundation Trust, the government's Legal Department and two others whose information was redacted in the report.

Puzey concluded by writing: "In my opinion, action should be taken to prevent future deaths and you (and/or your organisation) have the power to take such action."

A spokesperson for the Ministry of Justice said: "We will carefully consider the findings of the Prison and Probation Ombudsman and the coroner and respond in due course."

An MPFT spokesperson said it "takes all matters of concern relating to care and treatment with the upmost seriousness".

They said: "Work is now taking place to review the coroner's report and implement appropriate action within the specified timeframe.

"Our thoughts remain with those impacted by this incident."

The BBC has also contacted Practice Plus Group for a comment.

All recipients of the report have until 5 May to respond to recommendations.

Correction 13 March: A previous version of this story stated Worcestershire Acute Hospitals NHS Trust had questions to answer over Surendra Patel's death. It has been updated to make clear the coroner was referring to Practice Plus Group and Midlands Partnership NHS Foundation Trust, and we have also changed the top image.

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