The Adult Critical Care Networks of England, Wales and Northern Ireland have produced a coordinated response in acknowledgment of the findings of two Regulation 28 coroner reports published in January 2017 regarding specialist care and implications relating to immediate availability of Intensive Care level 3 provision. This response references the letter on the subject from Sir Bruce Keogh of 27 February 2017 (see below), which highlights the key features and concerns raised by the Regulation 28 reports. We would like to thank the North of England Critical Care Network for writing the original Memorandum of Understanding upon which this is based and for allowing its further development into this national memorandum by the collaborative working structure of our Networks.

In summary, there have been two cases in the UK when at coroner’s inquest it was stated there were delays in transferring patients to specialist neurosurgical units for immediate lifesaving neurosurgery. These delays were judged to have adversely affected outcome. One of the contributing factors cited was a lack of available intensive care beds at the receiving specialist centre.