Health groups 'missed signs' in Powys Kaylea Titford death

A report looking into the death of the Newtown teenager, whose parents, Alun Titford and Sarah Lloyd-Jones, were ja for gross negligent manslaughter last year.

The report, written by Dr Donna Peach, found “information sharing and communication between the English hospitals, the local hospital, the GP and the parents could have been more robust to establish why Kaylea was not brought to appointments.

“That could have been explored further to identify any safeguarding concerns or offer any further support to the family, particularly concerning the distance the family had to travel to appointments.”

The report also found that “there was practice knowledge that Kaylea was on an increasing weight trajectory with limited physical ability to burn calories. However, there was an absence of oversight and review of her weight management akin to her changing needs and disability."

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In the report it finds multiple health professionals missed concerns including a paediatrician wrote to the school nursing service to request her weight and height be recorded but found that there was “no written evidence of that request” within Kaylea’s health records.

As well as this in September 2019, paediatric urology decided not to offer further appointments after she “was not brought to five previous appointments”. However, that decision was later reversed, and Kaylea was seen virtually in May 2020.

The last occasion Kaylea was seen in person by a health professional took place in early February 2020 as a follow-up appointment following treatment for an ear infection six weeks earlier.

She was not brought to a follow-up appointment and they found there was “no evidence the Powys Teaching Health Board’s Was Not Brought Policy was followed on that occasion”.

Health authorities were criticised for there being “a void in current provision for children and their parents with identified chronic disabilities who are not subject to a formal care and support plan to ensure periodic reassessment of changing needs.”

They also found that there was evidence Kaylea and her parents received advice regarding the initial treatment for lymphoedema, a chronic condition which requires wearing compression garments, taking good care of skin, moving and exercising regularly, having a healthy diet and lifestyle, and using specialised massage techniques and “the condition was noted to be improving”. However, there was “no evidence” of her being offered a follow-up appointment.

A number of recommendations were made in the report for Powys Teaching Health Board including “to further embed the “Was Not Brought policy” and to consider cross-border involvement if a child misses an appointment.

They have also been advised “to raise awareness, implement and embed the updated All Wales Weight Management Pathway for children, young people and families published by Welsh Government in 2021”.

They have also been advised to “clarify or create a protocol regarding the regular monitoring of the skin condition of children with complex health needs and mobility limitations, including spina bifida.”