We saw yesterday in ‘Revisiting the “Midazolam Murders”‘ that in many institutions the infamous Liverpool Care Pathway (LCP) had been continued in all but name, even after it was scrapped in 2014 following complaints and public outrage. Nevertheless, the April 2020 NICE guideline NG163 brought back the LCP for COVID-19 patients suffering “breathlessness”.
This is a story about a medical inquest in a coroner’s court. They happen every day of the week. But this one has the potential to blow the whole of the end-of-life written and unwritten policy out of the water.
So far there have been three separate hearings for this inquest: in March, August and December 2025, and it’s not over yet.
Derek Dimmock, aged 86, was admitted to Royal Trinity Hospice in south London, on June 6th 2020 for gout treatment. Nevertheless, within three hours, a hospice doctor had assessed that he was “in the process of dying” and put him on a syringe driver (necessary for delivering intravenous drugs) and prescribed end-of-life drugs, including midazolam, alfentanil (for short-term pain relief) and oxycodone, a strong opioid.
Derek Dimmock quickly became comatose and died the following day.
Royal Trinity Hospice recorded his death as heart failure and claimed that his kidneys were failing. Convinced that he had died of an overdose of the drugs, the family demanded an inquest.
Admission to Royal Trinity Hospice
The day before admission Derek Dimmock was seen by a community nurse, who told the court he did not appear to be about to die and recalled that he was able to swallow when she gave him a cup of tea. On the day of admission, his wife also agreed that he did not appear to be on the verge of death. Similarly, the paramedics who transported him had earlier assessed him and reported that he was conscious and able to talk and drink.
On arrival at Royal Trinity Hospice, however, it is a completely different story. Two palliative care doctors said that Dimmock’s GP had told them that Dimmock’s wife and son thought he was “beginning to die”. This is denied by the family’s barrister, James Bogle KC, and in any case the family are not medical professionals.
As for Dimmock’s GP, he apparently could not appear as a witness owing to now being on long-term sick leave. He had prescribed midazolam for Dimmock without doing his own assessment of the patient, after another community nurse recommended “anticipatory medications” because she assessed that he was deteriorating. The GP’s notes do not mention that Derek Dimmock was near end of life.
The GP’s practice partner, called to give evidence, could not explain why Dimmock’s GP had not wanted to carry out his own assessment.
The hospice alleged that Derek Dimmock had agreed to an end-of-life protocol, but it was never signed and never seen by the family before his death. The family’s barrister told the coroner: “The family alleged as far back as 2021 that this is a false and fraudulent document so they should know they could not rely on it.”
Expert opinion on actual cause of death
Palliative care specialist Professor Sam Ahmedzai, whom we saw in yesterday’s piece giving an expert opinion on the LCFCPG report, gave evidence on behalf of the Dimmock family. He said that in his opinion, although Derek Dimmock had complex health needs, putting cause of death as heart failure “was misleading and incorrect”, as well as being “very unsatisfactory and, frankly, insulting”. He said the death certificate should have stated that he died of acute intoxication with the drugs administered by the hospice, as well as acute renal (kidney) failure aggravated by enforced dehydration.
In Professor Ahmedzai’s opinion, the midazolam doses given to Derek Dimmock were alarmingly doubled without any assessment from a doctor and were administered by a nurse with a single signature, whereas there should have been two nurse signatures. He also noted that the treatable gout and dehydration were not adequately addressed before end-of-life protocols were initiated. Derek’s wife said it became clear to her that her husband was being deprived of fluids and she did not believe a swallow test was carried out.
An NHS palliative care consultant, Dr Aparajita Das, appointed by the coroner as an independent expert, having heard the evidence of Professor Ahmedzai, asked whether the case should be discussed in a coroner’s court or as a broader public inquiry.
Professor Ahmedzai’s opinion was shared by health scientist Dr Kevin Corbett, a former palliative care nurse practitioner. He told the coroner: “You can live with heart disease for weeks, months or years.” He also challenged the use of midazolam and the application of NICE guideline NG163 in this case, pointing out that high doses of midazolam could hasten death by suppressing respiration, especially in non-terminal patients such as Derek Dimmock. He also questioned whether the hospice’s swift deployment of the syringe driver (necessary for administration of intravenous drugs) adhered to ethical standards, suggesting it may have caused an unnatural death.
A palliative care nurse admitted that the syringe driver was faulty and she had had to replace it, so she was unsure how much of the drug cocktail had been given. The hospice should have recorded in their controlled drugs book the number of milligrams left in the syringe driver once they removed it. The controlled drugs book is required by law to be kept for two years. However, despite knowing there was to be an inquest into the death, the hospice destroyed the book.
On this point, Professor Ahmedzai said: “It is very disturbing that you would destroy the drug book when there was an investigation going on. I am shocked about the record-keeping on these charts, and the fact that no one picked up on it. It is truly shocking for a specialist unit.”
Dr Corbett questioned much of the evidence presented by Royal Trinity Hospice, in particular:
- How could hospice staff have carried out a face-to-face assessment before Derek Dimmock even arrived at the hospice?
- The midazolam dose was unquantifiable because of the faulty syringe driver, the fact that it had to be replaced, the fact that the amount discarded was not recorded and the illegal destruction of the drugs book. He makes the point that: “Midazolam is a Schedule 3 controlled drug. It’s not just two paracetamol.” This was a serious medical error in the records.
At this point, the hospice’s counsel applied to the coroner to have Dr Corbett’s evidence excluded entirely because he was no longer practising. The request was denied but restrictions were placed on the topics on which he was permitted to comment.
As the Dimmock family’s counsel, James Bogle commented: “It would be hard to find a nurse in this country more qualified academically. He is probably one of the better qualified people in the country to be able to give that evidence.”
Missing witnesses and concerns about the coroner
We have already seen that Derek Dimmock’s GP, who prescribed the midazolam without assessing the patient, could not give evidence as he was on long term sick leave.
And during the final week of the inquest, two nurses who cared for Derek Dimmock were to be recalled but were suddenly ‘unavailable’, in spite of the court date having been set months earlier. The family’s barrister called the workplace of one, only to find that she was at work and could have attended.
Other witnesses were also absent or unavailable for cross-examination: one doctor had gone abroad and was therefore no longer under the jurisdiction of the coroner.
Finally, it appeared that the Royal Trinity Hospice Director, former chief executive of NICE, Sir Andrew Dillon, had resigned one day after the start of the inquest into Derek Dimmock’s death.
In the middle of the August 2025 hearing, the inquest was unexpectedly halted by the coroner moments after Dr Kevin Corbett had given his evidence.
Frustrated with the delays and lack reasons provided, Derek Dimmock’s son complained to the Chief Coroner. Maajid Nawaz reproduces the letter on his Substack, which states that Professor Ahmedzai was listed as giving his evidence that day. He was in the court, waiting to be called but that day’s session was ended, even though the coroner had earlier been claiming that court availability was at a premium. The court then sat empty for virtually the entire day.
The letter complains about this and other delays, which were causing the family additional anguish and distress, for which they held the coroner personally responsible.
It goes on to say that in the family’s opinion, the coroner had shown bias in favour of Royal Trinity Hospice throughout the whole of the inquest. He had “aggressively and almost contemptuously cross-examined Dr Corbett” and compared this to the “very friendly and smiley way he treated the hospice’s witnesses”. The letter claimed the coroner had also favoured counsel for the hospice over James Bogle, the family’s counsel, accusing the coroner of “chumminess” and “childish giggling” with the hospice’s counsel, which could clearly be heard on the court audio recordings. All this showed a clear sign of “disrespect for the role he is carrying out”.
Similar cases at Gosport Hospital
In his cross-examination, James Bogle revealed that Dr Wright, who was on duty the night that Derek Dimmock died on the ward, had previously carried out an audit of the deaths at Gosport War Memorial Hospital, where patients allegedly had their lives shortened through the use of opioids.
According to Sky News in September 2022, more than 450 elderly patients died between 1987 and 2001 after being given the powerful painkillers.
In October 2024, Sky News reported that police had identified 24 suspects and details had been passed to the Crown Prosecution Service.
Then in November 2025, the BBC reported that the police had decided that no charges would be brought against any individuals, as the cases “have not met the evidential test for criminal prosecution”. A further case had been dropped by the Crown Prosecution Service.
No mention of midazolam here, but the principle seems to be the same: automatic end of life pathway, insertion of syringe drivers, no patient consent, families kept in the dark etc.
It seems curious that Dr Wright, having seen what could go wrong at Gosport War Memorial Hospital, would not do her best to ensure that the problems were not repeated at Royal Trinity Hospice.
Further delays
The coroner advised the family that they would receive outstanding answers to questions put to court-appointed expert Dr Aparajita Das by the end of December 2025, that he would provide an update in January 2026 and hand down conclusions by February 2026. Then the family were told the conclusions had been postponed to March 2026. Despite numerous requests from the family to the court seeking updates, there has still been nothing.
Jacquie Deevoy describes the inquest as “a marathon of delays, absences and shocking revelations”. She posted a memento mori for Derek Dimmock on the sixth anniversary of his death last month, mentioning that the family were still waiting for the coroner to give his verdict on the inquest.
We owe our elderly and their families much better than this.
In researching this article I am indebted to the work of Sally Beck in the Conservative Woman (here, here, here), Jacquie Deevoy and Maajid Nawaz on Substack (here, here, here, here) and Rachel Roberts in the Epoch Times.
Dr Rachel Nicoll is a medical researcher, lecturer and writer. You can contact her here.
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The Hospice gave the cause of death as. “Heart failure”. The ultimate cause of every death, irrespective of any other factors, is when the heart stops
The Trinity Hospice is not a hospital. My brother died there in the terminal stage of cancer and the whole family was overwhelmed with the care he received there. Hospices are for the dying and also for respite. The whole thing sounds much more like a cock up caused by poor communication and the subsequent panic.
I don’t think this is unusual in hospitals,certainly if my experiences with my elderly father are anything to go by. Younger doctors often judge end of life to be approaching on slim evidence. Family members summoned when a simple urinary infection was eventually diagnosed and years of life followed.
Shocking. The headline says “hospital” but wasn’t this a hospice? Should he have been anywhere near a hospice if he wasn’t actually dying? That said, what were his underlying health conditions? Was he in fact more ill than is implied here?
The National Death Service strikes again. NICE produces a death protocol, quietly withdrawn after 20k deaths, doctors prescribed without seeing patients, nurses bunging patints full of drugs without even examing them, legal cover up with evidence lost. Delay until it’s forgotten.
I remember, here in Exmouth, Devon, during the early covid scamdemic, there was a number of people who died in a nursing home, who were given meds ordered by a doctor. The nursing home went on to blame the care home staff who administered the drugs prescribed by the doctor, for these deaths. During the scamdemic, things went on that affected the elderly, which have never been discussed out in the open. The UK is not the only country where this happened. Always have an advocate with you whenever you enter a hospital, always.
The NHS appears to have a great many “Dr Shipmans” who think it is their right to decide who may live and who will die.
The lesson to be learned is to keep yourself and your elderly relatives out of NHS Hospitals and/or Hospices … at least until they really are at death’s door.
The entire thing needs a thorough investigation, from Hancock down, to my mind the killing of the elderly is a planned cull, carried out by the NHS, and then covered up, it probably is still going on. I would warn anyone over 60 who has the misfortune to enter one of our hallowed NHS sites to check that they are not on a DNR, no matter how minor the injury, and to have an outsider check the drugs they are being given.
After all we have a Government that is desperate to bring in the State sponsored killing bill for the elderly and the less than perfect, and one which allows the killing of a full term baby up to the point of a millimetre of exit from the birth canal.
Government needs to reduce the Pension, the Welfare and the NHS bill, to my mind its a commercial calculation.
I looked up the hospice website. One doctor says: “Until I worked here I never knew how calm and lovely a hospice would be.” No wonder, if this is the treatment they are giving out to their residents.
Even allowing for there being two sides to every story this case appears to demonstrate medical negligence, and then a cover-up. No patients should be considered for end of life care until treatable disease has been firmly excluded. The conduct of the coroner’s court is inexplicable and appears equally reprehensible.
A patient of mine suffered in a similar way and I ended up making a formal complaint on behalf of the relatives against my own hospital. This was years ago. It seems nothing changes.
Hancock issued 2 million vials of the toxin Midazolam.
In LD 1 and 2; some 50K older people died behind closed doors.
Supposedly the Fake PCR test said they had Rona (same test was used for ‘HIV’).
DNR tags were applied to end of life cases.
This was a mass culling, not a mistake.
Oh, and we should add – every single death was remunerated. Every single test, exam, bed, care protocol paid for. Apparently the Communist Death Care System abhors profits – except it doesn’t as evidenced by the Rona scamdemic.
But, just think of how much IHT was accelerated to the Treasury.
And the pensions bill cut.
That’s my assumption …. and it’s also why they are still pushing the Covid and ‘flu jabs on as many people as possible.
Dead people don’t claim pensions.
It is okay to say corona.
The sooner medical care is returned to the competitive private sector the better.
People – who don’t understand it – badmouth US medical care system, but there a case like this would be a multi-million dollar law suit, and it wouldn’t just be the hospital is would be very one who went near the patient.
Knowing you are on the hook for potential damages whether doctor, nurse, hospital administrator, hospital,owners – even companies supplying equipment or drugs can be sued, is a big incentive not to screw up, be negligent, or misbehave or for hospitals not to employ incompetent staff.
At the end of these enquiries what will be the outcome? Who will go to gaol? Who will be sued, made to pay? Nobody. So on to next time.
When people know they will never personally pay the cost and consequences of their actions or failure, then it’s a case of moral hazard – nothing to limit their behaviour, or stop them.
There are many models and all are better than NHS. The German and French systems of health care and the Swiss system of social benefits are much more efficient than ours.
The American healthcare system is hardly one to admire. Doctors practice defensively due to litigation. Go in for a hang nail and you will get a mri scan, full body, cardiac work up, full blood counts, you name it the doc will run down a list of tests to be done. Everybody makes a buck and there is no way in hell the doc will ever be sued.
Isn’t the profit motive a great thing? What would you rather have, everybody being over-thorough and making a buck or nobody giving a shit?
I lived in France which has a mostly private provision setvice, with the State system only part paying, where most had private top-up insurance to take care of what the State doesn’t cover.
And yes everyone made a buck (in fact €), and it is a feature of private provision that there is a tendency to over-test, over-treat. Providers are only paid if they treat patients – waiting lists were not profitable.
And the elderly are particularly well taken care of because since most diseases are diseases of advancing age, elderly patients are regarded as Cash Machines for the providers, their death cuts off the money supply, unlike here where they are a drain on budgets, nuisances – so just hurry up and die would you!
They knew there would be an inquest so they destroyed the log book? Bang to rights, surely? If this was not deliberate in order to add him to the Convid stats, then there must at least be a case for severe medical malpractice and its subsequent cover-up?
When the BP oil rig in the Mexican (now American) Gulf blew up one of the main contractors realised they would be held largely to account for the accident. They wilfully destroyed all papers in the knowledge the US courts could only apply a penalty per page and it was cheaper to pay a few tens of millions of dollars than take the hit for their faults. BP suffered for the error and for many deceitful claims.
In this case the officers and trustees who disposed of the records or failed to check they were being retained should be fired with prejudice and held accountable for contempt.
I am well and truly fed up with public bodies and tax payer funder people of all ranks causing such distress and error with no accountability. What is even worse is they know the system under Uniparty will always let them off.
It is okay to say covid.
Every day I’m astounded again by the incompetence and lack of humanity of public organisations in this country. We need to start again.
In this case not only the medical establishment but apparently also the coroner.
That’s murder.