An assistant coroner has warned a hospital trust that it must take urgent action to prevent future deaths of patients under its care.
The warning from Rachel Galloway comes in the wake of the death of pensioner Patrick Clifford, who died following an unsupervised fall while he was a patient at Royal Blackburn Hospital.
Although Ms Galloway said she did not believe Mr Clifford's time under the care of the trust contributed to his death, she did warn that there were opportunities missed.
In a report sent to the trust, Ms Galloway highlighted concerns about hospital staff's understanding of policy when it comes to falls, difficulties transferring X-ray images to other hospitals, and the radiology department at the Royal Blackburn Hospital refusing to carry out the specific type of X-ray which Mr Clifford needed.
Responding to the report, Dr Damian Riley, executive medical director at the trust, said:
"Our thoughts are with the family and friends of Mr Clifford and we appreciate this is a very difficult time for them.
"Following Mr Clifford's death, an investigation was carried out and the findings shared with the Coroner, the family and the clinical staff involved in Mr Clifford's care.
"The Coroner has received assurance that Trust processes were updated and recommendations identified during the investigation have been implemented."
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