The public inquiry into the Nottingham attacks opened on 23 February with a commitment to establish a full and detailed account of the events leading up to 13 June 2023 and to make recommendations aimed at preventing similar tragedies in future.
Opening the first day of hearings, the Chair acknowledged the “deeply emotional and momentous day” for those closest to the victims and survivors. The inquiry has already gathered and analysed a substantial body of evidence and will now hear oral testimony from more than 100 witnesses over a four-month period. In addition to live evidence, thousands of documents and written statements will be considered as part of the investigation.
The inquiry is examining the actions of Valdo Calocane, referred to throughout proceedings as VC, and the conduct of agencies and individuals who had contact with him prior to the attacks. It will consider what was done, what could or should have been done, and the effects of key actions, omissions and decisions. The Chair made clear that the inquiry will hear all evidence in one continuous set of hearings to avoid further delay for families and survivors.
Counsel to the inquiry, Rachel Langdale KC, set out the factual background to the attacks. In the early hours of 13 June 2023, Barney Webber and Grace O’Malley-Kumar, both 19 and students at the University of Nottingham, were fatally stabbed on Ilkeston Road. Later that morning, Ian Coates was fatally attacked on Magdala Road. Calocane then used Mr Coates’ van to deliberately drive into pedestrians in the city centre, seriously injuring Wayne Birkett and Sharon Miller, and injuring Marcin Gawronski.
In November 2023, Calocane pleaded guilty to three counts of manslaughter by reason of diminished responsibility and three counts of attempted murder. On 25 January 2024 he was made subject to a hospital order and restriction order under sections 37 and 41 of the Mental Health Act 1983. The restriction order means he cannot be discharged without the approval of the Secretary of State for Justice or a Mental Health Tribunal.
The inquiry’s terms of reference do not permit it to consider judicial decision-making or the reform of homicide law, which is currently under review by the Law Commission. However, it can examine the underlying factual material relating to psychiatric evidence and other matters known at the time of sentencing, as well as the adequacy of police and Crown Prosecution Service procedures and communications with families.
A central focus will be Calocane’s mental health history and the actions of Nottinghamshire Healthcare NHS Foundation Trust and other agencies before the attacks. The inquiry will consider multiple previous reviews, including investigations by the Care Quality Commission, NHS England’s independent homicide review, and inspections of the Crown Prosecution Service. Those reports identified themes including risk assessment, discharge planning, communication with families and agencies, and the management of medication and community treatment orders.
The Chair said the inquiry comes at what was described as an “inflection point”, with recent changes to the Mental Health Act, developments around a proposed Hillsborough duty of candour, and reforms affecting victims’ rights and policing. The inquiry will examine broader questions about how serious mental illness is understood and managed, how agencies share information, and how risks to the public are identified and addressed.
Evidence will include a detailed multi-agency timeline of Calocane’s interactions with health services, social services, the University of Nottingham, Nottinghamshire Police and Leicestershire Police between 2019 and June 2023. The inquiry will also hear from bereaved families and survivors in March.
The Chair said that while previous inquiries into homicides involving mental health patients had led to recommendations, there was a widely expressed desire for this inquiry to address both immediate and underlying causes and to produce recommendations capable of bringing about lasting change.
The inquiry is required to provide a final report with recommendations by May 2027.
