Top health officials have vowed to work nationally to improve guidelines around nasgastric tubes, following the deaths of two Cumbrian patients.

Professor Sir Bruce Keogh, national medical director of NHS England, says he is "committed" to ensuring that errors which led to the deaths at Cumbria's two main hospitals do not occur elsewhere.

He and his team have pledged to carry out a number of actions to improve the safe practice of nasogastric tubes within the NHS, after being contacted by David Roberts, senior coroner for Cumbria.

Mr Roberts wrote to Sir Bruce - as well as Stephen Eames, chief executive of the North Cumbria University Hospitals NHS Trust, and health minister Philip Dunne - following an inquest into the deaths of Michael Parke, from Cockermouth, and Amanda Coulthard, from Penrith.

Mr Parke died at at the West Cumberland Hospital in Whitehaven in December 2012, while Mrs Coulthard died at Carlisle’s Cumberland Infirmary in April 2015.

Both were a result of aspiration pneumonia - caused after nasogastric tubes were wrongly inserted into their lungs and then the tubes were used to try and feed the patients.

At the conclusion of the inquest, Mr Roberts outlined steps that should be taken by the trust, health secretary Jeremy Hunt and NHS England.

Mr Roberts called on the health secretary and NHS England to ensure a 2011 National Patient Safety Alert (NPSA) is "properly implemented nationally", stating that the evidence put before him during the inquest was that it had not been.

In response, Sir Bruce said the monitoring of a trust's compliance to a patient safety alert sits with the Care Quality Commission (CQC), but added: "However I am trying to ensure that this situation does not occur."

Sir Bruce's letter outlined actions he intended his team should carry out as "a very minimum".

These included:

*Working closely with NHS Improvement to further support their patient safety messaging for nasogastric tubes.

*Working through the internal Quality Assurance Group to ensure the issue remains high on the agenda and is communicated to all parts of NHS England.

*Coordinating communications across NHS regulators, including writing directly to medical and nursing directors within trusts and within Clinical Commissioning Groups (CCGs) to ensure all are reminded of the dangers posed by misplaced and unchecked nasogastric tubes.

*Exploring with Health Education England (HEE) where training could be improved and securely embedded within all relevant staff curricula.

*Exploring with Medicines and Healthcare products Regulation Authority (MHRA) and where possible with suppliers, to ascertain whether the safety messaging requirement on packaging is adequate or whether additional, or alternative, messaging should be incorporated so as to try to prevent future deaths.

Sir Bruce added: "I shall also liaise with the Department of Health in relation to the use of nasogastric tubes so that the NHS minimises the risk of future deaths in this area of healthcare."