A coroner has ruled a Rainham man died from natural causes after considering health-service shortfalls identified at an inquest and in a serious incident report.

Phillip Marshall, 62, was found dead at his home more than 24 hours after calling the out-of-hours non-emergency service 111, complaining of sudden severe chest pains.

He died from bronchial pneumonia.

A switchboard health adviser referred his case to Medocc, which deals with urgent medical problems when GP surgeries are closed, with the instruction to call him within an hour.

After four unsuccessful attempts to reach him on his mobile, Medocc boss Dr Simon Collins closed the case, fewer that three hours after receiving the email from 111, which is run by the South East Coast Ambulance Service (Secamb).

Medocc was not told Mr Marshall had nobody with him at his home in Middleton Close.

The inquest heard Dr Collins “assumed” the retired draftsman was not alone.

He also took his age into account, feeling that if he were 92 he would have been more of a concern.

The incident report considered the health adviser’s questioning technique, saying she wrongly bunched two questions into one.

John O’Sullivan, for Secamb, told an earlier hearing, the adviser should have “stuck to the script” set out by the NHS.

But assistant coroner Katrina Hepburn concluded these factors “on the balance of probabilities” did not contribute to Mr Marshalls’s death.

She could not determine the time he passed away but deemed his condition must have deteriorated quickly after he made his initial call at about 7.45pm on February 10.

He was pronounced dead at his home by paramedics at about 8.50pm the following day.

Mrs Hepburn noted Mr Marshall chose to call the non-emergency number rather than dial 999.

She said the two services had put improvements in place.

"We have contributed fully and in an open and transparent manner with the coroner in relation to all the issues raised" - Secamb

Mrs Hepburn concluded that the cause of death was natural, and did not intend to write a report to either 111 or Medocc.

At the previous hearing, Phillip Marshall’s former wife, Sharon Marshall, told the court: “I don’t feel the correct procedures were followed.

"I feel there were failings by both 111 and Medocc.”

Representing the family, Mrs Marshall said a report of “sudden chest pains” should have prompted an ambulance to have been called.

After the inquest, John O’Sullivan, on behalf of Secamb, said: “Our thoughts are with Mr Marshall’s family for their loss.

"We have contributed fully and in an open and transparent manner with the coroner in relation to all the issues raised.

"We have also listened to the family’s feedback and acted accordingly.

“This work includes completing the action plan that arose from our investigation, which was accepted and signed off by our commissioners.

"We have worked closely with our partners to ensure that where possible processes are improved, including ensuring partners are fully aware when a patient is at home alone.”