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The Coroners Act 2009 allows a coroner to make recommendations as part of their findings following an investigation into a death, suspected death, fire or explosion. Coronial findings are available on the Coroners Court Website.
In some inquests and inquiries, recommendations are made. Where recommendations are made to NSW Ministers and Government Agencies, they are required to report to the Attorney General within six months of receiving a coronial recommendation in accordance with Premier's Memorandum 2009-12, outlining any action to be taken to implement the recommendation.
The Department of Communities and Justice maintains and publishes coronial recommendations and the subsequent responses.
You can view recommendations and any responses received via the search field.
Responses received between 2009 and 2022 are presently maintained on our Archive page.
CORONIAL LAW – Boat capsize over the Penrith Weir-Subsequent drowning - Missing safety buoys barrier at the weir -Issues with the inspection and replacement of
Cause of death; pulmonary embolism; assessment of risk of venous thromboembolism in a psychiatric ward; impact of the delineation of treatment for physical and
CORONIAL LAW – manner of death, injury in racehorses, stress fracture, ligamentous injury, ruptured oblique sesamoidean ligament, injury management prior to tr
CORONIAL LAW – mandatory inquest – death in custody – was the cause of death asthma or arrythmia – was the medical care and treatment appropriate
CORONIAL LAW – long term missing person – whether missing person is deceased – whether findings with regards to identity, date, place, cause, and manner of dea
CORONIAL LAW – Mandatory inquest pursuant to s 23(1)(d)(ii) of the Coroners Act 2009 (NSW) – Death in custody; intentional self-harm following adverse court ou
Self-harm, suicide, Royal Prince Alfred Hospital, involuntary detention, voluntary detention, Mental Health Act 2007
CORONIAL LAW – whether missing person now deceased, date and place of death, cause and manner of death, New South Wales Police Force Missing Person Standard Op
CORONIAL LAW – death in police operation – police shooting – use of force – adequacy and appropriateness of response by NSW Police – use of body worn video by
CORONIAL LAW – 1988 death of First Nations teenager – suspicious circumstances – subdural haemorrhage – inadequate early investigation – racism and unconscious
If you have any enquiries, please contact the Department of Communities and Justice, Coronial Recommendations.
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