R (on the application of Grice) v HM Senior Coroner of Brighton and Hove [2020] EWHC 3581 (Admin)

The Facts

Garnham J considered a judicial review of a refusal to resume an inquest into the death of Shana Grice, who had been murdered by her former boyfriend at her home in Brighton. There had been a criminal investigation culminating in a conviction. There had also been a statutory Domestic Homicide Review, an investigation by the Independent Office for Police Conduct, an inspection by HMP Inspectorate of Constabulary and Fire & Rescue services into Sussex Police and its response to cases of stalking, and police disciplinary proceedings concluding with findings of gross misconduct against one officer and misconduct against two others.

The primary ground on which the refusal was challenged was that it was a breach of the Article 2 ECHR investigative duty. The family argued that investigations on the part of the state to date were inadequate because they were not sufficiently independent, were ineffective, provided insufficient scrutiny and permitted insufficient involvement of Ms Grice’s family. Further, the inquest would enable the determination of whether a prevention of future deaths report was appropriate.

The requirements of Article 2

Garnham J set out at [55-6] the familiar general principles governing inquests, including that Article 2 imposes on the state negative obligations not to take life without proper cause and carefully defined positive obligations to protect life. It also imposes:

procedural obligations, including both (i) a general obligation to have in place proper systems for investigating all deaths; and (ii) in respect of certain deaths, a specific obligation to establish one or more independent investigations which satisfy Convention standards.”

“…Where the Article 2 procedural obligation to establish a Convention-compliant investigation is engaged in relation to a death and has not been discharged by procedures other than an inquest, the statutory provisions governing inquest conclusions are modified so that the question “how” the deceased came by his/her death is read as “by what means and in what circumstances” the deceased came to die. In practice, this can open up scope for conclusions addressing wider circumstances of death and underlying causes, and it may require a somewhat expanded form of narrative conclusion.”

The Article 2 procedural obligation is engaged automatically in some situations (such as suicides in prison or deliberate killings by state agents), or if there is an arguable case that the state or its agents breached one or more of the substantive Article 2 duties in relation to the death.

Further, he set out at [63-4] that the precise requirements of an Article 2 compliant investigation vary according to the circumstances of the case under consideration, but there are minimum Jordan requirements:

“a) the authorities must act of their own motion; b) the investigation must be independent; c) the investigation must be effective in the sense that it must be conducted in a manner that does not undermine its ability to establish the relevant facts; this is, as it was described in Jordan “an obligation of means rather than results”; d) the investigation must be reasonably prompt; e) there must be a ”sufficient element of public scrutiny of the investigation or its results to secure accountability in practice as well as in theory; the degree of public scrutiny required may well vary from case to case”: and f) there must be involvement of the next of kin ”to the extent necessary to safeguard his or her legitimate interests.”

He held at [61] to [62] that in answering the question as to whether the investigations other than the coronial investigation satisfied the Article 2 procedural obligation “in a manner which adequately served the public interest” the Coroner was obliged to “consider whether all the other investigative procedures of the state have collectively satisfied the requirements of the procedural obligation … It is necessary for the Coroner to consider “the totality of available procedures”, including public investigations and any potential for a civil claim.”

Garnham J also emphasised at [84] to [85] that it was important to note what was not required in an Article 2 compliant investigation:

“(i) It is not a requirement of the ECHR that any particular procedure be adopted to fulfil the Jordan requirements. The form of the investigation may vary according to the circumstances and those requirements can be satisfied by a set of separate investigations, rather than by a single, unified procedure..

(ii) The requirement for the family of the deceased to be involved in an investigation to the extent necessary to safeguard their interests does not mean that the investigating authorities must satisfy every request for a particular step to be taken in the investigation…

(iii) The requirement of public scrutiny does not invariably require a public hearing… And neither requirement means that the family of the deceased must be able directly to test evidence:

85. Furthermore, in my view, there is no requirement that each element of the State’s investigative procedure meets each one of those tests; the question is whether, viewed in its totality, the investigations meet the minimum requirements identified in Jordan . So, the fact that next of kin of the victim ordinarily play no active part in a criminal trial does not mean that the criminal trial falls out of account in assessing whether the totality meets the state’s investigative obligation. Similarly, the fact that there is limited public scrutiny of one part of the process or limited involvement of the next of kin, will not necessarily invalidate the whole.”

He also noted at [58] that in all inquests, the coroner is accorded a broad range of judgment as to the scope of the inquiry. Further, a decision that the Article 2 procedural obligation is engaged will have little, if any, effect on the scope of inquiry or conduct of the hearing because any properly conducted inquest will consider the circumstances surrounding and events leading to death. The key effect of Article 2 engagement is upon conclusions at the inquest.

The effect of the criminal proceedings

Garnham J held at [59-60] that a coronial investigation has to be suspended following notification that a person has been charged with a homicide offence in relation to the death in question, unless the prosecuting authority indicates that it has no objection to the coronial investigation continuing or there is exceptional reason for not suspending the investigation (para 2 of Schedule 1 to the CJA 2009). No such indication or other exceptional reason had been relevant here, and accordingly, the Coroner had no choice but to suspend the inquest in 2017. A coronial investigation may not be resumed unless, but must be resumed if, the coroner thinks there is sufficient reason to resume it after the conclusion of the criminal proceedings (para. 8(1) of Schedule 1). He held that “it follows from that statutory language that the decision on whether or not to resume an inquest is one for the coroner’s judgment and is one ‘of a highly discretionary character’.”

At [87] he held that a murder trial alone will usually meet the state’s Article 2 obligations in respect of the death, and an inquest thereafter will not be necessary, and indeed be the exception “in most cases a criminal trial will involve a sufficient exploration of the circumstances surrounding the death.”


Garnham J reviewed the various investigations and the extent to which they investigated the circumstances of Ms Grice’s death, had involved the family and had led to failings being identified. He held at [86] to [87] that the criminal trial would not be sufficient in itself in the circumstances of this particular death to satisfy Article 2 as it had become apparent that there were serious failings by the police that contributed to Ms Grice’s death. However, he held it was “significant in Article 2 terms” that the sentencing judge’s remarks had prompted an investigation by the IOPC.

In respect of the IOPC investigation he again held at [89] that it had been ‘Article 2 effective’ through being “conducted in a manner consistent with an ability to establish the relevant facts”. He noted at [90] to [91] that the HMICFRS report had given further oversight of Sussex police and identified further and persisting areas of concern. Further, the disciplinary proceedings had ensured that the officers directly concerned were held to account for their actions. He concluded at [92] to [93] that:            

“92. In my judgment, there were here prompt, independent enquiries initiated by the state of its own motion, which were effective, both in the manner in which they established the relevant facts and in the results they achieved, which provided a sufficient element of public scrutiny of the investigation or its results to secure proper accountability and which involved the family to the extent necessary to safeguard their legitimate interests. In my judgment the Coroner was not only entitled to find that these enquiries satisfied article 2; she was right to do so.

93. It is apparent that what the Claimant seeks is a much more detailed enquiry than any of those that have taken place hitherto with a much fuller analysis being produced in consequence. In my judgment, as Mr Hough submits, a fully Article 2-compliant inquest would not produce such an outcome. The Courts have repeatedly made clear that in Article 2 inquests determinations should be relatively succinct… While it may be appropriate for conclusions to address underlying causes of death, they should not usually address matters of policy and resourcing.”


This case is a useful and authoritative summary of the relevant principles concerning the purpose, scope and limits on the Article 2 investigative duty in the context of inquests, as well as of the more niche considerations applying where there has been a previous criminal homicide investigation and trial.