Clinical Negligence Solicitors

The Early Notification Scheme is a national programme for the early reporting of infants born with a potentially severe brain injury following term labour to NHS Resolution. The aim of this scheme is to support the stated government priorities to halve the rate of stillbirth, neonatal death, and brain injury and to improve the safety of maternity care, whilst also responding to the needs of families where clinical negligence is identified, including through the early admission of liability where appropriate. Since 1 April 2017, acute Maternity Trusts have been required to report all incidents of babies born at term (that is >37 completed weeks of gestation) with a potential severe brain injury following labour to NHS Resolution within 30 days. In September 2019, NHS Resolution issued The Early Notification Scheme progress report, which is an overview of the scheme to date, as well as a thematic analysis of a cohort of cases from year one of the scheme (2017-18). In the first year of its operation between April 2017 to March 2018, 746 qualifying cases were reported to the Early Notification scheme. A study of a sample of 96 out of the total 197 cases, in which NHS Resolution panel solicitors were instructed to investigate liability identified a number of clinical issues, including, limited support staff and confusion over duty of candour. Issues with fetal monitoring were a leading contributory factor in 70% of cases. In 63% at least two or more factors were identified delays in acting on a pathological CTG was the most common factor. Difficult delivery of the head at caesarean section and/or impacted fetal head was a contributory factor in 9% of cases in this cohort. The Early Notification Scheme allows NHS Resolution to begin their investigations early and to offer support to families with babies who have suffered a potential brain injury as a result of substandard care. The report makes six recommendations as a result of the clinical issues recognised in the investigation:

• All families whose baby meets the early notification criteria and requires treatment for a potentially severe brain injury should be offered an apology in accordance with the statutory duty of candour, a description of the intended investigation process and options for their involvement in investigations;
• An independent package of support should be offered to all NHS staff to manage the distress that can be associated with providing acute health services and in particular to those involved in incidents;
• An urgent need for an evidence-based, standardised approach to fetal monitoring;
• Increase awareness of impacted fetal head and difficult delivery of the head at caesarean section including the care techniques required;
• Work with existing national programmes to improve the detection of maternal deterioration in labour;
• Increase awareness of the importance of high quality resuscitation and immediate neonatal care on outcomes.

The report confirms that since the commencement of the scheme, the scheme has already reduced the time between incident and resolution. To date, 24 families have received an admission of liability, formal apology and in some instances, financial assistance with care and other needs within 18 months of the incident. We hope that the recommendations in the progress report will improve the care in maternity departments to avoid further clinical issues resulting in babies being born with brain injuries. Author Saniya Taqi is a trainee solicitor in the clinical negligence and personal injury departments and works under the supervision of director, Rebecca Thomas. The clinical negligence team has extensive experience assisting individuals whose child has suffered from brain injuries following labour as a result of substandard care received at hospital as well as those who have received an apology letter from an NHS Trust. Contact Saniya on 020 3114 1168 or at saniyat@duncanlewis.com Contact Rebecca on 020 3114 1309 or at rebeccat@duncanlewis.com Duncan Lewis Clinical Negligence Solicitors Our clinical negligence team has significant experience acting in a vast array of claims. These vary from A&E failures and GP negligence claims, to misdiagnosed cancer and wrongful death claims. Our solicitors act for children and adults who have suffered profound and permanent brain, spinal or neurological injuries and associated disabilities as a consequence of failings in both NHS and private hospital medical care. If you have any queries relating to Clinical Negligence or think that you may have a claim, please do not hesitate to contact our team of expert solicitors on 033 3772 0409.