NHS Resolution has today published the second report into its ground-breaking scheme driving proactive liability investigations and early resolution of birth injury cases to support families, staff and healthcare providers.
Although the NHS remains one of the safest healthcare systems in the world within which to give birth, avoidable errors within maternity still occur. Maternity costs make up the largest cost to the NHS in value of claims. The Early Notification Scheme provides a faster and more caring response to families whose babies may have suffered severe harm.
The second report: The evolution of the Early Notification Scheme provides an overview of progress made since the report into the first year of the scheme, which was published in 2019. The report updates on the progress of the key recommendations which were made in the first report and reflects on modifications and improvements made to the scheme since its launch five years ago. It provides an analysis of the main clinical themes, based on a small cohort of cases, and makes recommendations to further improve outcomes for affected families.
One of the key conclusions in the report is that there has been a significant reduction in the time taken to admit legal liability on cases involving a brain injury at birth. The Early Notification Scheme has reduced the average time from seven years to approximately 18 months based on the cases analysed. This enables learning to be identified and shared quickly, while providing support to families when they need it most.
Some of the improvements and changes made to scheme since its launch include focusing efforts on babies with a brain injury and where there will be the greatest impact. We have also set up a Maternity Voices Advisory Group to build closer links with families to support the development of the scheme.
The second report makes three new recommendations, drawn from learning from recurring themes, to contribute to the continued national effort to improve outcomes in maternity:
- NHS Resolution to support the work of royal colleges and wider stakeholders to improve antenatal counselling before trial of vaginal birth after caesarean section
- NHS Resolution to support the work of royal colleges and wider stakeholders to improve awareness in relation to response to harm for families and staff
- NHS Resolution to support the working relationships with NHS providers, and wider stakeholders, encouraging a joined up approach between trust legal services and maternity and risk teams.
A priority for NHS Resolution is to do all that we can to support improvements in the safety of maternity services in England. The Early Notification Scheme is part of our strategy to remould traditional litigation processes to deliver better outcomes for families and faster learning for the health service. It illustrates how getting closer to the incident can enable early, interim compensation payments to be made which can make all the difference to families at a time when they are most needed.
Helen Vernon, Chief Executive, NHS Resolution
Minister of State for Health Will Quince said: “No parent or baby should have to experience avoidable tragedies like these but when things do go wrong it is vital that families are supported and lessons are learned. These recommendations will help ensure families receive a faster, more caring response, with learnings fed back quicker to create a safer system. We want the NHS to be the safest place in the world to give birth and have invested £127 million into maternity services across the country to boost staff numbers and bolster good leadership and culture.”
Nicky Lyon, member of the Early Notification Maternity Voices Advisory Group said: “Each number in this report represents a real family now caring for a child with potentially complex needs. As parents whose children have experienced significant brain injuries, we know how a complex and often lengthy legal process can add further distress to an already challenging situation.”
Sarah Land, member of the Early Notification Maternity Voices Advisory Group, added: “With the development of the Early Notification Scheme, NHS Resolution is aiming to meet the needs of families more adequately and quickly at a very emotional and difficult time.”
Birte Harlev-Lam, Executive Director, Midwife, at the Royal College of Midwives, said: “When tragedies like these happen it is imperative that there is the quickest possible legal and financial resolution for families to help them through a deeply distressing time. It is also critical that lessons are learned, and action taken quickly to reduce the chances of these tragedies happening again. That is why the Royal College of Midwives is at the forefront of a major Government funded initiative – the Avoiding Brain Injury in Childbirth programme – to develop ways of avoiding brain injuries in childbirth. As this report shows, progress is being made, but there remains much to do to make what is a terrible situation for families a little easier to bear.”
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: “We welcome the second report of the Early Notification Scheme, and the recommendations to continue a collaborative effort to improve maternity outcomes. Any brain injury suffered during childbirth is a tragedy and all those working in maternity care want to ensure that both mother and baby have the best possible outcomes. The Early Notification Scheme is an important programme to ensure that when babies have suffered avoidable harm, there is a compassionate response to help support affected families and accelerate investigation processes.
“We are committed to learning from these incidents to prevent avoidable harm and improve maternity safety. By drawing on expertise from across the health sector, and listening to the experiences of women and their families, the Avoiding Brain Injury in Childbirth project will build on the progress already made with the Royal College of Obstetricians and Gynaecologists’ Each Baby Counts project and develop tools that will support maternity units provide the best possible care while establishing clear processes for effective fetal monitoring.”
