The NHS remains one of the safest healthcare systems in the world within which to give birth. However, avoidable errors within maternity can still occur, which can have devastating consequences for the child, mother and wider family, as well as the NHS staff involved.
Although secondary to the human impact, such incidents can also result in a significant financial cost to the NHS. Obstetric claims accounted for 62% of the total estimated value of new claims reported to our clinical schemes in 2021/22, despite only representing 12% of the number.
NHS Resolution is committed to supporting the National Maternity Safety Ambition to halve maternal and neonatal deaths and reduce significant harm. In order to support achieving this, NHS Resolution’s Early Notification (EN) scheme proactively investigates specific brain injuries at birth for the purposes of determining if negligence has caused the harm. We do this by requiring our Clinical Negligence Scheme for Trusts (CNST) members to notify us of maternity incidents which meet a certain clinical definition. The intention of the scheme is to:
- Investigate potential eligibility for compensation and take proactive action to reduce legal costs and improve the experience for the family and affected staff;
- Share learning rapidly with the individual trust and the wider system in order to support safety improvement and prevent the same things happening again;
- Build on our Saying Sorry and Being Fair work to ensure the process to obtain compensation is not a barrier to openness, candour and learning;
- Preserve evidence to ensure we are able to respond to cases that a family may choose to bring at a later date; and
- Improve the process for obtaining compensation for families, meeting needs in real time where possible and trying to reduce the risk of claims increasing in value due to inflation or unmet needs (such as psychological support) translating into larger losses.
Further information
Since the launch of the scheme, we have seen some early successes against these objectives. The scheme has reduced the time between the incident occurring and the case being notified to NHS Resolution. In some cases it has also seen unprecedented speed in the time from the incident to a claims decision, with an associated reduction in costs. Early Notification has helped us to encourage trusts to be open about incidents with families and optimise opportunities to learn.
To learn more about the scheme and our planned changes, please use the following links:
- If you are a trust, please go to our Early Notification page for NHS trusts or member organisations for more information. We have produced a number of case stories to help identify potential risks in clinical areas, promote learning and prevent fewer incidents like these occurring in the future.
- If you are a parent, family member or carer – please go to our Early notification page for parents, family members or carers for more information about the scheme.
Published reports
The second Early Notification report, published on 29 September 2022, provides an overview of progress made since the report into the first year of the scheme. 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.
Our Early Notification scheme progress report: collaboration and improved experience for families is available providing an overview of the scheme to-date alongside a thematic analysis of a cohort of cases from year one of the scheme (2017/2018). We have also produced a summary of the Early Notification scheme progress report.
Five years of cerebral palsy claims: a thematic review of NHS Resolution data provides and in-depth analysis of the causes of incidents which lead to claims and the investigations which follow.
In November 2017 the Secretary of State for Health and Social Care updated on progress with the National Maternity Safety Strategy, bringing forward the ambition to reduce the number of stillbirths, neonatal and maternal death and brain injuries by 50% to 2025 (previously 2030). Our work is integral to this ambition. The Early Notification scheme was referenced as providing a new route for families to access compensation, based on the current principles of liability. The updated strategy also recognised the key role we have to play in helping to incentivise the delivery of best practice to improve safety, using the pricing lever of our main indemnity scheme, the CNST.
Contact
Please contact us if you would like to discuss the Early Notification scheme by emailing us at nhsr.enteam@nhs.net or calling us on 0207 811 6263.
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