Support for families or carers

Welcome to NHS Resolution‘s Early Notification (EN) scheme support page for families and carers.

We have included links so you can find out everything you need to know, from what the EN scheme is, flow diagrams, FAQs and where you can find further information and support. We have produced an EN summary leaflet which is available to read and download. This gives you an overview of NHS Resolution and the EN scheme. The leaflet also provides you with next steps, the contact details for our EN Family Liaison and Mediation Lead and the EN team and signposting to support organisations.

The EN scheme processes

The flowchart below shows the steps for the EN scheme investigation process.

EN scheme investigation process Baby born and meets MNSI criteria for serious brain injury Trust reports incident to MNSI for investigation MNSI creates reference number and starts investigation Trust reports incident to NHS Resolution NHS Resolution acknowledges incident to Trust MNSI completes investigation MNSI give family information on NHS Resolution and the EN scheme NHS Resolution send introduction letter to family Trust shares MNSI report with NHS Resolution NHS Resolution reviews MRI information within MNSI report and/or MRI report EN MRI criteria met NHS Resolution undertakes an initial clinical review (1) EN MRI criteria not met No investigation takes place NHS Resolution sends letter to Trust and family (We will signpost you to legal advice and support organisations) Clinical Negligence scheme for Trusts route (You have the option of pursuing a claim where the EN investigation isn’t taking place. More details can be found on our website) NHS Resolution undertakes an initial clinical review (1) Early indication of substandard care which may/reasonably expected to have made a difference to the outcome NHS Resolution sends letter to family notifying them of the legal investigation (2) (You have three months to reach your decision from the date the letter is sent. We will contact you two weeks later to confirm you have received the letter and then four weeks later to confirm if you have made a decision about the legal investigation) Early indication of no substandard care or the care would not have made a difference to the outcome No investigation takes place NHS Resolution sends letter to Trust and family (We will signpost you to legal advice and support organisations) Clinical Negligence scheme for Trusts route (You have the option of pursuing a claim where the EN investigation isn’t taking place. More details can be found on our website) NHS Resolution sends letter to family notifying them of the legal investigation (2) Permission received (Once you give us your permission, we can start our liability investigation) NHS Resolution commence legal investigation NHS Resolution sends letter to Trust and family Move to legal investigation process Permission not received (If you do not give permission for an investigation to take place or we do not hear back from you, no investigation will take place) No investigation takes place NHS Resolution sends letter to Trust and family (We will signpost you to legal advice and support organisations) Clinical Negligence scheme for Trusts route (You have the option of pursuing a claim where the EN investigation isn’t taking place. More details can be found on our website)
Click to open the flowchart

We have also summarised the scheme process:

A baby born with serious brain injury which meets the criteria for an MNSI investigation will be reported to MNSI by the Trust. If MNSI accept the case and an investigation is commenced, the Trust must also report the incident to NHS Resolution and will provide the family with information about NHS Resolution and the EN scheme. After the MNSI investigation is complete the Trust will share the final MNSI report with NHS Resolution. NHS Resolution’s Early Notification team will send a letter to the family introducing the Early Notification scheme and share contact details.

NHS Resolution will complete an initial review of your clinical care and then write to you with the outcome. Where there are potential concerns about the care provided that may have caused injury to your baby we will complete a full legal investigation. If your baby was born on or after 1 October 2023, NHS Resolution will ask for your permission to do this and ask you to send us a signed form permitting us to access additional medical records.

Families who do not meet the criteria for inclusion in the EN scheme are informed in writing and signposted to independent legal advice and support organisations.

Legal investigation process

The flowchart below shows the steps of the legal investigation process.

Legal investigation process: NHS Resolution commence legal investigation (NHS Resolution may appoint a law firm to assist in the investigation) Medical records and other relevant information from the hospital Trust are obtained (Where you have provided permission to access records held by other organisations, these will also be obtained) NHS Resolution instruct medico-legal experts (These are experts in Midwifery, Obstetrics and Neonatology. Your records are shared for them to provide a view on the care you received using the clinical negligence test) Clinical negligence legal test considered (The clinical negligence test: 1. Experts determine if duty of care has been breached as result of substandard care and 2. Use radiological evidence to determine if harm was caused from substandard care identified) NHS Resolution collaborate on whether clinical negligence is identified Clinical Negligence identified NHS Resolution sends letter to family with outcome (We will signpost you to legal advice and support organisations) Moves into compensation Process (Family encouraged to obtain legal representation) Clinical Negligence not identified NHS Resolution sends letter to family with outcome (We will signpost you to legal advice and support organisations Please note, your investigation make take longer depending on a number of factors. You or your representatives will be updated during your investigation.
Click to open flowchart

We have also summarised the legal investigation process:

If the case meets the full criteria for inclusion in the EN scheme and the family agree to be part of the scheme, NHS Resolution will commence a legal investigation.

Firstly, NHS Resolution will obtain medical records and other relevant information from the hospital Trust, as well as records held by other organisations if permission has been provided by the family.

Medico-legal experts are instructed who will consider the medical records, any other relevant documentation, and will provide independent opinions on the standard of care provided. Lawyers will meet with the medico-legal experts to discuss the case in detail and decide whether there is eligibility for compensation.

The family are provided with the conclusion of the investigation in writing, together with signposting to independent legal advice and support organisations.

An introduction to the Early Notification Scheme for families

We have published an animation designed to explain what our Early Notification Scheme does.

As part of our third strategic objective, to collaborate to improve maternity outcomes, and ongoing consideration for how the EN scheme should be developed, we’ve been working closely with our Maternity Voices Advisory Group and a group of parents via PEEPS-HIE to improve our direct communication with families and ensure consistent contact with our Family Liaison team once a case is accepted onto our Early Notification Scheme.

The Early Notification Maternity Voices Advisory Group (MVAG) was established to provide external stakeholders, in particular families and their representatives, with a forum through which they can advise and support future service developments within the Early Notification Scheme.

This animation was co-designed with MVAG and a group of parents via PEEPS-HIE and aims to be clear, concise and understandable for any families who might have experienced an incident of maternity harm and have been accepted onto the EN Scheme or are seeking to understand more about what the scheme does.

We also hope it will act as an important signpost for further support for families and where they can contact our internal teams for more information if needed. We aim to create a further animation explaining the liability investigation in more detail in the near future.

Contact

For more information, you can contact a member of the EN team or our EN Family Liaison and Mediation Lead directly by email nhsr.enteam@nhs.net or by telephone 0207 811 6263.

You can also speak with the maternity contact at your hospital.

Information about MNSI and the investigation they will undertake can be found on their ‘Investigation overview for families’ webpage.

Helpful resources

We understand that this must be a difficult time for you and your family. There are several organisations that can provide you with specialist advice, including:

Bliss
www.bliss.org.uk/
A national charity that supports babies born premature or sick and their families. They can offer advice and support via a freephone helpline. Tel: 020 7378 1122.

NHS Improving Access to Psychological Therapy  
www.england.nhs.uk/mental-health/adults/iapt
Free access to psychological therapy on a regional basis through the IAPT service. This can be accessed by the link and services in your area located including self-referral details.

Peeps HIE
www.peeps-hie.org 
Support to families affected by babies born with Hypoxic Ischaemic Encephalopathy (HIE). Tel: 0800 987 5422.

Sands  
www.sands.org.uk
A charity set up to offer support to anyone affected by the death of a baby and to improve the care bereaved parents receive.

The Samaritans
www.samaritans.org
A free 24-hour listening and advice service 365 days a year. They can be contacted from any phone anytime by calling 116 123 from the UK and Republic of Ireland.

Organisations providing independent information, advice and support

Action against Medical Accidents (AvMA)
www.avma.org.uk
AvMA is an independent charity which offers free advice, information and support to people affected by sub-standard healthcare, they can refer you to solicitors who specialise in this work and who are accredited by them. AvMA can advise and support families on MNSI maternity investigations, the Early Notification scheme and other processes. AvMA’s telephone helpline also provides free advice and is staffed by professional volunteers. The helpline is open between 10am and 3.30pm, Monday to Friday. Tel: 0345 123 23 52.

Law Society
www.lawsociety.org.uk
An organisation which can provide details on how to contact a specialist clinical negligence lawyer to obtain independent legal advice.

Citizens Advice Bureau
www.citizensadvice.org.uk
Free advice by a volunteer who may be able to put you in touch with a legal advisor.

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