What is NHS Resolution’s Early Notification scheme?
The Early Notification (EN) scheme is a key initiative towards achieving the delivery of safer maternity care, providing a more rapid, caring response to families in cases of severe harm, and supporting a learning culture.
The 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.
It is designed to do two main things:
- To speed up investigations into whether or not your baby is entitled to receive compensation by investigating your case proactively, being open with you about our conclusions and signposting you to appropriate sources of advice and support; and
- To help ensure that steps are taken to learn from things that have gone wrong to improve maternity care as well as sharing good practice.
What will happen once a matter is reported to NHS Resolution?
HSIB will firstly conduct a safety investigation into your baby’s birth. Once we receive the HSIB investigation report, NHS Resolution will then undertake a clinical triage to confirm whether the clinical criteria for investigation under the Early Notification scheme are met. NHS Resolution will then write to you directly to confirm that a legal investigation will start. We will also let you know when you should expect to hear from us again with an outcome into whether or not you are entitled compensation. We will also make sure that you know how to access other resources such as independent legal advice.
No EN investigation will take place where you have declined an HSIB investigation, unless you request this directly via your trust.
NHS Resolution’s in-house, specialist team will review all available information about the care you received during the antenatal period, the delivery of your baby and the period immediately after the birth. This may also include relevant medical records, statements and any other available investigation reports. We will review this information to decide whether:
- There is any evidence that your baby has an intrapartum hypoxic brain injury that would meet our criteria for investigation; and
- If so, whether there are any concerns about the care provided to you and your baby; and
- If so, whether there is any query as to whether, with appropriate care, injury to your baby might have been avoided.
If the answer to all of these questions is yes, we will conduct a full legal investigation with the assistance of external panel solicitors and independent experts to enable us to determine whether the care provided to you and your baby was of the standard that you were entitled to expect in line with the relevant legal tests and, if not, whether that substandard care caused or contributed to the outcome for your baby.
If you would like to know more about the legal tests involved when assessing these questions, please see the Action against Medical Accidents’ website which has some very useful explanations.
Do I (as a patient or family member) need to do anything?
No. We appreciate this must be a very difficult time for you so we will work with the hospital directly. During the investigation, it can be helpful for us to review your baby’s medical records from their GP or other hospitals. If that needs to happen, we will ask for your consent to obtain these records. You do not have to give consent if you do not want to. Please be aware, however, that if you choose not to provide us with access to the records then this will limit the investigations that we are able to undertake.
During the investigation, we will keep you informed of the process and what steps are being taken. We will make sure that you have contact details for the Early Notification team and will be able to signpost you to sources of advice and support, as well as for independent legal advice. Please see below for details of some examples of organisations that are able to provide support.
Please also be assured that all information will be handled sensitively and securely and that learning from EN investigations is shared on an anonymised basis only (so as to encourage improvements both within specific trusts and nationally) unless we have the family’s express agreement to provide specific details.
Contact
For more information, contact NHS Resolution directly on nhsr.enteam@nhs.net or call us on 0207 811 6263.
You can also speak with the maternity contact at your hospital.
Information about HSIB and the investigation they will undertake can be found here – HSIB’s role in maternity investigations.
Helpful resources
Support organisations
We understand that this must be a very difficult time for you and your family. There are several organisations that can provide you with specialist advice, including:
Bliss www.bliss.org.uk
Bliss is the national charity that supports babies born premature or sick and their families. They can offer advice and support via email
NHS Improving Access to Psychological Therapy www.england.nhs.uk/mental-health/adults/iapt/
The NHS provides 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
Peeps Charity provide support to families affected by babies born with HIE Hypoxic – Ischaemic encephalopathy. 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
The Samaritans provide 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.
Legal advice
Action against Medical Accidents (AvMA) http://www.avma.org.uk
AvMA is an independent charity which offers free medico-legal advice to people affected by sub-standard care. They can advise and support families with regard to the ENS or other processes which are open to them. AvMA also accredits specialist clinical negligence solicitors to whom families can be referred, if necessary, or provide families with their details. Their helpline is open between 10am and 3.30pm, Monday to Friday. Tel: 0845 123 2352.
Citizens Advice Bureau citizensadvice.org.uk
The Citizens Advice Bureau provides some free advice and may be able to put you in touch with a legal advisor.
Law Society www.lawsociety.org.uk
For independent legal advice, from a specialist clinical negligence lawyer, you can contact the Law Society.
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