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Waqar Shah
The breaking news is that Health and Social Care Secretary, Wes Streeting, has ordered a wide-ranging national investigation into NHS maternity and neonatal services. It follows a series of meetings between the Secretary of State and bereaved families and is said to come alongside a package of immediate actions to boost accountability and safety.
The Government says that the investigation will provide 'truth and accountability', drive urgent improvements and address systemic problems said to have been ongoing for more than 15 years. This investigation follows years of independent reviews into maternity services at individual trusts which have found many similar failings – including issues of safety and leadership, and culture, along with not listening to women.
I would however ask the question many families will also be asking - will this new “rapid” investigation finally lead to meaningful change?
The investigation is to take place in two parts, with the first urgently looking at the ‘worst performing’ maternity and neonatal units in the country, including Sussex. The second part will look at the ‘entire maternity system’ with the aim of producing ‘one clear national set of actions’, bringing together the learning from previous inquiries.
Earlier independent reviews have included the Ockenden review in 2022, which found serious failings at Shrewsbury and Telford NHS Trust. In the same year a damning report was published relating to failures in maternity care at East Kent Hospitals University NHS Foundation Trust. This year Nottingham University NHS Trust was fined over £1.6 million for safety failings in relation to three mothers and their babies.
The new national effort will include liaising with clinicians, experts and - in my view crucially - families who have been harmed by failures in care. A National Maternity and Neonatal Taskforce has been set up, chaired by Wes Streeting, to include a panel of experts and bereaved families. The Nursing and Midwifery Council has said it looks forward to working with the independent taskforce to ‘drive forward urgent improvements, and tackle the scourge of health inequalities’.
Wes Streeting has been meeting affected families and forcefully comments: ‘What they have experienced is devastating – deeply painful stories of trauma, loss and a basic lack of compassion – caused by failures in NHS maternity care that should never have happened.’ Further, in a speech at the Royal College of Obstetricians and Gynaecologists on Monday, Mr Streeting is reported as saying that families ‘describe being ignored, gaslit, lied to, manipulated and damaged further by the inability for a trust to simply be honest with them that something has gone wrong’.
The inequalities faced by women from black, Asian and deprived backgrounds is to be an area of focus. An anti-discrimination programme to tackle these inequalities has been announced by Wes Streeting as part of a series of immediate measures. Racial disparities in maternity care are already well documented, with black women being almost four times more likely to die during pregnancy or childbirth than white women. Black babies are more than twice as likely to be stillborn than white babies.
Surprisingly, it was recently reported that data is not being collected by the NHS with regard to the ethnicity or nationality of people bringing maternity claims of clinical negligence. I consider that it is vital that this data is properly collected to enable this shocking disparity in care to be better understood and addressed. However, I do question if in fact it is this very same cohort of women, (who are so frequently unseen and unheard) who do not have the resources, information, or support, to pursue a clinical negligence claim in the first place.
The national investigation is to begin this summer and is expected to report by Christmas. Given the length of time such investigations can take I very much hope that this short 5-6 month “rapid” investigation will be of sufficient detail and content to lead to workable, practical changes and will not simply end up on the shelf after a short-lived period of nationwide publicity.
I have previously blogged on various NHS initiatives with the aim of learning from mistakes, with the goal of achieving maternity improvements, more swift access to justice, and a reduction in the costs associated with medico-legal claims. There has been a great deal done already, with all good intent, to identify failings and to address areas for improvement. However, the catalogue of poor care across the UK sadly continues and there can be no doubt that each and every pregnant woman deserves a far better service than is currently being delivered.
Sharon Burkill joined the Clinical Negligence and Personal Injury team as a Legal Director, in 2024, having previously been a Senior Associate at the firm between 2005 and 2016. Sharon re-joins Kingsley Napley following a five-year period in the medical negligence team at Irwin Mitchell.
This year, World Cerebral Palsy Day falls on 6 October with a theme of ‘#Unique and United’. The Kingsley Napley Medical Negligence and Personal Injury team strongly support the vision of this global movement - which is about recognition of the 50 million people who are living with cerebral palsy and striving for a more accessible and inclusive world.
Legal claims for hypoxic brain injuries during birth – caused by a disruption in oxygen supply - remain prevalent. These injuries can have a devastating impact and lead to lifelong conditions including Cerebral Palsy. Indeed, claims relating to brain injuries sustained during birth account for a significant percentage of the total value of clinical negligence damages paid out each year. This is because the average amount of damages for such cases is very high, not infrequently running to tens of millions of pounds, with some impacted children having lifelong needs for care, treatment, equipment and housing. Nonetheless, claims for clinical negligence in this area can be particularly thorny to prove. In this article I consider when the doctrine of ‘material contribution’ – said by the Court of Appeal to have been ‘bedevilled by apparent inconsistency’ – may apply to hypoxic birth injury cases where the window for avoiding injury can be short. Does every minute really count?
The Government has this week confirmed the names of 14 Hospital Trusts that will be part of a rapid national investigation of maternity and newborn baby care across England that was announced by Wes Streeting back in June. (See my colleague Sharon Burkill’s blog on that announcement here). I am carefully watching the developments with regard to this investigation, knowing full well from my clients and their stories how desperately improvements to our maternity services are needed.
We were delighted to take part in a 15km walk on Saturday 6 September for the Dame Vera Lynn Children’s Charity (DVLCC) to raise funds for this excellent cause.
The Health Services Safety Investigations Body (HSSIB) has shared insights into safety concerns raised by women and families and other stakeholders about maternity and neonatal care within NHS England, highlighting once again the need for meaningful change.
Where there has been a concern surrounding medical care at an NHS Hospital, an internal investigation may be carried out and a written report produced to assist with learning from the incident. From a patient perspective, the report can be helpful in understanding more about the event and what, if anything, went wrong.
We are extremely concerned to read reports that treatment guidelines relating to glaucoma allegedly have not been followed at the George Eliot Hospital NHS Trust in Warwickshire, leading to patients’ sight being harmed. Some patients are said to have suffered permanent visual damage.
Each year NHS Resolution, the body dealing with legal claims against the NHS, produces a report which provides insights into what is happening with clinical negligence claims. This year the picture is very mixed. It shows that claims for clinical negligence are on the rise although more cases are being settled without the need for Court proceedings. Nonetheless, despite Government efforts, high levels of maternity cases and associated costs persist.
In this blog, Richard Lodge talks about providing medical treatment to a non-english speaking patient
According to a recent article in The Guardian NHS England has confirmed that since 2022, equipment failures within the NHS have been responsible for:
Kingsley Napley’s head of Medical Negligence and Personal Injury has had an article published in this month’s APIL PI Focus magazine which includes a collection of articles examining the topic of birth injury. James’ piece deals with causation and the doctrine of material contribution in legal claims for hypoxic brain injuries during birth.
Hip replacement surgery is very common, restoring mobility and quality of life to thousands every year in the UK. It is recognised to be the most cost effective for the NHS in returning patients to productive lives. The components wearing surfaces may be metal, ceramic or plastic, and will often last over 20 to 25 years, or even longer for some people.
Concerns over NHS maternity care are very sadly seldom out of the news. As a lawyer who has specialised in birth injury claims over many years, it has been all too clear to me for a long time, that far too many women and babies, fail to receive anywhere close to adequate maternity care leading in some instances to devastating outcomes.
Fatigue within the NHS presents a significant risk to patient safety, yet in healthcare its consequences remain largely unrecognised despite the increasing demands on NHS workforces.
While we mostly associate dementia with the affect it can have on our memory, it can also affect our ability to think and communicate and our capacity to manage our own affairs. When undertaking legal proceedings, as solicitors, we have a duty to ensure that our clients have the mental capacity to give proper instructions to bring, or defend, a claim. Where our client does not have the necessary capacity, a Litigation Friend may be appointed
We are now in Action for Brain Injury week, run annually by the charity Headway to raise awareness and understanding of the different aspects of brain injury. The theme this year is ‘On a good day’ which aims to highlight the fluctuating and unpredictable nature of brain injury and the gap that can arise between someone’s capabilities on a good day versus a bad day. Headway wants people to see both sides of the story. It seeks to change behaviours and opinions towards those who might be having an ‘all-too-common bad day’.
New research suggests that UK cancer cases have risen in women but fallen in men. Women’s cancers include gynaecological cancer (i.e. cervical, ovarian and vaginal cancers) and breast cancer. Here I look at the impacts of delays in diagnosis and treatment failures, provide some guidance on bringing a medical negligence claim and consider why there is hope for the future with new technologies.
A lack of awareness and understanding appears to exist when it comes to women’s reproductive health conditions, and the diagnosis and treatment of hysterectomies is no exception to this.
In this blog we will be discussing where negligence can occur in relation to the treatment of hysterectomies, from initial misdiagnoses to surgical errors.
Endometriosis and Pelvic Inflammatory Disease (PID) are two conditions which affect a large number of women every year, and can have devastating effects on fertility and well-being, but frustratingly continue to experience long delays in diagnosis.
As a lawyer specialising in women’s health claims, I am increasingly concerned about the challenges facing those seeking access to care for issues around gynaecology and reproductive health. Problems in this area are rife. They include very long waiting times, delays in diagnosis, a lack of understanding by some medical professionals, instances of discrimination as well as women reporting feelings of being dismissed.
We welcome views and opinions about the issues raised in this blog. Should you require specific advice in relation to personal circumstances, please use the form on the contact page.
Or call +44 (0)20 7814 1200
Waqar Shah
James Ward
Jessica Rice
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