Prevention is better than cure

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22 March, 2019

Obstetric claims represent 10% of clinical negligence claims by number and account for 48% of new claims reported.

Birth injuries have significant human and legal cost. The consequence of such can result in permanent, catastrophic injury.

Lawyers are often blamed for spiralling costs, but there are a number of factors that have influenced these figures. Improved care and treatment of patients means that those that have suffered negligence and disabling conditions such as cerebral palsy, are living longer and the cost of ongoing care is greater.

It is not surprising that the NHS Resolution are looking at ways to reduce the incidents and manage the consequence.

Leonie Millard recently attended a clinical negligence debate in Manchester on 3rd March 2019, where several strategies were discussed to deal with this;

  • The Early Notification Scheme introduced on the 1st April 2007 requires that members report within 30 days all internal incidents of potential severe brain injury. This should allow access to support early on.
    The NHS reports that there has never been a safer time to have a baby in England. The stillborn and neonatal mortality rate has fallen by a fifth in the last decade.
  • The Safer Maternity Care action plan, advocates safety champions and strong leaders to adapt best practice.
  • The Saving Babies' Lives care bundle focuses on the reduction of stillbirth and early neonatal death. It deals with:-
    1. Reduction of smoking in pregnancy
    2. Risk assessment and surveillance for foetal growth restriction
    3. Raising awareness of reduced foetal movement
    4. Effective foetal monitoring during labour

The "EBC" project collects data on all antepartum stillbirths. The MBRRACE UK enquiry highlighted screening for gestational diabetes, monitoring foetal growth, managing reduced foetal movement and learning from deaths to prevent antepartum stillbirths.

A report from Michael Magro, for NHS Resolution '5 years of cerebral palsy claims' published in September 2017 was a review of NHS Resolution data. The report looked at key themes including foetal heartrate monitoring, breach birth, inadequate quality assurances around staff competency and training, patient autonomy and informed decision-making.

In our experience, patients often speak to Lawyers when they feel that the answers and explanation for things that have gone wrong are dealt with poorly. If Trusts would make admissions early on it would allow for better management of the infant and a clear pathway for the family who have to deal physically and emotionally with events that can turn their world upside down.

A common cause of negligence is failure to accurately interpret an ECG. There is training but no demonstrable evidence that those reading them can successfully apply the training in practice. Maternity guidelines indicate best practice and evolve, as does the service.

Compensation

There is great variability in care, treatment and services governed by austerity, waiting list time, quality of care and availability of a clinical leader in an MDT (Multi-Disciplinary Team) for management in a complex case. There is not equal opportunity to access resource.

Ultimately, the Trust would not have costs to pay if the incidents did not happen. Where things do negligently go wrong you cannot give the infant and their families the life that they would have had, but you can make life as interesting and enjoyable as possible.

For further information please contact solicitor Leonie Millard in our Clinical Negligence department via email or phone on 01254 770517.

Learn more about our Clinical Negligence department here

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