The Early Notification Scheme: One Year On

NHS Resolution, the body responsible for managing compensation claims against the NHS, has reported on the first year of its Early Notification Scheme.

The scheme was introduced to improve maternity and neonatal services in England and to better support families whose babies have suffered an avoidable brain injury at birth.

Research included analysing 96 birth injury cases and identifying the key themes. These themes included:

• limited support to staff
• a lack of family involvement
• confusion over duty of candour (the duty of health care professionals to be open and honest when something goes wrong)
• in 70% of cases there were issues with fetal monitoring (by CTG, electronic monitoring of the heart rate of the baby which detects early signs of the baby not coping with labour)
• in 63% of cases at least two or more factors were identified – problems with a delay acting on a pathological CRG being the most common factor.

The report makes 6 recommendations, in summary:

1. families whose baby has suffered an avoidable brain injury at birth should be offered an open conversation about their care, an apology and a plan of investigation
2. staff should be offered a support package, particularly those involved in the incident, to manage any distress
3. fetal monitoring must be improved immediately
4. increase awareness of difficult delivery of the fetal head and the techniques that can be implemented to ensure safety
5. urgently improve the detection of maternal deterioration
6. increase awareness of high-quality resuscitation and immediate neonatal care.

Click here to read the full NHS Resolution report

Sandra Patton, head of Ashtons Legal’s Medical Negligence team, comments:

‘Over decades of representing families of babies who have sustained brain injury at birth I have seen the devastation and hardship this causes, and any efforts to reduce that toll are welcome. This report reflects our own long experience of compensation claims for birth injury cases and that so often CTG monitoring is put in place but, when there are signs that the baby is struggling, no action is taken. If the problems continue and the baby is not delivered quickly enough, the oxygen levels to the baby’s brain can be reduced to the point where permanent brain damage results. It seems that finally the issue of failure of proper interpretation of CTG monitoring is being formally recognised and a commitment made to address it. Finally we may see some real progress in making CTG monitoring as effective and safe as it should be.’