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Concern Over A&E Closures

A Fragile State

On 27 September 2018 the Shrewsbury and Telford Hospital NHS Trust agreed to temporarily suspend overnight A&E services at the Princess Royal Hospital (PRH) in Telford. It was reported that the 8pm until 8am overnight closure would begin during November 2018 and last for at least six months.

It appears that the major contributing factor necessitating the closure is concerning staffing level as Inspectors described that considerable workforce challenges remain in a ‘fragile state’. The Royal College of Medicine recommends that between the Shrewsbury and Telford A&E departments there should be 20 emergency medicine consultants and 32 middle grade doctors. However, it is thought that the former number currently stands at a mere 10 and the latter only 11, therefore meaning the staffing levels are less than half what is recommended. A lack of nurses is also a concern and; the Trust has been relying heavily on agency nurses and currently has 24 vacancies.

What does this mean?

Understandably, the national headlines have been worrying for the local community. It means that after 8pm, ambulances will be diverted to neighbouring Trusts and those with health concerns will have to travel the 18 mile difference to Shrewsbury’s A&E department instead.

Leaders from Shropshire and Telford & Wrekin councils have expressed their anxiety for the safety of their residents and launched a petition entitled ‘Organise a rescue plan to prevent the avoidable overnight closure of PRH’s A&E’ which urges the government to intervene. The petition has currently been signed by over 20,500 residents, meaning that the government will have to respond.

Councillor Davies stated, “We need to do all we can to pressure people into taking action. I would also urge people to write to their local MP and to the Secretary of State for Health and Social Care urging him to intervene.”

Interestingly, Shropshire and Telford & Wrekin councils launched a similar petition as far back as 2016 entitled, “Keep A&E services at Telford's PRH. A reduction of services is not acceptable”. Unfortunately, it appears that this petition went largely ignored; gaining only 2,849 signatures and the situation is now at crisis point.

Just on 16 October it was reported that both Shrewsbury and Telford Hospital’s A&E departments were at full capacity with a backlog and all ambulances were on divert to Stoke for a two hour period between 1pm and 3pm save for paediatric and GP referral cases. Councillor Davies said that this was a serious escalation and; “If you’re a patient in Ludlow, Oswestry or Powys, your nearest hospital was Stoke which is absolutely catastrophic”.

More Doctors and Nurses

It has been reported that PRH’s A&E could be maintained in the short-term if the Trust had an absolute minimum of seven additional level middle grade doctors and 15 more registered A&E nurses.

Recruitment efforts are currently continuing and consultants at SaTH have issued an open letter reassuring the people of Shropshire, Telford & Wrekin and Mid Wales that they “now have a clear vision for the future of our hospitals. This year, we have appointed many new consultants to the Trust who want to make their home here and help us realise this vision”.

Solution

Here at Lanyon Bowdler we work with many clients whose care has been affected by a delay in treatment, or lack of attention due to the unavailability of staff at A&E departments. The number of cases that have presented themselves to us over a long period of time has been greatly concerning. We hope that a solution will soon be found so that patients in the area can be treated promptly with dignity and care.

Although we can help people who have suffered unacceptable injuries due to falling standards we obviously seek to prevent failings happen in the first place, because all local residents are potentially at risk. We shall be writing to our local MPs requesting action and we would urge any person reading this to do the same.

The Movement Centre Golf Day

A few weeks ago on a wet Friday morning, I and two of my colleagues Beth and Lyndsey, along with my friend Sue, arrived at Arscott Golf club for The Movement Centre Charity Golf Day. This has been run for several years now and is well supported by local businesses.

Sue and myself were travelling from Bridgnorth and following the previous night’s heavy rain, the roads were much slower, the usual 40 minute journey taking us an hour. On arrival at the club it was clear that the weather was going to be less than kind. Not only was it lashing down with rain but it was blowing a very cold gale force wind. I was more than grateful that recalling my mother’s advice I had remembered to put my vest on! We had to put on all our waterproof gear so by the time we were fully equipped we had only 10 minutes to tee off time. We rushed to the club house to find a slightly panicking Beth & Lynsey who had fortunately registered us all for the day’s golf.

As it was a shotgun start we had to find our way to the 17th tee. After a couple of detours we arrived just before the hooter went to signal start of play. Sophie, who works in business development for the personal injury and medical negligence teams, took photographs despite us looking more like fishermen than golfers! None of us had ever played there before so it was a bit scary to find we were faced with a par 3 over water (golfers you will understand our consternation!)

It was difficult to stand up with a force eight blowing let alone hit a golf ball, but we gave it our best shot. Unfortunately the first three shots went in the water and the fourth landed somewhere on the next fairway! It would be great to say that after this inauspicious start we ripped up the course and bought home the prizes. Unfortunately it didn't quite work out like that but we had a fun time despite the weather. Sue did manage to win the ladies longest drive having beaten me by about a foot. (We are still friends!)

Following the golf we all retired to the clubhouse for a lovely meal, presentation of the prizes and a charity auction. The weather obviously hadn't affected some people as there were some good scores posted. More importantly around £2,000 was raised for The Movement Centre.

For those who are not aware, The Movement Centre is a charity that works with children with a disability, such as cerebral palsy, which affects their movement control. As a charity they need to raise vital funds every year in order to deliver their services.

Thank you to Curtis Langley, fundraising and marketing manager for The Movement Centre, for arranging and organising the day.

Problems Associated with Cannula Insertion - Extravasation & Infiltration Injuries - An Overview

A potential claim for damages can arise from a patient suffering an extravasation or infiltration injury after cannula insertion.

What is an extravasation injury?

An extravasation injury is the inadvertent leakage of a solution that is vesicant. This means any medicine or fluid with a potential to cause blisters, severe tissue injury (skin, tendons or muscle) or tissue death if it escapes away from the intended venous pathway.

Extravasation can result in mild skin reactions to severe tissue death and sometimes amputation is the only treatment option. Other possible complications associated with an extravasation injury include infection, complex regional pain syndrome, and loss of limb function.

What is an infiltration injury?

Extravasation is different from infiltration. Infiltration is the inadvertent leakage of a non – vesicant solution away from its intended vascular pathway into the surrounding tissue.

Infiltration does not lead to tissue death. However, it can be associated with problems. If a large volume of medicine or solution it may cause redness, swelling, and discomfort around the site and can even cause nerve compression and acute limb compartment syndrome, sometimes resulting in long term disability.

Surgical intervention may be required ie fasciotomy to relieve nerve compression (pins and needles to loss of feeling or movement) and compromised blood circulation to a limb.

There are many risk factors

Peripheral and central venous cannulas/catheters can both cause extravasation injuries. These may include the type of cannula used ie butterfly needles (metal/steel), large sized catheters relative to the vein size it’s inserted into, and cannulas inadequately secured.

Cannulas can also be inserted into undesirable locations eg antecubital fossa (elbow crease area), the back of the hand or at the wrist, plus repeated use of the same vein increases the risk of an extravasation injury as well.

The volume of the vesicant drug/fluid infused, its concentration, pH (extremes of acidity or alkalinity), and osmolarity, affect the resultant damage. Drugs that cause blood vessels to constrict eg noradrenaline and cytotoxic agents are associated with tissue death if they extravasate.

Age

The extremes of age –the very young and old, and patients with small fragile or thrombosed veins are at increased risk from extravasation injuries. As are patients with altered sensory perception (post stroke), poor understanding of risk, patients with lympoedema or the active patient.

There are associated clinician risks, such as lack of knowledge/unfamiliarity of central venous catheters use and management, as well as distraction.

Signs of injuries

Signs of infiltration injuries present as coolness or blanching at the cannula insertion point/swelling, tenderness or discomfort/taut or stretched skin/leakage of fluid at the cannula insertion point, inability to obtain blood return/change in quality or flow of the infusion or injection/numbness, tingling –‘ pins and needles’.

Extravasations signs also include:- burning, stinging pain/redness followed by blistering,tissue death and ulceration.

Extravasation injuries are graded (1 - 4) according to the severity of the injury. Severe injuries often require plastic surgical intervention.

Good practice includes that the access device should be well secured. The needle port should be observed before administering any vesicants or irritant fluids. The patency of the vein and catheter should be assessed before administration. The pressure of the infusion pump monitored and a rise in pressure or a change in flow investigated, the infusion site should be regularly inspected during the duration of the infusion.

Early intervention & monitoring

It is crucial that early recognition and intervention of an extravasation or infiltration injury occurs so to minimise the impact on tissue damage.

It is a medical emergency and the responsibility of medical staff administering intravenous therapy to be competent to undertake the procedure and maintain knowledge and skill. Close monitoring should be adhered to throughout the infusion. Once an infiltration/extravasation injury is suspected relevant medical staff should be alerted, as well as elevation. Often, initially the catheter involved is left in place and if possible the site where the injury has occurred elevated.

Individual Hospital Trusts should have their own policies in place for the management and treatment of infiltration/extravasation injuries.

Baby Loss Awareness Week

Baby Loss Awareness Week is held from 9 to 15 October to raise awareness about the key issues affecting those who have experienced pregnancy loss or baby death in the UK.

Thousands of people are affected each year by the loss of a baby, a still birth or a miscarriage. This is one of the most tragic events that can happen to a parent and more than 60 charities across the UK have collaborated to unite bereaved parents, their families and friends and others across the world, to commemorate the lives of babies who died during pregnancy, at or soon after birth and in infancy.

Baby Loss Awareness Week calls for tangible improvements in research, care and policy around bereavement support and highlights bereavement support and services available for anyone affected by the death of a baby at any stage.

One of the events being held is a ‘Wave of Light’ on 15 October at 7pm where families across the world will light a candle in remembrance of all the babies that have died too soon.

Please visit https://babyloss-awareness.org/ for further information on the organisations, events and how to get involved.

A key point of the week is to raise awareness, as the loss of a baby is something that is often not talked about. Raising awareness helps break the silence in order for parents to get the support that they so often need, but do not know how to access or feel unable to access.

The charities involved are also calling on all NHS Trusts and Boards across the UK to improve bereavement care for anyone affected by pregnancy and baby loss.

This year, Baby Loss Awareness Week marks the roll-out of the National Bereavement Care Pathway (NBCP), a ground-breaking programme set to transform bereavement care for thousands of families each year.

The NBCP standards include:

  • All bereaved parents given opportunities to spend time making memories with their precious babies;
  • A dedicated bereavement room available and accessible in every hospital;
  • Bereavement care training for all staff who have contact with grieving parents;
  • Support for healthcare staff dealing with the trauma of baby loss so that they are able to care for bereaved parents.

Here at Lanyon Bowdler we work with many parents who have experienced the loss of a baby. We meet people at various points in time, some of which are newly bereaved and some who have contacted us at a later point in time, but it is clear the pain caused by the loss of a baby does not go away. Through our clients we understand that support for parents affected by the loss of a baby is paramount in every situation, particularly as the cause of the baby’s death is not always clear.

Baby Loss Awareness Week raises awareness not only about the tragic death of the babies but also all of the issues that parents face, and continue to face, after the devastating loss of their baby.

Visit to Worcestershire Headway

Princess Anne recently visited Worcestershire Headway, a charity that helps people who have suffered brain injuries, and I was fortunate enough to be invited along. The event was meant to have been in March, but was postponed due to the ‘Beast from the East’, and was to mark the opening of a new kitchen.

The Princess Royal was shown around the building and met many of their clients, as well as those who help to raise funds for Headway. She took the time to speak with many of them individually about their stories and how they had been helped by Headway.

I spent time talking to several of the volunteers who go in each week to help the clients. They put on practical classes such as cooking, art and woodwork and many of the items made by clients were on display; a bird house, which had been made by one of the clients, was given to Princess Anne as a gift.

A few weeks before Princess Anne’s visit, I was shown around their premises by Kathryn Davies, the Chief Executive of Headway Worcestershire. It was fascinating to hear about the work they do and to meet some of their clients, many of which have been using the service for a number of years.

As is the case with many charities their funding has been cut significantly in the last few years and they now rely heavily on their own fundraising efforts. The visit from Princess Anne was a real boost to their profile and should help to raise awareness of the wonderful work that they do.

Is There a Duty to Ensure Advice Given by Reception Staff is Reasonably Accurate?

Yesterday the Supreme Court gave their verdict on a case concerning the liability of an NHS Trust following incorrect information given by a receptionist, in the A & E Department, to a patient attending with a head injury which resulted in that patient suffering a serious injury.

In Darnley v Croydon Health Services NHS Trust Mr Darnley had attended A & E following an assault in which he had suffered a head injury. He was told by the receptionist that he would have to wait four to five hours. He left after 19 minutes, not knowing the triage nurse would examine him within 30 minutes of arrival. His condition deteriorated and he was later taken back to hospital by ambulance, but by then had suffered permanent brain damage that could have been prevented.

There is no doubt that hospital A & E and GP receptions are very busy. However, there is a duty, to ensure the advice given to patients attending is reasonably accurate. In this case that information was in relation to waiting times. The receptionist was aware of the protocol in head injury cases; to be seen by the triage nurse within 30 minutes. This is not a new or expansion of the duty.

Had Mr Darnley been advised that he would be seen within 30 minutes he would have stayed, and when he did deteriorate this would have been in a hospital setting. He would have undergone appropriate treatment and would have made a full recovery.

As with all reports of cases in the media you only get a snapshot, and it is often where the misconception lies. Arguments that this decision will result in a new means of attacking the NHS are unfounded. The duty was there in the common law.

If you attend hospital or your GP practice you are entitled to receive accurate information from the staff, including the non-medical staff, and if that inaccurate information causes harm as a result then there is an entitlement in law to seek a remedy.

In this case Mr Darnley suffered serious permanent injury. It is important that members of public attending hospitals as well as the staff, are protected by the law as it has developed in this area. This case re-enforces the duty of care between hospital and patient.

Protecting Your Children's Inheritance

For many couples making their Wills, it often seems natural and right to them that they should leave everything to each other and for their assets to pass to their children only if their partner should die before them. But is this always the best thing to do? If either or both of them have children from another relationship, the answer might be no.

No control

Clearly, there is a need for couples to make appropriate financial provision for one another, but this does not always mean that they have to leave all of their assets to their partner outright. If they do, they will have no control over those assets after their death and there is no guarantee that they will ultimately pass to their chosen beneficiaries, such as children, in the event that they die before their partner.

Children from previous marriages

Take the example of a couple who have both been married before and have children from their previous marriages. They own their home jointly, as beneficial joint tenants, which means that when the first of them dies, the house will automatically pass to the survivor, regardless of any contrary provision in their Wills.

They both want to make Wills to provide for each other and (ultimately) for their children. They make “mirror” Wills in which they leave their estates to each other but, if their partner predeceases them, then to their children or their respective children. They both want their own children eventually to receive an inheritance, following the second partner’s death.

Sometime later the husband dies. The matrimonial home passes automatically to the wife outright because they owned it as joint tenants and the survivor inherits the whole. His other assets pass outright to his wife under the terms of his Will. His children from his first marriage do not inherit anything. Everything now rests on the wife’s Will, to ensure his children receive their intended inheritance on her death.

No provision for late husband's children

The wife later remarries and has little contact with her step-children. She decides to make a new Will to reflect her new circumstances. The new Will provides only for her new husband and her own children; it does not make any provision for her late husband’s children, even though she inherited all of his assets which he ultimately wanted to pass to his own children. There is nothing that the step-children can do about it.

Their step-mother’s family will eventually inherit everything, including their late father’s assets. It is all so unfair, and not what their late father had intended. This situation could have been avoided if their father had dealt with things differently.

Tenants in common

Rather than owning their matrimonial home jointly, as joint tenants, they could still have owned the property jointly, but as tenants in common. This means they would have owned their own percentage shares in the property which they would have been free to leave by Will to their respective children. The Wills would have provided that, when the first of them died, the survivor would be able to continue living in the matrimonial home for the rest of their life (still enjoying the benefit of their partner’s share) but, on the partner’s death, their share in the home would pass to their own children.

Life interest

It is also possible to make a similar provision in relation to other assets, including money. This is known as a “life interest” and is commonly used in Wills in circumstances where couples have children from other relationships that they want to ensure will inherit some or all of their assets following their partner’s death. It is relatively simple and can save a lot of heartache.

Early Intervention in Post-Separation Arrangements for Children

Soon to be President of the Family Division, Sir Andrew McFarlane, has recently voiced his support for the Early Intervention Project (EI) promoted by Dr Hamish Cameron.

The EI, amongst other things, focuses on how to manage parents’ expectations at an early stage in respect of the arrangements they put in place for their children.

Focus on reaching an early agreement

If parents are aware of the likely/possible outcome(s) of Children Act proceedings, then it may help them focus on reaching an early agreement which benefits everyone, most importantly the children.

Key to this approach is the idea that the judiciary issues guidance on what range of arrangements are considered the norm, (in respect of cases where neither party have raised any concerns in respect of safeguarding risks).

The judiciary has previously avoided publishing such guidance, as it is accepted that no two families are the same and thus the children’s needs and the final child arrangements order made is likely to be different for every case.

More focus on both parents having contact

However, over the last few years there has been more of a focus to promote both mothers and fathers having contact with their child, as it is assumed this is beneficial for the child unless the child would be at risk of harm.

This notion was further advanced when the Children and Families Act amended the introductory welfare of the child definition in October 2014, to include a presumption that it is beneficial for children to have both parents involved in their lives. All of which is great news for parents who are not having contact and feel they have a mountain to climb in order to do so.

Standing temporary order

During Sir Andrew’s key note speech to Families Need Fathers Conference he referred to other jurisdictions linking this approach with other steps. For example, the possible imposition of a ‘standing temporary order’ based on the norms for the age of the child in order to maintain some contact in the interim.

Currently the court can be reluctant to impose an interim child arrangement order where the parties are not in agreement, albeit such cases tend to be when safeguarding concerns have been raised by one of the parents.

Sir Andrew has said that he plans on discussing the above with a number of full time family judges in the coming future. He asserts that if there is significant support for the above proposal then he intends to take it forward. If implemented this could be a significant shift in the court’s approach and expectations of parties within court proceedings.

Matters of the Heart

The heart is well associated with love and emotion and the term heart break is often thought about with the breakdown of relationships and grief.

The heart however is also an extremely important organ in the body and if it breaks in a physical sense it can have severe consequences.

The science

The heart is the muscle at the centre of your circulation system, pumping blood around your body as your heart beats. This blood sends oxygen and nutrients to all parts of your body, and carries away unwanted carbon dioxide and waste products. It has four chambers (the upper chambers are the atria and the lower chambers are the ventricles) and four valves. These are the aortic and mitral valve on the left side and the pulmonary and tricuspid valve on the right side. The valves act like gates to keep the blood moving in the right direction.

What can go wrong?

Most people have heard of a heart attack (also known as a myocardial infarction) but there are actually many things that can go wrong with the heart. There can be problems with the structure, the cardiovascular system, the electrical system or the valves. The general term for diseases of the heart muscle is cardiomyopathy. Common problems are hypertension (high blood pressure), ischaemic heart disease which can include angina and heart attacks, abnormal heart rhythms known as arrhythmias and pulmonary oedema (heart failure). There are of course other things that can go wrong and it can be quite complex.

When the heart breaks

If something is wrong with the heart, the most important thing is that it is diagnosed as quickly as possible so that it can treated in the most effective way. Sometimes the heart is broken to the extent that a transplant will be needed and again the earlier it is picked up, the better the chance there is of receiving a transplant. The branch of medicine that deals with the heart is known as cardiology.

Sometimes it is not picked up and sometimes it is treated incorrectly. It could be misdiagnosed, delayed, or treated incorrectly. An ECG (electrical tracing of the heart) is often used to detect heart problems but they can be misinterpreted.

The consequences of incorrect treatment for a heart condition can be severe. Symptoms of diseases of the heart are already difficult but if the treatment is not right it can lead to more extreme symptoms, brain injury and death.

If you have been a victim of cardiology mistreatment or misdiagnosis, it’s important to consider all the options available to you.

We have been able to assist many clients who have been affected by negligence in the treatment of heart conditions and our team are happy to discuss it with you and guide you through the process sensitively.

Having THAT Conversation

As the eldest sibling and the perceived ‘responsible one’ it has fallen upon me three times in recent years to be involved in end of life ‘best interests’ decisions meetings with medical staff and professional carers, for close relatives when those relatives were lacking in capacity to make such decisions on their own behalf.

The first occasion was relatively straightforward. I was a full-time carer for that relation for nearly twenty years and was fully aware of both medical conditions and treatments received over that period. I was well aware of that person’s wishes with regard to on-going treatment.

Right decisions

The other two were less straightforward. Unfortunately both relatives had suffered from dementia for some time and I had not had the opportunity to discuss with either of them their wishes in these circumstances. However, I am sure that the decisions which were taken following discussions with the medical staff and professional carers were the right ones.

When discussing with clients their wishes with regard to the terms of Health & Welfare Lasting Powers of Attorney I am able to draw on my own experiences. The terms of a Health & Welfare Lasting Power of Attorney will only be brought into effect as and when the donor is unable to make such decisions for him or herself due to lack of mental capacity.

Whilst the donor has mental capacity the attorneys cannot act on the donor’s behalf although they might be included in any discussion. The form provides that the donor can give authority to his or her attorneys to make life-sustaining treatment decisions on his or her behalf, or alternatively that the donor does not give such authority.

Not just about resuscitation

When discussing the options with a client (whichever is selected), I ask whether the donor has already discussed with the attorneys/family his or her wishes with regard to such treatment in the event that he or she is at that time mentally incapable of making such decisions on his or her own behalf. The response generally is that ‘I do not want to be resuscitated’. When it is explained that the life-sustaining treatment decision can also include consideration of, for example, blood transfusions, organ transplants or even something as simple as antibiotics for a chest infection, it is generally clear that not only has the donor not discussed such matters with the proposed attorneys or family but that they have not considered the position themselves.

Have THAT conversation

Drawing on my own experience, I encourage the donor to ‘have that conversation’ with the attorneys and family. None of us know what is around the corner. Indeed having that conversation is not a once-and-for-all decision. Lasting Powers of Attorney can be prepared many years before such time as they might be needed and a donor’s personal circumstance, particularly with regard to health issues, may change considerably over the period. It is a matter which should be kept under review and discussed on a regular basis.

Although many families will insist that they do not wish to discuss such matters, because they do not wish to countenance the possibility of the donor (generally mum or dad) becoming so ill that they lose mental capacity and such decisions have to be made on their behalf, I know from experience that bearing in mind such decisions have to be taken at a time when the attorneys and the family cannot consult with the person on whose behalf the decision is to be made, they will thank you for advising them as to what action they should take at the relevant time.

I am now off to update my own Statement of Wishes.

Unmarried Mother Wins Right to Claim Widowed Parent's Allowance

Siobhan McLaughlin, 46, won a Supreme Court battle to access widowed parent’s allowance for her bereaved four children.

Sadly her partner of 23 years and father to their four children had passed away in January 2014. Following his death she was told she was not entitled to bereavement payment or widowed parent’s allowance because they were not married. As they were only cohabiting she was not entitled to claim such benefits.

What Benefits Exist and Who is Entitled?

There are three payments available to the partners of those who pass away at a young age:

  • • a bereavement support payment;
  • • a widowed parent’s allowance; and
  • • a bereavement allowance.

They are paid for from the National Insurance contributions of the person who has passed away. The deceased may have paid significant sums of monies over their lifetime in National Insurance contributions, which would have gone towards qualifying for a pension in old age. If they die, some of those monies paid by the deceased are paid to their partner for their and their children’s benefit. Currently the DWP distinguishes between those parents who were married and those who were not. The latter not being entitled to make such claims.

Court’s Decision/Judgment and Potential Impact

The court declared the government’s refusal to pay the said benefits to Ms McLaughlin breached the family’s human rights and that the current law on the allowance is 'incompatible' with human rights legislation.

President Lady Hale said: ‘The allowance exists because of the responsibilities of the deceased and the survivor towards their children. Those responsibilities are the same whether or not they are married to, or in a civil partnership, with one another. The purpose of the allowance is to diminish the financial loss caused to families with children by the death of a parent.’

‘It is difficult indeed to see the justification for denying people and their children benefits, or paying them at a lower rate of benefit, simply because the adults are not married to one another. Their needs, and more importantly their children’s needs, are the same.’

The court also said it is up to the Government to decide whether or how to change the law; however, its decision in this case will certainly put pressure on the government to revisit its policy and consider changing the same.

Maternity Care at Shrewsbury & Telford Hospital NHS Trust

It is now common knowledge that in 2017 the former Health Secretary, Jeremy Hunt, ordered an investigation into maternity care at the Shrewsbury and Telford Hospital NHS Trust (SaTH). The investigation initially planned to look at the care involved with 23 cases; however, this soon expanded and is now thought to include at least 104 families. Unfortunately, allegations include baby deaths, maternal deaths and brain injuries, and as a result the investigation has received national attention. As the number of families involved continues to increase, the severity of the issue becomes evermore worrying and now appears to be worse than anyone expected.

Concern at the rate of cases

Lanyon Bowdler’s clinical negligence department has represented numerous families who have been devastated by the loss of their baby, or where life-changing brain injury has occurred due to avoidable failings in care. We are therefore concerned by the rate at which cases continue to appear at SaTH despite the investigation having launched last year. Experiences under the care of the Trust have caused families we have worked with unspeakable amounts of pain and grief. It is therefore saddening that with each new headline, another family’s story is uncovered. At the forefront is the knowledge that many of the cases have similar errors, which are potentially avoidable.

The rise in families involved indicates that improvements are not being made and safety concerns remain. The widespread investigation appears yet to make any significant impact on improving services under the Trust.

Treatment every right to expect

On 6 September 2018, Heidi Smoult, the Care Quality Commission's deputy chief inspector of hospitals, confirmed that due to safety concerns "We have now taken urgent enforcement action against the Trust to ensure that people always get the care and treatment they have every right to expect." The urgency of this situation, understandably, puts local families in need of maternity care in a distressing position.

Families want reassurance

Lanyon Bowdler’s involvement with families affected has received an abundance of media attention. Consequently, people are now becoming aware of the possibility of bringing a claim when things go wrong. Above all, families want reassurance that the hospitals will take on board their concerns and do everything needed to ensure no more preventable deaths occur in the maternity unit.

In light of the vast number of families affected, it is hoped the Investigation will be conducted transparently and provide the answers that many feel are needed. Imperatively, it should be remembered that the overriding purpose is to identify failings and avoid repetition of mistakes, improve the service, and ultimately restore public confidence.

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