In conversation with...Sian Brown: NHS Resolution’s Early Notification Scheme

Sian Brown is one of Browne Jacobson’s Partners and the head of our Early Maternity Team. The team focuses primarily on supporting the work carried out by NHS Resolution’s Early Notification Team, but also helps Trusts with investigations into cases where babies have died, many of which result in inquests; or where women have suffered severe injuries as a result of childbirth.

She undertook her training contract in 2005 before qualifying into the clinical negligence team in 2007. She has had a short break to experience life from the Claimant’s perspective and has also worked within an NHS Trust to help improve patient safety before returning to the firm in 2017.

What is NHS Resolution’s Early Notification Scheme?

The Early Notification Scheme is a national programme run by NHS Resolution allowing for the early reporting and investigation of cases in order to provide families with early explanations of incidents, fair resolution and highlighting lessons that can be learned. It reflects the Government’s goal of halving the rates of stillbirth, neonatal death and brain injuries associated with obstetric delivery.

Why is this scheme so important?

Historically, resolution of claims relating to birth injury often took a significant time because of the nature of the investigations needed to determine the cause and extent of injury prior to a claimant bringing a claim. This meant that families could be left without support during the early crucial years and made investigation of such incidents difficult, as staff may have moved away or memories may have faded. The introduction of the scheme has led to early admissions of liability, where appropriate, within 18 months of the birth, and enabled support to be provided to families when they need it the most.

What is the benefit to the NHS?

One of Sian’s key passions about the scheme is how it can really make a difference in driving improvements within NHS Trusts to help prevent future incidents. Through the Early Maternity Team’s work with NHS Resolution’s Early Notification Team they identified that a Trust’s electronic records system was generating an incorrect risk factor for advising mothers of the success rate of a VBAC (vaginal birth after Caesarean section). With their input and recommendations, this system was then changed to ensure that consent is accurately recorded and that the risks are personalised for the mother, improving the quality of the care provided to each patient. The Early Maternity team has also worked with another Trust to change its consent forms to better explain about the manoeuvres that might be required for shoulder dystocia, improving the understanding of all patients in that Trust. Without the devoted work of Sian’s team supporting NHS Resolution it might have been several years before these changes were identified.

What is the future for the Early Notification Scheme?

Sian and her team are strong advocates of the benefits of NHS Resolution’s Early Notification Scheme and believe that its unique model can be used to help drive early resolution and costs savings. By implementing early investigation of incidents, the evidence is fresh in people’s minds, and full and open conversations can be had with patients and their families about the care provided.

Obviously, such a scheme is not without its challenges. By breaking away from traditional models of case management, this has involved a significant change in mindset within the team. But by promoting innovative thinking in the way cases are handled, with NHS Resolution and other panel firms, Sian and her team have been able to disrupt the sometimes formulaic and lengthy pathway from incident to a settlement.

When not running the Early Maternity Team, Sian can be found in the country surrounded by her two boys, horses, dogs and mud.