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NHS Resolution Annual report and accounts 2021/22 33

The growth in obstetrics claims volumes over the past three years is due to the impact of trusts
reporting cerebral palsy/brain damage claims earlier through our EN Scheme. The scheme, established
in 2017, allows us to investigate potential eligibility for compensation and to take action to reduce
legal costs while improving the experience for the patient's family and affected staff.

The impact of the Early Notification Scheme can be seen when looking at the recent value of maternity claims.
The scheme has already achieved reductions in the time between an incident occurring, an investigation into
eligibility for compensation initiated, and admissions of liability being made. Seeking early notification of maternity
incidents means that NHS Resolution can proactively investigate liability sooner, while trusts are encouraged
to be open about incidents, be candid with families and maximise opportunities to learn from them.

What is the Early Notification
(EN) Scheme?

It is a key initiative towards achieving the delivery Implementing a more focused approach
of safer maternity care, providing a more rapid,

From 1 April 2021, our EN Scheme moved to
caring response to families in cases of severe harm,
an 'outcome-first' approach. The criteria for an
and supporting a learning culture. The scheme
investigation was narrowed to babies who have
proactively investigates specific brain injuries at
an abnormal MRI scan where there is evidence of
birth for the purposes of determining if negligence
changes in relation to intrapartum hypoxic ischaemic
has caused the harm. We do this by requiring
encephalopathy (HIE). This ensures the scheme
our CNST members to notify us of maternity
focuses on those babies who have suffered harm
incidents which meet a certain clinical definition.
and where there is potential for complex care needs
It is designed to do two main things: and a high value financial compensation payment.
• To speed up investigations into whether or not The new approach has led to a reduction in
a baby is entitled to receive compensation by duplication with the Healthcare Safety Investigation
investigating cases proactively, being open about Branch (HSIB) and has enabled trusts to focus on
our conclusions and signposting families to liaison with HSIB and the family. To progress the
appropriate sources of advice and support; and liability investigation (the legal investigation into
clinical negligence) by the EN Scheme, a decision
• To help ensure that steps are taken to learn
was made to focus only on those incidents where
from things that have gone wrong to improve
HSIB had completed their investigation.
maternity care as well as sharing good practice.
Early admissions

During the past five years we have been able to make a
significant number of early admissions1. As the volume
of admissions increases, so does the number of interim
payments made. There are now some children, due to
their age and the length of time the scheme has been
running, for whom we are able to fully quantify their
needs. This has led to an increase in the value of the
payments made, while simultaneously reducing the
impact of inflation on these claims. This has resulted in
an increase in damages payments under the scheme
from £3.2 million last year to £10.2 million this year.

An admission is an acknowledgement of legal liability for substandard care.