The role of NHS resolution in the maternity safety landscape in england

M R C O G PA R T 2 · S O S P O C K E T C A R D · K N O W L E D G E A R E A 2 – T E A C H I N G A N D R E S E A R C H

The Role of NHS Resolution in the Maternity Safety Landscape in England Wonnacott A, Barton KS et al. The role of NHS Resolution in the maternity safety landscape in England. TOG 2025;27:154–159. doi:10.1111/tog.12977

£2.6m 13% / 64% 18% SPENT ON CLINICAL NEGLIGENCE CLAIMS MATERNITY CLAIMS: SHARE OF VOLUME / UK OBSTETRICIANS WITH SIGNIFICANT PTSD 2022/23 POTENTIAL VALUE 2022/23 SYMPTOMS

DO N' T-M IS S FA C TS

1. NHS Resolution’s 4 core services: claims management, practitioner performance advice, primary care appeals, safety & learning

2. Negligence test: duty of care → breach → causation (balance of probabilities); claims brought against the trust, not the clinician

3. Case law order: Bolam → Bolitho → Montgomery → McCullough

4. MIS = 10 safety actions/year; meet all 10 → trust recovers CNST contribution + share of unallocated funds

5. EN Scheme: term babies (≥37+0wks), severe brain injury in first 7 days of life (grade III HIE / active cooling / decreased tone+coma+seizures); outcome-first approach from 1 April 2021

6. EN vs MNSI vs MBRRACE-UK vs CDOP: differing remit – legal liability vs learning vs statistics vs local authority death review

7. 2022 EN report themes: delay in birth & fetal monitoring, mostly non-technical skills; Impacted Fetal Head a recurring, poorly standardised issue

8. Maternity claims: 13% of volume, 64% of potential value (2022/23); 18% of UK obstetricians report significant PTSD symptoms

REPORTING PROGRAMMES AT A GLANCE

EN (NHS Resolution): legal liability MNSI (CQC): learning MBRRACE-UK: statistics/learning CDOP: learning

ABBREVIATION KEY

CNST — Clinical Negligence Scheme for Trusts CDOP — Child Death Overview Panel

MIS — Maternity Incentive Scheme CAG — Collaborative Advisory Group

EN — Early Notification Scheme RCOG — Royal College of Obstetricians and Gynaecologists

ABC — Avoiding Brain Injury in Childbirth programme RCM — Royal College of Midwives

MNSI — Maternity and Newborn Safety Investigations S&L — Safety and Learning (directorate/team)

HSIB — Healthcare Safety Investigation Branch (former host of HIE — hypoxic ischaemic encephalopathy MNSI) IFH — Impacted Fetal Head CQC — Care Quality Commission PTSD — post-traumatic stress disorder MBRRACE-UK — Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK

Source: The Obstetrician & Gynaecologist (TOG), RCOG journal — 159. doi:10.1111/tog.12977

Clinically reviewed by NHS obstetricians and gynaecologists

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