NHS Resolution have now released their second report regarding the Early Notification Scheme, entitled The Second Report: The Evolution of the Early Notification Scheme.

The second report builds upon the first report, which was released after the first full year of the scheme in 2018, by updating on the progress of the recommendations set out in the first report. The report also outlines how the scheme has developed and makes further recommendations based upon analysis of the scheme to date.

The key finding in the report is a vast improvement in the timescale for a liability decision to be reached since the introduction of the scheme. Previously, and in non-EN cases, the average time for a liability decision is 7 years from the date of injury. This timescale has been reduced to approximately 18 months in EN cases. This is not only beneficial to families, allowing mobilisation of support from a very early stage, but it is also beneficial for learning within Trusts, allowing issues to be identified and acted upon much closer to real time.

The report outlines the following key developments since the EN scheme commenced in April 2017:

  • The adoption of an expert ‘summit’ process, in which multiple similar cases are discussed simultaneously, allowing consideration of liability issues to be fast-tracked.
  • Streamlining of the original reporting criteria, to include only those cases where injury has been confirmed. This ensures a focus on babies who have suffered harm and for whom there is a potential likelihood of complex care needs and a high value financial compensation payment.
  • The creation of a Maternity Voices Advisory Group to develop closer links with families and to support and inform the work of the scheme, as well as collaborating to produce family-facing resources.

The report can be found here - The second report: The evolution of the Early Notification Scheme - NHS Resolution

The report also identifies common clinical themes which have arisen through a cohort of analysed cases, with the aim of providing an understanding of why harm occurs and where efforts need to be focussed to improve care on a system-wide basis. The following situations arose frequently in the cohort:

  • Problems arising from delays in escalation.
  • Problems with fetal heart rate monitoring.
  • Uterine rupture in women opting for vaginal birth after caesarean section.

The report goes into further detail on these common themes, providing recommendations for addressing each, which will be of interest to clinicians in improving care.

Taking into account the key findings from analysis of the scheme to date, alongside the objectives for its future progression, the report concludes by recommending that NHS Resolution supports the work of the royal colleges and wider stakeholders to:

  • improve antenatal information provision and counselling before trial of vaginal birth after caesarean
  • improve awareness of the options available and the response to harm for families and staff.”
  • encouraging a joined-up approach between trust legal services and maternity & risk teams.”

The report indicates that a larger evaluation of the EN Scheme will be conducted in 2023 to assess the impact on families, staff, and the service.