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Posted on 18th September 2017

NHS Resolution Reports No Improvement In Serious Negligence Claims

A report by NHS Resolution finds that instances of the most serious types of medical negligence claims have not changed over the past 20 to 25 years.

Instances of failure to monitor baby’s heart rates and brain damaged babies are as common now as they were two decades ago. Although the report eludes to problems with doctors and midwives, it also says that there is a staff training issue throughout the NHS.

Examples of some problems include attempted delivery of babies in the breech position despite medical staff having little or no training or experience, midwives asked to monitor baby's heart rate when they did not understand how to use the equipment or read the print outs and even an instance of a doctor not knowing how to resuscitate a baby.

When compiling the report, experts reviewed 50 cerebral palsy cases between 2012 and 2016 where liability was admitted. There was a total of 296 compensation claims for cerebral palsy in this timeframe.

The analysis required to compile the report found that investigations by the NHS when things went wrong, was performed poorly and only 40% involved parents.

Of the cases reviewed the report confirmed

  • 32 claims where foetal heart rate monitoring was to blame
  • 26 instances of poor skill levels of staff involved
  • 22 instances of poor communication
  • 18 instances where guidelines or policies were not followed
  • 17 instances of staff having inadequate knowledge
  • 11 instances where heart rate monitoring was misinterpreted
  • 10 cases occurred due to problems with equipment
  • 9 instances of problems with neonatal resuscitation
  • 8 instances where heartrate monitoring equipment was not started at the right time
  • 7 occurred due to staff shortages
  • 6 instances involving breech babies
  • 4 instances where excessive workloads were a contributing factor
  • 2 instances where midwives or doctors didn’t get help from more senior staff members

In one instance where the foetal heartrate monitoring equipment was used, the CTG scan result was found to be abnormal for 3.5 hours. Hospital policy stated that there should be a “fresh eyes” assessment every hour by a different medical expert but despite the labour-ward coordinator being in the room twice and the pregnancy being rated as “high risk” there was no obstetric review.

The author of the report, Dr Michael Magro said “every case presents an opportunity for learning in order to improve the safety of maternity care. Where families can, and are, willing to participate in investigations, they bring a unique perspective and invaluable insight as to what went wrong.”

He continued “We recommend that serious incident investigations should not be closed unless the family have actively involved throughout the investigation process or else have explicitly confirmed that they do not wish to be involved.


The publication of this NHS Resolution report clearly shows there have been many opportunities over the past 20 years for mistakes to be learned from. The report also confirms that lessons simply are not being learned.

The media regularly reports that the NHS is struggling financially and one media source questions whether a compensation claim should be made. The news article states “With medical negligence cases sharply up, citizens need to ask if they really want services drained to compensate a few claimants who can prove their case”

With compensation claims for medical negligence high on the Government’s agenda for reform due to rising costs, significant cost savings could be achieved initially by addressing and learning from the problems highlighted in this report.

For a family who’s new born baby has cerebral palsy due to the neglect of a medical professional, the emotional and financial burden will be enormous. If neglect is proven, there must be a way for that financial burden to be transferred to the negligent party.

If you or a loved one have suffered an injury due to the negligent actions of a nurse, doctor or consultant, contact us on 0330 355 9210 or for a free claim assessment.