Renewed focus required on neonatal care to reduce the incidence of avoidable brain injury

Posted on September 26, 2019


A new NHS report examines how future incidents of brain injury at birth can be prevented and how families can be better supported.

A report from NHS Resolution assessing the first year of its innovative Early Notification (EN) scheme to drive improvements in maternity and neonatal services has shown that issues with neonatal care contributed to the baby’s outcome in nearly third of reviewed cases.

The report notes that while ‘neonatal care is rarely the focus of investigations at a local level, or when being reviewed from a legal liability perspective’ the delivery of neonatal care – and initial resuscitation in particular – contributed to the poor outcome of babies in a third of cases which were reviewed. Key issues identified were:

  • Seniority of neonatal clinicians attending the birth
  • Communication between different professionals
  • Timely calling for, and arrival of, neonatologists.

Additionally, the report notes the importance of multi-disciplinary teams working together when an incident occurs in a maternity setting – indeed, among all the cases of babies born alive and requiring significant input from neonatal clinicians reviewed by this report there was no evidence of neonatal involvement in 61 per cent of investigations.

The report recommends that there needs to be increased awareness ‘of the importance of high-quality resuscitation and immediate neonatal care on the outcomes for newborn babies’ as well as highlighting the importance of collaboration between different teams.

The EN scheme also aims to ensure that families are better supported if their baby suffers rare, but tragic, avoidable brain injuries at birth.

Prior to the establishment of the EN scheme in April 2017, the average length of time between an incident occurring and an award for compensation being made was 11.5 years. Through the EN scheme, 24 families have received an admission of liability, formal apology and in some cases, financial assistance with their care and other needs within 18 months of the incident. There are a further number of cases currently being reviewed.

Justin Irwin, Chief executive of Bliss said: “The Early Notification Scheme is proving to be a helpful tool in ensuring that more families get the answers and support they need after experiencing the devastation of avoidable brain injury at birth. If the National Ambition to halve neonatal brain injury is to be achieved by 2025, renewed energy must be focused on ensuring that babies receive the care they need from specialist members of the neonatal team as quickly as possible. Bliss welcomes the recommendations of the report, and hope Trusts encourage closer working between maternity and neonatal teams.”

Read the report in full here.