England is a safe place to give birth, and every year thousands of babies are safely delivered to delighted parents by experienced and dedicated NHS staff. This is the outcome that all families expect and the vast majority of families experience. However, tragedies can sometimes occur, and babies can suffer serious harm during delivery. Thankfully these incidents are rare, but it is clear that there is still more that we can do to achieve our vision to make NHS maternity services among the safest in the world.
Currently when substandard care occurs during labour and delivery which results in the most severe forms of birth injury (cerebral palsy/brain damage), the only means by which families can secure compensation is through the adversarial and often lengthy process of litigation. The average length of time between an incident occurring and an award for compensation being made is 11.5 years as the Court must wait until the injured child's prognosis is clear to make a final compensation settlement. This uncertainty is amplified by the adversarial culture associated with litigation, and adds further uncertainty and stress for the families involved.
Alongside efforts to improve the experience for families in these difficult circumstances, the Government is also committed to reducing incidents in future through increased learning.
The cost of these incidents is not just a human tragedy, and the rising cost of litigation against the NHS also contributes to pressure on health service funding and risks diverting funds away from frontline care. The current expenditure on maternity claims is nearly £500m per year. There is also perceived inequity in the healthcare provision between those whose injury is due to clinical negligence and those that are not.
The National Maternity Review (Better Births, 2016) independently chaired by Baroness Cumberlege, recommended that the Department of Health should consider a Rapid Resolution and Redress scheme for severe avoidable birth injuries.
The RRR scheme aims to introduce a system of consistent, robust, and independent investigations for all instances where there may be severe avoidable birth injury, along with access to ongoing support and compensation for eligible babies through an administrative scheme without the need to bring a claim through the courts, with the main aims of:
Reducing the number of severe avoidable birth injuries by encouraging a learning culture;
Improving the experience of families and clinicians when harm has occurred; and
Making more effective use of NHS resources.
This would be a voluntary scheme which would not affect an individual's right to litigate. The scheme would apply to harm associated with treatment under NHS maternity services in England only.
Why We Are Consulting
This consultation outlines the Government’s proposal to introduce a Rapid Resolution and Redress (RRR) scheme - a voluntary administrative compensation scheme for families affected by severe avoidable birth injury. This online survey is an accessible way of responding to the consultation.
We are launching this public, 12 week consultation in order to gather a wide range of views which will enable us to fully consider and design a policy which supports the needs of families; effectively reduces the number of harmful incidents; and is operationally deliverable.
This consultation will consider several options around proposed scheme design, including:
how the scheme is administered;
the eligibility threshold for compensation; and
how learning would best be disseminated and actioned to reduce future harm.
We also intend to use this consultation as a call for further data and evidence, to help us to further enhance the evidence base and inform future policy decisions. Views on this consultation are particularly invited from:
Families and individuals who have been affected by a serious birth injury, in particular injury resulting in cerebral palsy/brain damage;
Clinicians who have experience of these serious events;
Charities, patient groups and legal organisations that have experience of these incidents and the litigation process;
National Research and Audit groups responsible for investigating these incidents currently
Responses are not restricted to these groups. We welcome the views of any person or organisation with an interest in this policy, directly or indirectly.
You can read the full consultation document, its accompanying impact assessment and two relevant pieces of background research on GOV.UK.
Please refer to "Section 5: Evidence" of the full consultation document for more information about further evidence that is relevant to this scheme, as well as for contact details.