Cerebral palsy claim FAQs

What should I do if NHS Resolution contact me after my child’s birth?

If NHS Resolution contacts you after your child’s birth it is important that you seek experienced legal help straight away.

NHS Resolution defends the NHS against compensation claims from patients who have been injured as a result of mistakes in NHS care. It is important that parents realise that NHS Resolution is the NHS’s defence organisation. We strongly recommend that if you are approached by NHS Resolution after the birth of your child you contact us for free, confidential, independent, specialist advice straight away. Your child may be entitled to claim substantial compensation.

Hospitals must notify NHS Resolution if a baby has suffered a brain injury at birth, so that NHS Resolution can carry out its own early investigation into the maternity care that was given and whether a compensation claim might arise for the baby. This includes speaking to the parents about the events that took place. This process is known as ENS or the Early Notification Scheme . NHS Resolution’s contact with the parents is sometimes known as Early Intervention.

NHS Resolution’s intervention (contact with parents) and ENS gives the NHS’s defence team:

• early information about the events which took place at birth so that they can investigate mistakes in maternity care;
• access to the baby’s parents’ recollections much earlier than if they have to wait for the parents to make a compensation claim for their child’s cerebral palsy or brain injury;
• direct access to the parents and the opportunity to ‘advise’ them about whether they can claim compensation. ENS lets them give this advice: 
  • before the parents can seek their own legal advice from lawyers who specialise in acting for patients in compensation claims; 
  • from the NHS defence team’s point of view.

After NHS Resolution have carried out their ENS investigation, they may:

• (sometimes)  admit that mistakes were made at birth;  
• (less often) also admit that the negligent maternity care was the cause of the baby’s brain injury;
• where negligence and causation ( full liability) are admitted, offer an interim payment.

Parents should know that even if NHS Resolution refuse to admit that their maternity care was negligent or caused the brain injury, their child may still be entitled to make a claim.

The Early Notification Scheme (ENS) only applies to babies who: 

• are diagnosed with Grade 3 HIE (hypoxic ischaemic encephalopathy) ;
• needed ‘cooling’ after birth;
• had fits, floppiness or were comatose after birth.

Parents should remember that claims relating to cerebral palsy, brain injury and neurodevelopmental disability often involve highly complex maternity  and neonatal mistakes  and the extent of the injuries they cause require significant expertise to identify. It takes skill and experience to ensure our injured clients receive the compensation they deserve. This is important because over the years to come, compensation will make a huge difference to the child’s quality of life.

At Boyes Turner we believe that when maternity mistakes lead to a child’s brain injury, the parents have a right to full, open and honest information about their child’s entitlement to compensation. NHS Resolution are using ENS to gain early understanding of maternity claims, but, in many cases, the families of injured babies are left without the level of advice or financial support for their child’s injury that they deserve. We strongly recommend that any parent who has been contacted by NHS Resolution or is going through the ENS process, contacts our birth injury lawyers for immediate, patient-focussed, specialist legal advice.

If you have been contacted by NHS Resolution following the birth of your child, and would like to find out more about how we can help, contact us by email at cerebralpalsy@boyesturner.com .

What is the Health Services Safety Investigations Body or HSSIB?

HSIB has changed its name, its status and the way it works, and become the Health Services Safety Investigations Body or HSSIB.

The new HSSIB will continue to carry out investigations into most types of patient safety incidents, but will not take over HSIB’s maternity investigations. Maternity safety incidents resulting in severe brain injury or neonatal death to newborn babies, intrapartum stillbirth or the mother’s death, will be investigated by the new Maternity and Newborn Safety Investigations Special Health Authority or MNSI. This is because the Health and Care Act 2022 gave HSSIB the power to conduct its investigations under ‘safe space’, which is not appropriate in cases involving severe harm to mothers and babies from failings in maternity or neonatal care.

The Health and Care Act 2022 gave HSSIB greater powers than HSIB. HSSIB now has power to:

• access patients’ medical records without having to ask for their consent;
• compel individuals and organisations (e.g. NHS trusts) to cooperate with HSSIB’s patient safety investigations;
• obtain any evidence that it considers relevant for an investigation;
• conduct investigations under ‘safe space’, which means that HSSIB can prevent any evidence it gathers from being disclosed, even to the injured patient or their family.  

HSSIB no longer carries out maternity investigations. MNSI has now taken over HSIB’s maternity investigations programme.

HSSIB is now an independent, non-departmental, arm’s length body (ALB) of the Department of Health and Social Care (DHSC).  HSSIB is led by a board of executive and non-executive directors who will establish and take forward its strategic aims and objectives. HSSIB’s board of directors will be accountable for the way HSSIB is managed, conducts its investigations, and for how it performs.  

HSSIB hopes that it's independence from NHS and DHSC, and its ‘safe space’ working procedures, will reassure patients and staff who have been involved in patient safety incidents that their investigations are unbiased, free from blame and are improving patient safety by helping the  healthcare system learn from the system failures and mistakes that contributed to the patient’s injury.

If you have been contacted by MNSI, HSIB, HSSIB or NHS Resolution after the birth of your child or in relation to the mother’s maternity care, we strongly advise you to contact us by email at cerebralpalsy@boyesturner.com immediately for free, confidential, specialist advice before you respond. Your child or your family may be entitled to substantial compensation.

What is the Maternity and Newborn Safety Investigations Special Health Authority (MNSI)?

The Maternity and Newborn Safety Investigations Special Health Authority is also known as MNSI.

MNSI is hosted by the Care Quality Commission (CQC) and investigates patient safety incidents which have caused harm to mothers and babies during their maternity or neonatal (newborn) care. Since 2018, maternity safety investigations have been carried out by the Healthcare Safety Investigation Branch, also known as HSIB. The former HSIB's maternity investigations programme has now been handed over to MNSI. MNSI will continue to investigate patient safety incidents which have led to maternal or neonatal injury from:

• severe brain injury to the baby which is diagnosed within the first seven days of life, including hypoxic ischaemic encephalopathy or HIE, or other causes of neurodevelopmental disability and cerebral palsy;
• intrapartum stillbirth – where the unborn baby was known to be alive at the start of labour;
• death of a newborn baby, also known as early neonatal death; 
• maternal death – where the mother’s death is related to pregnancy or birth.

The Maternity and Newborn Safety Investigations Special Health Authority (MNSI) was created because HSIB changed to become the Health Services Safety Investigations Body or HSSIB. This change affects the way HSSIB works. The new HSSIB’s increased powers will allow it to investigate patient safety incidents under ‘safe space’, but this process is not appropriate for maternity and neonatal (newborn) safety investigations. The Health and Care Act 2022, which opened the way for HSIB’s transformation to HSSIB, did not provide for maternity incidents to be investigated by HSSIB.

In August 2022, HSIB announced that a new Special Health Authority tasked with investigating maternity safety incidents would be called the Maternity and Newborn Safety Investigations Special Health Authority  and would also be known by its shortened name or acronym, MNSI. Those plans were subsequently changed and arrangements were made for the CQC to host MNSI.

According to the government, MNSI will aim to achieve maximum learning from maternity safety incidents by:

• providing independent, standardised, investigations of maternity incidents that provide answers to families about the cause of their loved ones’ death or serious injury;
• preparing reports to help the healthcare system at all levels learn to improve clinical and safety practices in trusts to prevent similar incidents and deaths occurring;
• analysing data gathered from investigations to identify trends and provide system-wide learning, including identifying where there has been improvement or lack of improvement; 
• becoming a system expert in standards for maternity investigations and supporting trusts to improve their own investigations;
• working with other organisations within the healthcare system to escalate safety concerns and share their knowledge.

Parts of MNSI’s role will be to provide NHS trusts with the expertise, skills and resources to carry out their own maternity safety incident investigations in future.

How long will it take to prove I have grounds for a claim?

It depends on the strength and complexity of the case as to how long it will take to prove that medical negligence took place. If the facts are clear, the NHS will usually admit liability within a year or so of our first instruction. However, if there are complicating factors for either negligence or causation, it can take much longer and in particularly difficult cerebral palsy claim cases, up to 5 years or even longer.

Are there time limits on bringing a claim?

The cerebral palsy claim is the child’s and time does not run against a child. Time will, therefore, begin to run when the child is aged 18 and the time limit on bringing a claim, generally, is 3 years after that, so 21. However, if the claimant does not have mental capacity to bring a claim on their own, time will never run against them (though evidence to establish a cerebral palsy claim is often lost after 24 years or so).

How is a cerebral palsy claim valued?

A cerebral palsy claim is valued firstly as a lump sum to compensate for the profound injury having occurred at all. That sum might be in the order of £250,000 or so. Secondly, a sum to reimburse all expenses and losses arising from the injury down to the case being concluded. The value of that will vary from case to case but is often a significant sum due to the cost of providing care in particular. Thirdly, and most importantly, a sum to cover all the future losses and expenses for life arising out of meeting the needs that the cerebral palsy has caused. That part of the claim can, in total, come to many millions of pounds and will cover care, accommodation, therapies and so on.

Who is the client? Is it the child with cerebral palsy or their parents?

We act for the injured child. They are our ‘client’ and we have a professional duty to act in their best interests. As they can’t give us instructions, one of their parents will usually take on the role of ‘litigation friend’ and instruct us on the child’s behalf. A litigation friend is also needed where our client is a young adult, over the age of 18, but mentally disabled by their condition. As long the litigation friend is acting in the best interests of their child, we can take instructions from them on behalf of the client.

At a later stage of the court proceedings, where the client receives money, either by an interim payment or settlement, a Court of Protection Deputy is then appointed to manage the (child) client’s money under the Court of Protection’s supervision, unless the child will be mentally capable of managing their own financial affairs at 18 years of age.

At Boyes Turner, our own Court of Protection specialist, Ruth Meyer, is appointed Deputy for many of our clients. This ensures that we can continue to work closely with the litigation friend (usually a parent) to set up care and therapies, buy essential equipment and provide adapted accommodation whilst ensuring that the disabled child’s money is properly managed, protected and accessible as required to meet their needs.

Am I too old? Can teenagers or young adults make a claim?

We are often instructed by teenagers or young adults who have decided to seek help with investigating whether they can claim compensation for their cerebral palsy. In some cases, their parents were previously unaware of their rights or chose not to make a claim when they were younger. Over the years, the family may have coped, but as the teenager transitions into adulthood, they find themselves struggling to meet their increasing needs. 

Many of our cerebral palsy clients have severe physical disability but are mentally capable of making their own decisions. They instruct us directly, usually with the support of their parents, in some cases whilst at studying at college or university.  

There is no limitation deadline (time limit) for an injured claimant who is mentally incapable of managing their own affairs. For mentally competent claimants who were injured in childhood, the time limit for starting a claim is generally to age 21. In exceptional circumstances, the court may waive the deadline, so it is always best to seek specialist advice and to do so as early as possible.

In practice, our ability to pursue a cerebral palsy claim for our teenage and older clients is determined by the availability of the medical records and other contemporaneous, supportive evidence.

Will our cerebral palsy claim make it worse for other NHS patients?

In the same way as any other individual or organisation which has a duty of care to others, the NHS is responsible for compensating the people it harms. It is not insured but it receives central government funding, which includes provision to meet the cost of negligence claims. Despite political statements that are designed to generate feelings of guilt in those who might be considering bringing justifiable claims, it is inaccurate and incomplete to suggest that compensation awards are paid from money which is used for frontline NHS care. 

High value compensation figures in cerebral palsy claims are usually reported as ‘capitalised equivalent’ settlements, which reflect the entire lifelong provision that has been made for the severely disabled child. Where the disability is severe and the child’s life expectationis long, resulting in higher annual costs and consequently larger awards, most of the compensation is paid in annual instalments (periodical payments or PPO) over the course of the patient’s life. If the patient does not live as long as the settlement intended, the annual payments cease on their death. 

It’s worth remembering, that in every case where compensation is agreed by settlement or awarded at trial, the NHS has accepted, or it has been proven in court, that the injury resulted from negligent care. We take great care in our scrutiny and early investigation of the claims that we take on. That means that we can be confident that every case we present to the NHS is justified, meritorious and likely to succeed. We believe our clients deserve nothing less from us, and our track record speaks for itself.