The coroner’s findings at the inquest last week into the death of baby Harry Richford at Queen Elizabeth the Queen Mother Hospital in Margate, have attracted widespread media coverage. The coroner found that neglect was partly to blame for Harry’s death and that his death, in November 2017, was “wholly avoidable”. It has also become clear that the hospital did not report the death to the coroner, despite the parents raising the need for this and that it was the parents who finally contacted the coroner, following a long struggle to try to get answers from the hospital.
Before Harry’s birth and death East Kent NHS Foundation Trust (which runs Queen Elizabeth the Queen Mother Hospital and six other hospitals) was placed into special measures following an inspection by the Care Quality Commission which rated maternity services provided by the Trust as inadequate. A review into maternity care at the Trust by experts from the Royal College of Obstetricians in 2015 also raised a number of serious concerns.
Sadly, Harry’s death is one of over 20 maternity cases currently being investigated at East Kent hospitals. This has led to Dover MP Natalie Elphicke calling for immediate action to improve maternity services, and Canterbury MP Rosie Duffield asking for a public inquiry.
The Care Quality Commission and the Health Services Inspection Board are due to report on their examinations of the Trust to the Department of Health imminently. As Ms Duffield herself recently said, hopefully this will act as a turning point for maternity services in East Kent going forward.
It’s important to remember that the majority of healthcare is performed safely and that patient safety is a priority. However, sometimes things do go wrong with medical treatment and when this happens many people don’t know where to turn for help and answers.
What are the options if things go wrong?
In the case of bereavements, it can of course be a particularly difficult and painful time, especially when the bereavement involves children. Charities such as Child Bereavement UK and SANDS can offer valuable help and support.
Resolving issues informally
Most NHS hospitals have a Patient Advice and Liaison Service (PALS). You can speak to them for help with resolving issues informally.
Making a complaint
Another option is to make a complaint about the healthcare provided. Under the NHS Constitution all patients have the right to have their complaints investigated. You can write a letter of complaint yourself. It should be addressed to the complaints manager at the hospital (NHS or private) or doctor’s surgery. It’s helpful to make sure that your letter covers the following:
(a) A statement of what you are complaining about, giving details of when and where it happened and the names and positions of members of staff involved, if possible.
(b) Details of why you are not satisfied.
(c) An explanation of anything you have already done, for example, an informal oral complaint and what happened as a result.
(d) Questions you would like answered.
(e) Details of what you would like to happen, for example, an explanation or apology.
(f) A request that you would like your complaint to be investigated and responded to in accordance with the NHS complaints procedure.
You should complain within 12 months of the event concerned or within 12 months of becoming aware that you had something to complain about. It is possible that the time limit may be waived if there are good reasons why you could not complain earlier. You should receive a response from the trust within 25 working days. If you do not, you can telephone them to make sure they have received your letter. This period can be extended, but the trust is required to inform you if this is likely to be the case.
If you are dissatisfied with the response to your complaint you can appeal to the Parliamentary Health Service Ombudsman.
In making a complaint, you may wish to seek assistance from SEAP who are responsible for delivering the Independent Complaints Advocacy Service (ICAS) across much of the South of England. ICAS is a free, independent advocacy service that can help you make a complaint about any aspect of your NHS care or treatment. This includes treatment in a private hospital or care home that is funded by the NHS
There are certain categories of death in a hospital which must be reported to a coroner. These include where the cause of death was unknown, unnatural or sudden and unexplained. In those circumstances the medical staff should report the death to the coroner but you are also able to contact the coroner if you are concerned that the death should have been reported and was not. The coroner may perform an investigation based on the papers, with or without a post mortem. They may also decide to hold an inquest, which is a hearing in court to establish the cause of death. The family of the deceased patient is entitled to legal representation at an inquest.
If you believe that you or a loved one has been injured as a result of substandard medical care it’s also a good idea to seek legal advice. You may be entitled to financial compensation for your injuries or loss and an experienced clinical negligence lawyer will be able to talk through with you whether this is a viable option in your particular circumstances. It’s usually possible to conduct a claim on a “no win no fee” basis at no upfront cost to yourself. It is important to seek legal advice at an early stage as there are time limits for seeking compensation. A good lawyer can act as a key advocate and voice for those who have suffered injury or bereavement, and be instrumental in helping to not only claim any financial compensation they may be due, but also in navigating their way around what can be a complex system, ensuring that their voice is heard and even helping to effect change to processes going forward.