Shared Insights

Quarterly safeguarding forum - challenging families and best interests, 28 September 2021

Victoria Colclough, Senior Associate at Browne Jacobson chaired the Quarterly Safeguarding Forum

Rebecca Fitzpatrick, Partner at Browne Jacobson spoke about the difficulties faced by professionals when dealing with challenging family members and highlighted the legal frameworks and mechanisms that can be implemented to manage these behaviours in order to protect staff and keep the patient’s best interests at the centre of decision making.

We were delighted to be joined by Catherine Keay, Head of Commissioning for Mental Health, Learning Disabilities and Autism at NHS Lincolnshire Clinical Commissioning Group who spoke about the CCG’s experiences of working with some of their more challenging families and provided some practical tips on how to manage these complex situations.

We were also pleased to be joined by Lisa Newboult, Named Professional Safeguarding Nurse at United Lincolnshire Hospitals NHS Trust who provided her valuable insight into managing challenging family members in order to ensure Trusts are acting in their patient’s best interests.

Rachael Morris, Partner at Browne Jacobson spoke on how this session would mark World Patient Safety Day which this year has a theme of safe maternal and newborn care. She provided an overview of the implementation of the Ockenden Immediate and Essential actions.

Amelia Newbold, Risk Management Lead at Browne Jacobson provided an overview of how Heads of Legal can support clinical improvement work.

We were delighted to be joined by Dr Angie Doshani Consultant Obstetrician and Gynaecologist at University Hospitals of Leicester NHS Trust (UHL) and Elaine Broughton, Head of Midwifery at UHL, who spoke about the impact of Ockenden at their Trust, the practical steps they have taken to implement the actions required, and shared practical tips for disseminating learning.

In this Shared Insights session, we discussed the future of interaction between NHS Trusts and Local Government amidst a drive for better integrated care; the new Liberty Protection Safeguard legislation due to come into force in April 2022, and the challenges of collaborative working between organisations.

We were delighted to be joined by:

Adam Lent, Chief Executive of think tank New Local, which specialises in advising public services with a network of over 60 local councils.

Mark Barnett, Partner in our Advisory and Inquests team at Browne Jacobson. He advises health and social care providers on issues involving the Mental Capacity Act, deprivation of liberty and Court of Protection applications.

Naomi De Silva, Associate at Browne Jacobson. Naomi specialises in claims against Children’s Services providers and claims under the HRA and DPA.

The first part of this Shared Insights session was led by Sharon Fletcher, Associate Safety and Learning Lead at NHS Resolution who, prior to the pandemic, started some work looking at the themes and learning arising from Operating Theatre claims between 2010 and 2020.

We were also delighted to be joined by Mr Arthur Stephen, Consultant Orthopaedic Surgeon and Divisional Director for Surgical Services at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB). Mr Stephen chairs the Trust Harm Review Committee at UHDB and is the lead for surgical service recovery at UHDB. He led a discussion about the challenges faced by NHS Trusts as they seek to restore surgical and other services post-pandemic.

Each speaker provided their unique perspective and learning outcomes from dealing with eating disorder patients.

Catherine Flannery, Associate at Browne Jacobson outlined what is required from a legal perspective for a successful application to the Court of Protection (CoP).

Claire Noble, Case Manager in the Mental Health, Learning Disabilities, Autism & CAMHS Commissioning Team for NHS Lincolnshire Clinical Commissioning Group spoke about challenges faced by CCGs and set out some practical learning points.

Majella Wright, a Specialist Nurse Practitioner at St Barnabas Hospice, an independent charity providing care for people living with life limiting illnesses, offered insights from her work with patients who have reached the terminal phase of their illness and their families.

Lisa Newboult, Named Professional in Safeguarding Adults and Mental Capacity Act at United Lincolnshire Hospitals NHS Trust spoke about the importance of having a Care Co-Ordinator.

In this Shared Insights session we discussed how different Coroners are approaching recovery from the pandemic. The session was chaired by Nicola Evans, Consultant, Browne Jacobson.

We were delighted to be joined by a panel of Coroners to answer questions from NHS Organisations as we plan for the increased court activity that recovery will bring:

Mr Zak Golombeck, Area Coroner for Manchester City

Dr Robert Hunter, Senior Coroner for Derby and Derbyshire

Mr Gordon Clow, Assistant Coroner for Nottingham and Nottinghamshire

In this Shared Insights session, we discussed the learning from the Paterson Inquiry and the implications for in-house legal teams, patient safety, clinical governance, workforce culture and large-scale reviews.

We were delighted to be joined by Jacqui Atkinson, Partner Browne Jacobson; Kathryn Fearn, Associate Director of Legal Services at University Hospitals of Derby and Burton NHS Foundation Trust; and Alison Bell, Advocacy and Improvement (Freedom to Speak Up) Senior Manager at NHS Improvement.

Helen Badger, Partner at Browne Jacobson provided an insight into the legal issues arising from Covid-19 related illness, including long COVID and PTSD.

Claire Parker, Senior Programme Lead (Health and Wellbeing) at NHS England and NHS Improvement outlined the range of national support available to NHS colleagues for health and wellbeing.

Carl May-Smith, Partner at Browne Jacobson gave practical guidance on dealing with HSE investigations where staff have tragically died during the pandemic.

Nicola Evans, Solicitor-Advocate at Browne Jacobson outlined the Coroner’s guidance on holding an inquest in the circumstances of a staff death during the pandemic.

For this session, we were delighted to be joined by Sangita Bodalia, Head of Early Notification (Legal) at NHS Resolution who discussed the changes to improve and streamline the investigation process for cases under the Early Notification (EN) Scheme (changes which came into effect from 1 April 2021).

We were also delighted to be joined by Sandy Lewis, Associate Director of Maternity Investigation Programme and Amanda Morgan, Regional Lead for Maternity Investigations (South) from HSIB who provided an update on the process for HSIB maternity investigations.

Together, Sangita, Sandy and Amanda discussed the interface between the HSIB and EN investigations.

Kelly Buckley, Senior Associate at Browne Jacobson also provided a Panel perspective and an overview of the process for those EN cases where it is appropriate for Panel to be instructed.

Lorna Hardman, Partner at Browne Jacobson spoke of her role as head of the firm’s clinical negligence practice and explained that the purpose of this session was to focus on the issues that Trust legal teams have faced over the last 12 months during the Covid-19 pandemic.

Lorna and Rebecca Taylor-Onion, Senior Associate at Browne Jacobson, have been focused on indemnity issues stemming from the pandemic. In the early stages of the pandemic they were involved with indemnity arrangements with the private sector and discharging patients to care homes. More recently they have advised on some of the indemnity issues arising from the challenges of the vaccination programme.

Rishipal Singh, Solicitor & Team Leader at NHS Resolution spoke of the challenging year everyone has faced and his experience of being involved in supporting NHS Resolution’s Covid-19 claims handling processes.

This was the first Shared Insights “Safeguarding Forum” which will run quarterly.

Laura Nazar, Senior Associate at Browne Jacobson outlined the practical challenges involved in managing legal proceedings for complex patients. She spoke of her experiences and provided top tips on how to overcome these challenges.

Karen Aucott at Nottingham University Hospitals NHS Trust provided an insight on how to manage complex patients when they are admitted to a ward at an Acute Trust. She discussed the importance of regular MDT meetings and family input.

Lisa Newboult at United Lincolnshire Hospitals NHS Trust discussed her role as Named Professional in Safeguarding Adults and Mental Capacity Act. Lisa explained her role as ‘project manager’ in complex cases and what this role entails.

Sian Brown, Partner at Browne Jacobson spoke of her role as head of the Early Maternity team which focuses primarily on supporting the NHS Early Notification team and helping Trusts with cases where babies have died following birth or where mothers have sustained severe injuries during childbirth. She spoke of the consequences of these claims and the current focus on safety in maternity services.

Kelly Buckley, Senior Associate at Browne Jacobson provided insight into the Ockenden report and the 7 “Immediate and Essential Actions” outlined.

Amelia Newbold, Risk Management Lead at Browne Jacobson set out an overview of the key themes seen in obstetric claims and inquests with a focus on those themes she thinks will be more prevalent in the claims landscape post Ockenden.

Jo Hartley, Associate Director of Midwifery and Neonatal Services, Dorset County Hospital NHS Foundation Trust spoke about the impact of Ockenden at her Trust and the practical steps they have taken to implement the actions required.

Elita Mazzocchi RM, NHS Resolution shared the links between the immediate and essential actions outlined in the Ockenden report and the NHS Resolution Maternity Safety Actions.

Rebecca Fitzpatrick, Partner at Browne Jacobson is one of the leading national specialists in mental health law. She spoke about the main challenges faced in complex cases when patients present to acute Trusts but also have complex mental health needs.

Lisa Newboult, Named Professional Safeguarding Adults and Mental Capacity Act at United Lincolnshire Hospitals NHS Trust (ULH) provided an Acute Trust’s perspective and explained some of the practical measures put in place at ULH to help staff improve patient outcomes.

Dr Adaeze Bradshaw, Clinical Director and Consultant Psychiatrist at Lincolnshire Partnership NHS Foundation Trust shared her experiences as a Community Psychiatrist dealing with eating disorders and Child and Adolescent Mental Health Services (CAMHS). She set out some of the steps taken within her Trust when managing these complex cases.

Charlotte Harpin, Partner at Browne Jacobson spoke about the key legal principles that apply when processing requests for access to confidential information and gave some practical tips on how to deal with issues that might arise when Trusts are dealing with complex information requests.

Marilyn Whittle, Head of Legal and Governance at Sheffield Children’s NHS Foundation Trust, joined to tell us some of the in-house complexities of dealing with confidentiality and disclosure of information to third parties such as the police.

Nicola is a Solicitor-Advocate who has specialised in health law for more than two decades. This included over a decade working at senior level within the NHS as the Associate Director of Legal Services at University Hospitals of Derby and Burton NHS FT (“UHDB”). Nicola now acts for a wide range of NHS organisations and NHS Resolution advising on complex health law queries and representing NHS Trusts at Coroner’s inquests, appearing in numerous jurisdictions. Nicola has extensive experience supporting clinicians through the inquest process and is one of the key speakers on the Mock Inquest training course.

Nicola was joined by Dr Robert Hunter, HM Senior Coroner for Derby and Derbyshire to talk about the implications of the Supreme Court’s decision in Maughan and the impact that Covid-19 continues to have on the Coroner’s courts.

Damian Whitlam, Partner at Browne Jacobson, advises NHS Trusts and NHS Resolution in resolving patient disputes efficiently and fairly, on indemnity issues with potential third parties and helps NHS organisations learn from claims to drive improvements in patient care.

Luke is a barrister at Browne Jacobson and provides advice, drafting and advocacy spanning criminal regulatory, coronial and associated civil matters. He works closely with NHS and public bodies throughout the lifetime of a case.

He was joined by Kathryn Fearn, Associate Director of Legal Services at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB).

Kathryn and Luke spoke about their experience dealing with anti-Covid protesters at UHDB. They emphasised the importance of Trusts developing a written plan so that you are ready to act quickly if anti-Covid or anti-vaccination protesters come on to your site to protest. Browne Jacobson recently assisted UHDB to deal with protesters on site and develop a plan to be followed if they return to site.

Helen is a Partner at Browne Jacobson specialising in employment within health, social care and education. She advises on a wide range of HR and employment matters, including disciplinary and grievance issues in the workplace, TUPE, equal pay, workforce change, discrimination and variation of terms and conditions of employment.

Helen provided some practical tips to share with HR colleagues on issues which may cause employee relations issues and litigation in 2021.

Carl May-Smith is a partner and barrister specialising in regulatory and criminal law, with a particular focus on the health and care sector. Carl provides a broad variety of advice including in respect of health and care standards (CQC and others), health & safety, fire safety and police investigations. His clients include care providers (independent and NHS) as well as commissioners and investors in the sector.

Carl provided an update on what individuals and NHS organisations should expect from the regulators in 2021.

Paul Wainwright, Partner, and Louise Jeffers, Senior Associate, at Browne Jacobson spoke of their involvement in Elder v George Eliot Hospital NHS Trust [2017] and the successful prevention of a potential £2 million fraud on the NHS.

Paul jointly heads up Browne Jacobson’s Fraud and Financial Crime practice and Louise specialises in high value and complex clinical negligence claims.

Linda Williams, Legal Services Manager at George Eliot Hospital NHS Trust provided valuable insight into the in-house experiences she has dealt with in relation to dishonesty claims, including her involvement in the case of Elder.

Paul Gausby, Fraud and Investigation Team Leader at NHS Resolution provided a look into the financial impact fraudulent claims have on the NHS.

Damian Whitlam, a Partner and Amelia Newbold, Risk Management Lead, at Browne Jacobson discussed the legal test codified in Montgomery v Lanarkshire Health Board [2015] and the impact of the Covid-19 pandemic on consent discussions.

Ed Pollard, a Partner at Browne Jacobson specialising in advisory law discussed consent in the context of patients who lack capacity to make a particular decision.

Tim Shurlock, Safety and Learning Lead and Alison Macefield, Associate Safety and Learning Lead shared the data on consent claims.

David Edwards, Lawyer in the Official Solicitor’s (OS’) Healthcare and welfare team spoke with Chris Stark, Partner and Victoria Colclough, Senior Associate at Browne Jacobson about when NHS Trusts should consider going to the Court of Protection.

Andy Hopkin provided legal advice on the steps organisations should take if they are subject to an investigation by the police, Health and Safety Executive or CQC. He was joined by Steve Murray, Head of Legal Services at University Hospitals of Leicester NHS Trust, who spoke about how internal investigations sit alongside external ones. They set out practical advice based on their experiences.

Andy Hopkin is a Partner at Browne Jacobson specialising in criminal and regulatory work, defending public and private sector corporate bodies and individuals in prosecutions brought by the police and other regulators such as the HSE and CQC.

Simon Tait and Nicola Evans led a discussion with Dr Robert Hunter, HM Senior Coroner for Derby and Derbyshire, Mr Gordon Clow, HM Assistant Coroner for Nottinghamshire and Miss Susie Hewitt MBE, Consultant in Emergency Medicine, University Hospitals of Derby and Burton NHS Foundation Trust.

Simon Tait is a Partner and Head of Health, Advisory and Litigation at Browne Jacobson. He is an experienced advocate with expertise in coronial law and represents health and public sector organisations in complex inquests across a range of jurisdictions. Simon also sits as an Assistant Coroner for Yorkshire South East.

Nicola Evans is a Consultant at Browne Jacobson who has specialised in health law for more than two decades. She acts for a wide range of NHS organisations and NHS Resolution, advising on complex health law queries and representing NHS organisations at inquests. Nicola has 12 years’ experience working at senior legal within the NHS as Associate Director of Legal Services for a large acute hospital Trust.

Ed Pollard, Partner at Browne Jacobson specialises in Healthcare Advisory law. His work includes inquests, mental health and mental capacity law, the court of protection, DoLS, fitness to practice and data protection issues. He spoke about the statutory and general Duty of Candour, the importance of embedding a “culture of candour” and the approach that Trusts should take to candour when dealing with issues arising from Covid 19.

Louise Pye, Head of Family Engagement at Healthcare Safety Investigation Branch (HSIB) highlighted how important it is to give families a voice and what HSIB has learnt from working with over 1,000 families during investigations into patient safety.

Clare Cooper, Family Liaison Officer and Isobel Thistlethwaite Head of Legal Services from Nottingham University Hospitals NHS Trust, Amy Johnson Family Liaison Office and Andrew Coburn Head of Legal Services from Derbyshire Healthcare NHS Foundation Trust all provided us with the Trust perspective of Family Liaison Officers and how they work with their Trust’s legal teams.

This session focused on effective triangulation of data and learning from claims with contributions from Amelia Newbold, Risk Management Lead at Browne Jacobson; Lorraine Cardill, Safety and Learning Lead at NHS Resolution; John Glendening, Head of Legal Services and Meg Haselden, Head of Nursing and Quality Governance at Sherwood Forest Hospitals NHS Foundation Trust; and Lorna Priestman, Director of Quality and Clinical Governance and Kathryn Fearn, Associate Director of Legal Services at University Hospitals of Derby and Burton NHS Foundation Trust.

The second victim and supporting clinicians through investigations, complaints, claims and inquests. Ed Pollard, a partner at Browne Jacobson specialising in healthcare spoke with Miss Susie Hewitt MBE, Consultant in Emergency Medicine of University Hospitals of Derby and Burton NHS Foundation Trust and Isobel Thistlethwaite, Head of Legal Services at Nottingham University Hospital NHS Trust about the impact of investigations on clinicians and how to support them through the process.

Ros Foster, Nicola Evans and Kathryn Fearn led a session on commissioning independent reviews when NHS organisations identify issues with a service, clinical department or clinician’s practice.
Ros Foster is a partner at Browne Jacobson who has over 25 years’ experience advising a wide range of clients on regulatory and administrative law issues. Ros specialises in healthcare regulation and leads Browne Jacobson’s information law team.

Nicola Evans is a Consultant at Browne Jacobson who has specialised in health law for more than two decades. She acts for a wide range of NHS organisations and NHS Resolution, advising on complex health law queries and representing NHS organisations at inquests. Nicola has 12 years’ experience working at senior legal within the NHS as Associate Director of Legal Services for a large acute hospital Trust.

Kathryn Fearn is an experienced Solicitor-Advocate and is the Associate Director of Legal Services at University Hospitals Derby and Burton NHS Foundation Trust (UHDB). Kathryn Fearn shared learning from two external reviews commissioned at UHDB and the lessons learnt from that process.

Helen Badger, Partner at Browne Jacobson specialising in employment within health, social care and education spoke about the law protecting whistleblowers, how to recognise a protected disclosure and the Trust’s statutory duties when dealing with whistleblowers. Alison Bell, the Freedom to Speak Up Guardian at University Hospitals of Derby and Burton NHS Foundation Trust, highlighted some examples of best practice and common pitfalls when dealing with whistle-blowers.

Julienne Vernon, Head of Dispute Resolution and Quality at NHS Resolution spoke with Paul Balen of Trust Mediation and Bev Hunt, Safety and Learning Lead (Mediation) at NHS Resolution about the benefits of mediation for Trusts.

Karen Reynolds is a partner at Freeths who acts for patients and families and specialises in clinical negligence claims. Karen explained how claimant firms were being affected by the pandemic and what the future may hold for litigation post Covid-19. She shared her thoughts on how NHS Trusts can work collaboratively with patients and their representatives to deal with claims more effectively and efficiently while continuing to recognise the need to keep the injured patient at centre of any dispute or claim.

Sarah Stork, Senior Associate at Browne Jacobson, provided an update on how the courts are dealing with litigation during the Covid 19 pandemic.

Sangita Bodalia, Head of Early Notification (Legal) at NHS Resolution explained how the Early Notification Scheme works, recent changes to the scheme in light of Covid -19 and the impact of these changes over the next 12 months. Katherine Hawes (Head of Maternity Investigations North) and Bethan Phelps (Maternity Investigator) gave an overview of the Maternity Investigation programme at Healthcare Safety Investigations Branch (HSIB). Scott Hislop (Principal National Investigator) gave an overview of the role of the National Investigations team at HSIB.

Carl May-Smith, Partner at Browne Jacobson specialising in regulatory and criminal law with a particular focus on the health and care sector, spoke about guidance and risk assessments for PPE, documenting decisions about PPE strategy and responding to PPE shortages. Dr Robert Hunter, HM Senior Coroner for Derby and Derbyshire explained that new guidance to Senior Coroners was expected imminently about resuming inquests with social distancing in place, and set out likely plans for remote hearings going forwards.

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