Birth injury news

 

What is a neonatal brain injury and how do I claim?

What is a neonatal brain injury?

Neonatal literally means newborn. In medical terms, the neonatal period relates to the first few weeks of life. A neonate is a newborn baby. Neonatal care is the specialist care of babies – often born prematurely, unwell or who are small for their gestational age – within the first weeks of life. Neonatal care usually takes place in a neonatal unit (NNU) or special care baby unit (SCBU) or a neonatal intensive care unit (NICU), depending on the level of monitoring and treatment and breathing support that is needed.

Can I get Legal Aid for a neonatal brain injury medical negligence claim?

Legal Aid is available for birth injury and neonatal claims resulting in neurological injury where the injury was caused during the mother’s pregnancy, the baby’s birth or the first eight weeks of the baby’s life. Where our specialist brain injury lawyers believe the severely injured child has a viable claim and they are eligible for Legal Aid, Boyes Turner make a Legal Aid application on the child’s behalf.

Does my newborn baby’s admission to NICU, NNU or SCBU mean that they have a claim for negligence?

There are many reasons why a newborn baby might be admitted to a neonatal unit. Some of the more common reasons include:

  • They need help with breathing and maintaining their oxygen levels by ventilation or continuous positive airway pressure (CPAP)
  • They are at risk of hypoglycaemia and need close monitoring and help with feeding to maintain their blood sugar and nutrition
  • Their heart rate needs monitoring
  • They are at risk of kernicterus and need phototherapy for jaundice
  • They are recovering from or are receiving treatment for an infection
  • They are recovering from surgery or other treatment
  • They need therapeutic cooling after suffering HIE (hypoxic ischaemic encephalopathy - brain damage from lack of oxygen)

Premature babies (born before 37 weeks of pregnancy) or those with very low birth weights often need neonatal care as they need more support and are at greater risk of complications.

In full term babies (born after 37 weeks) who have been admitted to a neonatal unit, most admissions relate to problems with respiration, hypoglycaemia (low blood sugar), jaundice or asphyxia. NHS Improvement has identified poor treatment associated with these conditions as potential causes of greatest harm which, where causing serious neurological injury, can give rise to a claim.

In a patient safety alert in 2017, NHS Improvement said: “It is a priority for the NHS to reduce avoidable harm that can lead to full-term babies (babies born after 37 weeks of pregnancy) being admitted to neonatal units. The number of unexpected admissions to neonatal units is seen as a proxy indicator that preventable harm may have been caused at some point along the maternity or neonatal pathway.”

Perinatal asphyxia or HIE, respiratory problems from meconium aspiration during birth, kernicterus from untreated jaundice, delayed treatment of infection and neurological injury from untreated hypoglycaemia are the most common neonatal brain damage claims that we see at Boyes Turner. Our clients come to us at many stages of their child’s development - shortly after birth, in early childhood or in teenage years - depending on when the damage becomes evident. Negligent medical treatment of the newborn child can cause severe disability which lasts far beyond the baby’s first few weeks.

Neonatal brain injury can present with a wide range of features. Once the damage is done, the injured areas of the brain cannot recover and as the baby grows and develops, the full extent of the problems caused by the neonatal injury are gradually revealed. These impairments can range from near normal development to a diagnosis of cerebral palsy and can present as:

  • delayed development
  • missed early years milestones
  • behavioural problems
  • difficulties with feeding or speech
  • impaired fine motor control
  • damage to the senses
  • spasticity
  • athetosis
  • severe cognitive damage. 

If you are caring for a child who has suffered a brain injury from negligent care at birth or in the first few weeks of life, contact us 0118 952 7219 or email mednegclaims@boyesturner.com.

Neonatal hypoglycaemia is a cause of brain damage - how do I know if my child has a claim?

What is neonatal hypoglycaemia?

Neonatal hypoglycaemia is a common metabolic condition in newborn babies which, if left untreated, can cause long-term brain damage and disability. Hypoglycaemia means low blood glucose or sugar. It becomes dangerous when the newborn’s blood sugar drops below safe levels, such as before the baby has established a regular feeding pattern enabling it to keep its blood glucose up in the first few days of life. 

What are the risk factors for neonatal hypoglycaemia?

Until adequate feeding is established all newborn babies are at some risk of hypoglycaemia, which is why it is part of the post-natal midwives’ job to ensure that the baby is receiving enough milk. The baby’s blood sugar is measured by a heel-prick blood test and is carried out routinely in some hospitals but should always be carried out for babies who are known to be at risk.

Those at increased risk include:

  • Newborn babies with birthweights below 2.5kg - the standard threshold level below which the baby’s blood glucose must be monitored
  • Babies with diabetic mothers
  • Babies who are small for dates with intra-uterine growth retardation (IUGR)

Regardless of birthweight or their mother’s state of health, any baby who is not feeding properly could be at risk, for example by:

  • Not waking up for feeds
  • Not sucking properly
  • Demanding feeding very frequently because they are not getting enough food at each feed

Is neonatal hypoglycaemia a medical emergency?

If acted upon quickly, neonatal low blood sugar can be corrected quickly by feeding, either by breastfeeding if that provides enough milk, by expressed breastmilk or formula milk or, if necessary, intravenously by a glucose drip.

In a review of medical negligence claims relating to neonatal hypoglycaemia, NHSLA (the NHS Litigation Authority, now known as NHS Resolution, which represents the NHS in legal claims) found that abnormal feeding behaviour was very closely associated with the condition, both as a cause and as a potential consequence of hypoglycaemia. Maternal concerns about abnormal feeding behaviour were often ignored by health professionals, missing a vital opportunity to take action to prevent hypoglycaemia before permanent damage was done to the infant’s brain.

If neonatal hypoglycaemia is severe or is left untreated, the baby’s condition will deteriorate, demonstrating other signs of illness. Neonatal hypoglycaemia with abnormal clinical signs must be regarded as a medical emergency requiring immediate action to avoid permanent brain damage and severe neurodevelopmental disability. Abnormal signs which are commonly seen with hypoglycaemia include:

  • Hypothermia (low body temperature)
  • Floppiness
  • Fitting or jitteriness
  • Infection
  • Respiratory (breathing) difficulties

Hypoglycaemia can also occur alongside and in combination with other serious conditions.

My baby has brain damage from hypoglycaemia – do I have a claim?

In its review of 25 neonatal hypoglycaemia claims which succeeded against the NHS over a ten year period at a total cost of over £162 million, NHSLA identified the most common errors in clinical care as:

  • Delays in obtaining blood glucose test results
  • Delays in taking action on a low blood glucose result
  • Delays in referring babies to the paediatrician once concerns have been identified
  • Delays in admitting babies who have been diagnosed with clinically significant hypoglycaemia to the neonatal unit (NNU)
  • Delayed administration of intravenous glucose on the NNU
  • Insufficient glucose being administered to correct the hypoglycaemia
  • Delayed attendance by the paediatrician when called by the midwife to review
  • Failing to advise the mother properly when the baby is discharged home.

Unlike asphyxial (oxygen deprivation) causes of perinatal brain injury, neurodevelopmental disability from neonatal hypoglycaemia might not be obvious to the parents in the immediate aftermath of the traumatic birth or the infant’s early childhood. Neurodevelopmental disability from avoidable neonatal hypoglycaemia might be disregarded or downplayed until the child grows and the impact of their injury later becomes evident when they struggle to cope at school.

In its review, NHSLA said it was likely that whilst the cases they knew about were those where the parents had identified potential deficits in care, it is likely that others who were harmed have not been notified to NHSLA via the litigation process.

Boyes Turner’s specialist brain injury solicitors are experienced in obtaining compensation for children and teenagers with neurodevelopmental injury from avoidable neonatal hypoglycaemia. We work with experts to ensure that, where liability for the injury is established, the extent of the injury and the impact on the individual’s mobility, cognition, education, work and independence is properly assessed to ensure that our clients are properly compensated. In addition, our special educational needs (SEN) team can help families with children affected by neonatal brain injury secure the educational support that they need for their child within the school that is right for them.

If you are caring for a child who has suffered neurodevelopmental disability from negligent medical care, contact us on 0118 952 7219 or email mednegclaims@boyesturner.com.

Epilepsy medicine Valproate linked to birth defects

The Medicines and Healthcare products Regulatory Agency (MHRA) has changed the licensing rules controlling the prescription of valproate drugs for women and girls of childbearing age with epilepsy. The new contraindication of drugs such as Epilim in pregnancy, follows evidence that up to 10% of babies born to mothers prescribed the drug have serious birth defects, with as many as 40% suffering developmental problems.

Birth defects associated with valproate in pregnancy

Birth defects suffered by babies of valproate-medicated mothers during pregnancy include congenital malformation of the spine (spina bifida), face and skull (such as cleft palate), limbs and organs including the heart, kidneys and sexual organs.

The long-term effects of the developmental problems suffered by valproate babies are not yet fully understood but include delayed walking and talking, reduced intelligence, impaired speech and language and memory problems.

Children exposed to valproate in the womb also have an increased risk of autism and attention deficit hyperactivity disorder (ADHD).

Valproate – little change despite warnings

“Valproate is a common treatment for epilepsy and bipolar disorder and is prescribed to thousands of women. The drug was introduced in 1974 and its product information for doctors has always included a warning that it carried a potential risk of birth defects.”

Over time, as more information has been gathered in Europe about the drug’s association with congenital malformations and developmental impairments, the MHRA’s warnings to doctors and pharmacists about the risks to the medicated woman’s unborn child have been strengthened. However, the MHRA’s latest alert confirms that despite the strengthened warnings that they issued to prescribers in 2015 and 2016 against prescribing valproate medicines in girls and women of childbearing age unless other treatments are ineffective and they are using effective contraception, one in five women taking valproate remain unaware of its risks in pregnancy. Without such information, women are unable to make informed decisions about their treatment. They risk becoming pregnant with high risk of serious injury to their child. MHRA’s previous communications appear to have had little impact on prescribing practice.

New regulation of valproate prescription from April 2018

In March 2018, after further research revealed the extent to which previous warnings had not been heeded, the European Medicines Agency, CMDh (Coordination Group for Mutual Recognition and Decentralised Procedures – Human), recommended tougher regulation of the prescription of valproate medicines. The new regulations will come into force at the end of April 2018 and will be backed up by amended guidance from The National Institute for Health and Care Excellence (NICE).

Valproate medicines are now contraindicated in women and girls of childbearing potential unless the conditions of a specified Pregnancy Prevention Programme are met, and only if other treatments are ineffective or not tolerated, as judged by an experienced specialist. The Pregnancy Prevention Programme also applies to female patients who are not sexually active unless there are compelling reasons to indicate that there is no risk of pregnancy.

Compliance with the Pregnancy Prevention Programme means that all female patients taking valproate medicines:

  • have been told and understand the risks of pregnancy and have signed a risk acknowledgement form.
  • are on highly effective, user-independent contraception -  such as long acting reversible contraceptive, a copper intrauterine device (coil), progesterone implant or levonorgestrel intrauterine system – or using two complementary forms of contraception including a barrier method and undergo regular pregnancy testing
  • see their specialist for review and re-evaluation at least once every year.

GPs must now identify and recall all valproate-medicated women and girls of childbearing potential to give them the patient guide, check that they have been reviewed by a specialist within the last year and are on highly effective contraception.  

Specialists are required to review and re-evaluate their patients at least annually, provide clear explanations and complete and sign the risk acknowledgement form which must be copied to the patient or their carer and sent to the patient’s GP.

Pharmacists must ensure that where valproate medicines are dispensed to women and girls of childbearing potential the (ideally whole) packs must bear a pre-printed warning label or the pharmacist must place a warning sticker on the pack.  Pharmacists are also required to discuss the risks in pregnancy with female patients each time they dispense their valproate medicines, and to check that they have the Patient Guide and have discussed their treatment and contraception with their GP or specialist.

I’m on valproate. What do I do now?

All women and girls who are prescribed valproate should now contact their GP and arrange to have their treatment reviewed. Meanwhile, MHRA emphasise that it is important women don’t stop taking valproate without first discussing it with their doctor.

Boyes Turner’s specialist birth injury and cerebral palsy lawyers have decades of experience of helping families whose children have suffered severe disability as a result of inappropriate medical care. We welcome the recent action taken by MHRA and NICE to enforce responsible prescribing practice in the hope that fewer babies will suffer the devastating disability caused by in-utero exposure to valproate drugs.

If you are caring for a child with serious disability arising from negligent medical care please contact us on 0118 952 7219 or email us on mednegclaims@boyesturner.com.

Sports prostheses for children

The Department of Health has announced that £1.5 million has been made available to provide specialised sports prostheses on the NHS for children in England.

Taking his inspiration from Team GB’s outstanding performance at the 2016 Paralympics, the Secretary of State for Health, Jeremy Hunt, says that every child should be able to participate in sport. He believes this investment in children’s specialised sports prosthetics will enable the next generation of children suffering from limb loss to lead more active lives.

Of the £1.5 million of funding, half has been allocated to a Child Prosthesis Research Collaboration, intended to support research and bring the latest prosthetic technology into the NHS. The remaining £750,000 will be made available to Limb Centres, which must apply on a patient by patient basis for grants of up to £5,000 per limb, including fitting and associated costs. Applications must come from Limb Centres which have assessed the child’s prosthetic needs and prescribed a suitable prosthetic limb. Patients cannot apply directly or through their doctor. The funding will be available until March 2018.

In order to qualify for NHS funding towards a specialised sports prosthetic, such as a running blade, the Limb Centre’s application must demonstrate that the child meets the government’s eligibility criteria:

  • The child or teenager must be under 18
  • They must have suffered limb loss or have been born without one or more limbs – either upper or lower limb.
  • They must be medically fit to engage in physical activity, as assessed by the Limb Centre
  • The Limb Centre assesses that the child or teenager will benefit from the prosthesis and from engaging in physical activity, whether that is participating in school sport, organised group sport, recreational activity or active play with other children.
  • For more specialised sport prostheses, it must be demonstrated that the child or teenager has an active interest or past history of participation in that sport
  • The prosthetic limb must have been prescribed by the Limb Centre as suitable for the child and, ideally, should have been trialled by the child before an award is made

The Department of Health’s announcement of 7th January 2016 doesn’t say whether the sports prosthesis grants will be made on a one-off basis or be renewable for further limbs as the child grows and their prosthetic needs inevitably change or the proportion of child amputees who will be able to benefit from the total funds of £750,000. But Boyes Turner welcome this initial move by the Department of Health towards improving mobility, health and accessibility for disabled children in the knowledge that individual lives will be improved, alongside the benefits to all that come from greater understanding, inclusion and facilities for those with disabilities.

Boyes Turner’s clinical negligence and personal injury claims lawyers act for clients who have suffered amputations and limb loss. Our clients have lost limbs as a result of negligent medical care, such as delayed treatment of sepsis, meningitis and infections, mismanaged diabetes and its associated conditions, negligent surgery and mismanagement of vascular conditions, and accidents which were caused by someone else’s fault, either at school, on the roads, on holiday or in the workplace.

We understand the importance of early rehabilitation and the restoration of mobility to our clients, and the essential role that expert prosthetic assessment and correctly fitted and suitable prostheses  play in an amputee’s recovery, dignity and quality of life. We are experts in securing the highest levels of compensation and early interim payments to get your rehabilitation started and your life back on track as soon as possible. Watch a video about how we have helped one of our previous clients here.

£90,000 compensation awarded following tragic stillbirth

The lady’s pregnancy was reported to be normal and all the usual scans were undertaken during the pregnancy. At 36 weeks, the midwife considered that the baby was breech and sent the lady for a scan. The scan confirmed breech presentation but showed normal growth.

Two weeks later, the lady had a further scan which showed that the baby was no longer breech but the sonographer previously failed to pick up that the baby had a growth restriction. Despite this, the lady was informed that her baby was developing normally. The following week, the baby was not moving as much as usual but the midwife advised this was normal as she was close to her due date.

At 40+3 weeks of the pregnancy, the lady had not felt any movement for some time and was sent to the hospital for a scan. The baby’s heartbeat could not be found and the baby was stillborn the next day.

The couple brought a medical negligence claim against the hospital trust alleging that the hospital had not recognised that the baby was growth restricted, but if it had been identified and acted on, the baby would have been born alive.

The hospital trust admitted their mistakes which resulted in the stillbirth. The parents’ legal representatives negotiated a settlement of £90,000 which included a claim for loss of earnings, funeral costs, therapy costs and damages for psychiatric injury.

“Here is a further case of a failure to identify and act on an abnormal growth scan, leading to a devastating stillbirth. It is unclear from this case whether the midwife’s actions were criticised but questions may have arisen as to whether the midwife appropriately took on board the mother’s concerns of reduced movement and whether she acted appropriately”.

Stillbirth negligence claim settled for £68,750

A lady who had a relatively straightforward first pregnancy and attended the usual appointments, sadly lost her baby at 38 weeks gestation. 

When she was 36+5 weeks pregnant, she attended an antenatal appointment at which the fundal height was measured as 33cm. Two weeks later it was measured at 36cm and a further two weeks later, 35cm.

At that final appointment, the baby’s heart rate was monitored and was strong. The following afternoon, however, the lady noticed that the movements of her baby had decreased and she attended the birthing centre. Very sadly, no heart rate could be detected and the baby’s death was confirmed by scan.

The parents attended a meeting with the hospital who told them that a growth scan should have been offered at the appointment when the measurements were 33cm, as the baby’s growth was restricted.

It was alleged that if the baby’s growth had been correctly measured and monitored, the lady would have been referred for a growth scan and had closer monitoring.  She would have been induced at an earlier stage which would have taken place before the baby died.

The hospital admitted the mistakes made in this case and the parents were able to settle the claim for £68,750.  The compensation award included claims for loss of earnings, headstone costs, psychiatric therapy and damages for the psychiatric injury for the mother and the father.

Sita Soni, solicitor with the Boyes Turner Medical Negligence Team, comments:

“It is extremely concerning how many cases we hear of where a baby’s growth is incorrectly plotted on a growth chart or not identified at all, but if it had been identified, closer monitoring and additional scans would have taken place, the baby’s death would have been avoided.  It is important there where hospitals admit their mistakes, lessons are learned to avoid the same errors being repeated.”

£80,000 compensation for couple following the tragic stillbirth of their baby

Facts of the case

The lady was informed that her pregnancy was progressing normally until she was around 34 weeks pregnant, when she was informed that her son had parvo virus and this might be harmful to the unborn child, it was reported.  The mother was feeling unwell herself, being hot and sick.  Blood tests were taken to check whether she had the virus herself.  The mother was told that if she had heard nothing further from the hospital within 10 days then she could assume that everything was fine.

When she was 36 weeks pregnant, she had a further appointment with the midwife.  The midwife told her that if anything was wrong then she would have been contacted. The midwife did not contact the hospital herself.

Two weeks later, the lady attended a midwife appointment, and very sadly the midwife was unable to detect a heartbeat. A scan confirmed that the baby had passed away.  It was reported that the baby had fluid on its lungs which could have been caused by anaemia or parvo virus.

The legal claim

The parents brought a claim against the hospital and the midwife alleging that they were negligent in failing to follow up the blood tests or taking fresh blood for testing.  It is unclear whether these failings were admitted.  It was however admitted that if the bloods were checked or more tests had been undertaken and the parvo virus detected earlier, then the unborn baby would have undergone a blood transfusion or would have been delivered alive earlier.

Both parents suffered psychiatric injuries as a result of the stillbirth.  The couple recovered compensation for the pain and suffering they experienced as well as a bereavement award, loss of earnings and funeral costs.

Sita Soni, solicitor with the Boyes Turner Medical Negligence team comments:

“In such devastating stillbirth cases as this, the hospital’s recognition of their mistakes is vital to ensure appropriate action so that errors like this do not happen again.  Here, a simple follow up call or retest would have detected the virus and saved this baby’s life.”

Are home births the answer to our NHS funding crisis?

Draft guidelines have been produced by the National Institute for Health and Care Excellence (NICE) regarding the care of healthy women and their babies during childbirth.  These guidelines recommend that home births and midwifery-led care should be encouraged for women with a low risk of complications.

“Low risk” has been described as women without any pre-existing medical conditions or risk factors such as, high BMI, high blood pressure or a previous history of caesarean section.

First time mums with a low risk of complications will be advised to give birth at a midwifery –led unit which could be either based at the hospital site or elsewhere.

Low risk mums who have given birth before will be advised to give birth at home where possible.

The guidance is a result of new evidence that suggests that in low risk women, the rate of intervention during labour is much lower and the outcome for a baby who is born at home is comparably the same as a baby born at an obstetric facility.

The guidelines are only in draft form and are open to consultation until 24 June 2015.

Emily Hartland, a solicitor in the Medical Negligence team at Boyes Turner, commented:

“Whilst some organisations are in support of the new guidelines, others such as the Birth Trauma Association have expressed some concerns that there is ‘no robust evidence to justify NICE assuring low risk first time mothers that to give birth in a free standing midwifery unit is as safe as is a hospital…… there is evidence to suggest the contrary.’ Boyes Turner act for many families where urgent care has been delayed with tragic outcomes.  Whilst these draft guidelines refer to low risk mums only, women should think very carefully about the risks of delivering at home or at a midwifery-led unit without immediate access to emergency care should obstetric complications occur. It is crucial that women are able to make informed choices and that any risk factors are carefully assessed throughout their antenatal care.  We are concerned that the failure to recognise complications early, either in the antenatal period or at delivery, could led to an increase in birth injuries both for mum and child and that pressure to cut costs  may be a key factor in the development of these guidelines.” 

Each Baby Counts' - RCOG launch campaign

The Royal College of Obstetricians and Gynaecologists launched a 5 year project to halve number of baby deaths due to complications during labour

In the UK, around 500 full term babies die or are left severely disabled each year because something goes wrong during labour, such as they are starved of oxygen.

The Royal College of Obstetricians and Gynaecologists (RCOG) has launched a new five year project which aims to halve the number of stillbirths, early neonatal death and brain injuries occurring in the UK as a result of complications during labour by 2020.

From January 2015, the ‘Each Baby Counts’ project, which is part funded by the Department of Health, will being collecting, pooling and analysing data from all UK maternity units to identify avoidable issues to improve future care and prevent these tragic events.

Professor Alan Cameron, RCOG Vice President for clinical quality has stated:

“We will monitor where these incidents occur and why.  Sharing of these sensitive data will provide us all with a unique opportunity to improve the care we provide and save lives”.

Rhiannon Jones, solicitor with the Boyes Turner Medical Negligence team, comments:

“We have significant experience of dealing with cases where the stillbirth, neonatal death or birth of a baby with brain injuries has a devastating effect on women and their families. By collecting information from around the UK, hopefully much can be learned to prevent these tragedies from occurring.”

Undetected hip dysplasia claim - £488,000 compensation awarded

A 9-year-old girl received £488k for alleged failures in diagnosing, treating and managing her congenital dysplasia of the hip following her birth in April 1994.

When the claimant was born at a hospital, the defendant health board did not examine her hips and no abnormality was detected.

At four days old, the baby was transferred to a second hospital of the same health board for a further examination and again, no abnormality was detected.

At 8 ½ weeks a follow-up appointment with a doctor also recorded that her hips were stable and no abnormality was detected.

Over the following months, the claimant’s mother became concerned that her daughter was dragging her foot whilst ‘walking’. After an urgent referral it was confirmed by examination and X-ray that she had a dislocated left hip.

The claimant was then admitted for treatment and specialist procedures but, despite these efforts, the hip had not been fully reduced by December 1995.

Private treatment

A private examination took place in December 1995, followed by a reduction procedure in January 1996.

Action was brought against the Defendant Hospital for a number of alleged failings.  Liability was admitted in relation to adequate treatment and care following diagnosis of an abnormality and that the outcome was worse than would otherwise have been expected.

The case settled out of Court for £488k.  This comprised an award for pain, suffering and loss of amenity in the approximate sum of £50,000.  The remainder of the total award included claims for past costs, future care costs, future aids and appliances, future surgery costs, future loss of earnings and future holiday costs.

Julie Marsh, Boyes Turner Medical Negligence lawyer, comments:

“We have seen a number of children’s medical negligence cases where this congenital condition is missed by doctors treating newly born children.  This can sadly result in a long and protracted treatment plan, involving many surgeries, and can also lead to permanent restrictions in mobility, which can have a lifelong impact, as is the case in this example. It is hoped that by drawing attention to the cases where these early checks on newborn children have missed this type of abnormality, hospital staff will undertake more thorough checks in the future, and will be trained to spot these abnormalities at a much earlier stage, avoiding so much pain and suffering in such young children.”

  • Page 1 of 4

The service was personal, professional and considered. I was treated so kindly and in the end I knew that not only had I found the right organisation but also the right person.

Boyes Turner client

How can we help?

Please get in touch 0800 029 4802

Or we are happy to call you back at a time that suits you

Office open Mon - Fri: 08:30 - 18:00

We are here to help

For more information or to speak to one of our experts, please call 0800 029 4802