Brain injury news

 

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

What is neonatal hypoglycaemia?

Hypoglycaemia means low blood sugar or low blood glucose. When a newborn baby’s blood sugar drops below safe levels, this is known as neonatal hypoglycaemia. Newborn babies can take a while to develop a regular feeding pattern, which means that some babies need help to keep their blood glucose levels up in the first few days of life.

Neonatal hypoglycaemia is common, but becomes dangerous if it is untreated, causing permanent brain damage and disability. If a baby suffers neurological disability as a result of incorrect treatment of hypoglycaemia, they may be entitled to claim compensation.

Who is at risk of neonatal hypoglycaemia?

Until they are feeding properly, all newborn babies are at some risk of hypoglycaemia. For this reason, 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. This test should always be carried out for babies who are known to be at increased risk.

Babies have a higher risk of hypoglycaemia when:

  • They weigh less than 2.5kg at birth. This is the standard threshold level. Any baby with a birthweight of less than 2.5kg must have their blood glucose monitored.
  • Their mother has diabetes.
  • They are small for dates or have intra-uterine growth restriction (IUGR).

Regardless of birthweight or their mother’s state of health, any baby who is not feeding properly may be at risk, such as:

  • if they don’t wake up for feeds;
  • if they don’t suck properly during feeding;
  • if they demand feeding very frequently because they are not getting enough food at each feed.

Is neonatal hypoglycaemia a medical emergency?

Neonatal low blood sugar can be corrected if action is taken quickly to feed the baby. Depending on how well the baby feeds, their blood sugar may be brought back up by breastfeeding if that provides enough milk, by expressed breastmilk or formula milk. Some babies’ hypoglycaemia may need to be corrected by an intravenous (IV) glucose drip.

In a review of medical negligence claims relating to neonatal hypoglycaemia, the NHS defence organisation, NHS Resolution, found that abnormal feeding behaviour was very closely associated with the condition, both as a cause and as a result of hypoglycaemia. Maternal concerns about their babies’ 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 treated 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?

NHS Resolution reviewed 25 neonatal hypoglycaemia claims which succeeded against the NHS over a ten-year period at a total cost of over £162 million. They identified the most common errors in hypoglycaemia 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 significant hypoglycaemia to the neonatal unit (NNU);
  • delayed administration of IV glucose on the NNU;
  • giving insufficient glucose 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 disability from birth injury caused by lack of oxygen (hypoxia or asphyxia), neurodevelopmental disability from neonatal hypoglycaemia might not be obvious to the parents in the infant’s early childhood. Neurodevelopmental disability from 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, NHS Resolution accepted that it was likely that there have been more babies harmed by errors in hypoglycaemia care than were reported by the hospitals.

Boyes Turner’s specialist brain injury solicitors understand hypoglycaemia negligence and are experienced in obtaining compensation for children and teenagers whose neurological disability was caused by incorrect neonatal care.

We aim for early admissions of liability. We then work with experts to assess the full impact of the injury on the individual’s mobility, intellect, education, work and independence, to ensure that our client is properly compensated. Our special educational needs (SEN) team can also help families secure educational support and the best school placements for with children affected by neonatal brain injury.

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

Podcast: Cycle safety during and after the Covid-19 Lockdown

With the latest Government advice encouraging people to cycle more and avoid public transport, now more than ever charities like Cycle Smart feel that cycle safety awareness is vital, especially amongst children.

Boyes Turner have supported the charity for many years, and in this episode partner Claire Roantree (who is also a trustee of the charity) talks to Cycle Smart founder Angie Lee.

They discuss the potential dangers facing cyclists both during and after the Covid-19 lockdown and how riders can keep themselves safe.

Listen to the podcast>>

 

Introducing Kim Smerdon, head of the Personal Injury team

Kim Smerdon leads Boyes Turner’s highly regarded personal injury team. A specialist in catastrophic injury cases, Kim acts for clients with acquired brain damage, spinal injuries and serious orthopaedic injuries. We pulled Kim away from her desk for 60 seconds to answer some questions…

What motivated you to specialise in personal injury law?

During my training contract, I spent a year in the litigation department working mostly on personal injury cases. I, alongside my training partner, acted for some very badly injured people. Seeing their struggles and determination motivated me to continue to help those who needed it.

Describe the most memorable case that you’ve won for a client.

I acted for a young man who was shaken by his father when he was 9 weeks old and sustained a severe brain injury, I worked with him for a number of years, settling his case when he was 19. He was awarded in excess of 3.5million by the Criminal Injuries Compensation Authority. He is now under the care of our Court of Protection team who help him manage his compensation.

What is the most rewarding part of what you do?

The most rewarding part of what I do is seeing the difference that our involvement makes. Where I can, I arrange early rehabilitation to ensure that they can maximise their recovery. We are partnered with charities and support organisations who can help people who have sustained a serious injury get back on their feet (either literally or metaphorically!) and it’s a great to see the improvement in people we work so closely with.

Outside of work I am a trustee for Headway Thames Valley. The majority of my day job is obtaining compensation for those who have suffered a head injury and I wanted to become more involved in this area on another level and help those who don’t necessarily have the benefit of a compensation claim. Headway Thames Valley is a local head injury charity, supporting not only those with a head injury but their families too – the majority of these people do not receive assistance as part of a legal claim so it is so rewarding to be able to help those people in my local community.

What is the hardest part of your job?

The hardest part of my job is having to deal with all the changes that limit access to justice eg by severely limiting or in some cases totally excluding the recovery of costs so that innocent victims lose some of their compensation – which is often needed for ongoing rehabilitation or to cover lost past or future earnings.

What one piece of advice would you give to someone who has suffered a personal injury?

If you have suffered a serious injury as a result of an accident that wasn’t your fault make sure that you find a good lawyer who has experience of dealing with claims like yours. It’s not all about the final sum received at the conclusion of the case – we help to obtain rehabilitation as soon as possible -  both emotionally and physically – to optimise your recovery and get you back to living a full a life as possible.

Describe your average day in three words:

There is no average day! But I do find each day interesting, rewarding – and busy!

To find out more about how the team can help you or to ask about making a claim contact them by email at personalinjury@boyesturner.com.

Why do children need to wear cycle helmets?

The health benefits of cycling are widely recognised for children who cycle for fun in parks and off-road environments, but also on the roads to get to school. Health and fitness, as well as environmental concerns, are great reasons to encourage kids to use their bikes for getting around, but as our brain injury lawyers know only too well, there are also risks to cycling on the road. 

How can parents encourage safer cycling?

Teaching children good road sense, the highway code and ‘bikeability’ or cycling proficiency can help them avoid being the cause of an accident, but serious injury from falls and collisions can still occur even when the child is riding carefully, from dangerous road and weather conditions or the carelessness of other road users.

To protect their child’s head from severe brain injury in the event of an accident, leading brain injury charity, Headway, and The Royal Society for the Prevention of Accidents (RoSPA) both advise parents to ensure that children always wear a cycle helmet.

Does wearing a cycle helmet reduce the risk of serious brain injury?

Absolutely! The purpose of a cycle helmet is to prevent or reduce the extent of injury to a cyclist’s head during a fall from the bike or a collision. The devastation caused by severe brain injury cannot be understated. Preventing skull fracture and severe brain injury is precisely what a cycle helmet is designed to do.

What does the brain injury charity, Headway, say about cycle helmets?

Headway believe that all cyclists should wear cycle helmet and that wearing helmets should be compulsory for children. They support their strong position by saying that it is based on research and expert opinion from leading neurosurgeons, together with common sense which dictates that wearing a cycle helmet will offer greater protection to a person’s fragile skull than not wearing one.

What does RoSPA, The Royal Society for the Prevention of Accidents, say about cycle helmets?

RoSPA strongly recommend that cyclists wear a cycle helmet, which reduces the risk of suffering a serious head or brain injury in an accident. However, they point out that cycle helmets alone do not prevent crashes from happening, nor guarantee survival. They are a secondary safety feature which provide a last line of defence for the cyclist’s head.  Therefore, preventing collisions from happening in the first place must be paramount. Unlike Headway, although RoSPA firmly believes cyclists should wear cycle helmets, it doesn’t call for compulsory cycle helmet laws. 

What does the law say about cycle helmets?

Despite the protection that a cycle helmet can offer, cyclists in the UK are not required by law to wear a helmet, however, the Highway Code states that cyclists ‘should wear a cycle helmet that conforms to current regulation, is the correct size and securely fastened’.

What do the statistics from research studies say about cycle helmets?

RoSPA refers to a number of studies which have shown how cycle helmets can help reduce and prevent serious brain injury. The statistics include:

  • a Cochrane Review of five case-control studies from different countries which suggested that helmets decreased the risk of injury to the head and brain by 65%-88%, and injury to the upper and mid-face by 65%;
  • a French study found that helmets contributed to a 24%-31% reduction in head injury and a 70% reduction in head injuries categorised above level 2 (moderate injury);
  • research into police data regarding cycling crashes over a five-year period from the Road Authority of Victoria  found that not wearing a helmet increased the risk of severe injury by 56%;
  • a study by McNally and Whitehead found that helmets effectively reduced the severity of head injuries over a full range of simulations. Where head impact occurred, the risk of serious injury (above level 3) was reduced by 40%;
  • cycle helmets have been found by many studies to make less of a difference at high energy impact with a vehicle but could prevent fatality in a third of high impact RTA cases;
  • the most recent and extensive review by Olivier and Creighton compared 64,000 casualties with and without helmets and estimates that wearing a cycle helmet reduces the risk of severe head injury by 69% and the risk of fatal head injury by 65%.

Headway refers to a 2018 study in the academic journal, Accident Analysis & Prevention, which gathered the findings of 55 studies from 1989 – 2017 and found that cycle helmets:

  • reduced head injury by 48%;
  • reduced serious head injury by 60%;
  • reduced traumatic brain injury by 53%;
  • reduced facial injury by 23%;
  • reduced the total number of killed or seriously injured cyclists by 34%.

Commenting on this study, Headway’s Chief Executive, Peter McCabe, said:

“There is an overwhelming body of evidence proving the effectiveness of helmets in reducing the risk of cyclists sustaining life-changing brain injuries. This latest piece of comprehensive research is yet another part of scientific evidence that reinforces this fact. It also highlights that although cyclists can take every care to avoid accidents, at times there are simply things that are outside of their control, such as icy road conditions or other road users. Cycling is a fabulous way to keep fit and active and at Headway we are passionate about promoting safe cycling, while supporting measures to make it safer for people of all ages to take to their bikes and get pedalling. Sadly however, we also know easy it can be to sustain a brain injury and the devastating effects that can result. Our message to all cyclists is please use your head – use a helmet”

Why do some people argue against making cycle helmets compulsory?

Reasons given by people who don’t want cycle helmets to be compulsory include:

  • it was suggested that some studies showed that cyclists or vehicle drivers take more risks, (such as riding faster or overtaking at closer distance) when the cyclist is wearing a helmet, however, further analysis of this research has disproved this idea, which is also known as ‘risk compensation’;
  • cyclists may be less aware of surroundings because of the fit of their helmet; 
  • some people are concerned that helmets may put people off cycling (losing the health benefits), either because they are perceived as not cool or uncomfortable or give the impression that cycling is a high risk activity.  However, as Headway points out, mandatory use of seatbelts and motorcycle helmets were initially argued against but in retrospect the benefits are now accepted.

What CAN’T a cycle helmet do?

The purpose of a cycle helmet is to reduce the extent and severity of the injury to the cyclist’s head and brain when a collision (or fall from the bike) occurs.

Clearly, wearing a cycle helmet alone cannot:

  • prevent a road traffic accident (RTA) or fall from the bike from occurring;
  • prevent all injuries – but it reduces the chances of devastating severe brain injury;
  • change the road infrastructure or make cycling safer in other ways on the roads – that must be dealt with by the government and the highway authorities. Headway and ROSPA both call for a range of additional measures to improve cycling safety, including safe cycling lanes and campaigning for education.

How does not wearing a cycling helmet in a road traffic accident (RTA) affect a cyclist’s brain injury claim? 

If a cyclist is head-injured in a road traffic collision that was caused by another driver’s negligence and their injury could have been prevented or reduced if they were wearing a cycle helmet, the driver’s insurers may argue that their failure to wear a helmet contributed to their own injury and their compensation award may be significantly reduced. 

Knowing the facts about cycle helmets and brain injury, what CAN a parent do?

Whether cycle helmets for children ever become mandatory in the UK remains to be seen, but the benefits of cycle helmets in reducing risk of serious brain injury are clear. It’s up to parents to do what we can to encourage our children to cycle safely and wear a correctly fitting helmet, so that they can enjoy being healthy and safe on their bikes.

Always:

  • ensure that the child’s bike is roadworthy and suitable in size for the child;
  • ensure the child wears a helmet;
  • ensure the helmet is made to correct safety standards – EN1080 in the case of children’s helmets and fits properly to maximise benefit, comfort and visibility;
  • ensure high visibility clothing is worn and there are lights on the bike – some helmets have built in rear lights;
  • ensure the child follows the highway code;
  • set a good example as an adult by using good road sense and wearing a helmet when cycling.

How can Boyes Turner help?

Boyes Turner’s personal injury team are recognised as national experts in the Legal 500 and Chambers directories for their expertise and experience in helping brain-injured cyclists and their families obtain rehabilitation, care, adapted accommodation, equipment, therapies and substantial compensation following road traffic accidents.

If you or a family member have suffered brain injury or serious disability in an accident caused by someone else’s negligence, and would like to find out more about making a claim, contact us by email at piclaims@boyesturner.com.

Why you should use a local solicitor for road traffic accident injury claims

If you are involved in a car accident or other type of road traffic accident where liability is disputed, having a local solicitor handle your claim can increase your chances of securing fair compensation.

There are a number of reasons a local claims specialist is likely to be the best choice, including their local knowledge, ability to take a ‘hands on’ approach and their connections with other local road traffic accident experts.

In this article, we will cover some of the key ways using a local road traffic accident claims solicitor can increase your chances of securing compensation in a disputed accident claim.

Making use of local knowledge

An experienced local road traffic accidents solicitor should have strong knowledge of local accident hot spots, traffic conditions and other factors that could be highly relevant to your claim. They will typically have dealt with many other claims similar to yours, possibly even at the same location and in similar circumstances.

This specific local knowledge can help your solicitor to ensure all of the relevant information is brought to light to support your claim (e.g. that several other people have had similar accidents at the same location in recent years).

This type of background information can be crucial to building your case, so its value should not be overlooked.

Visiting the scene of the accident

Where there is a dispute over liability for a road traffic accident, police reports and police witness statements should not be taken at face value when building your case. In our experience, there is no substitute for visiting the scene of accident in person to collect accurate evidence on factors that may have played a part in the events leading to an accident.

This visit should always take place as soon as possible and at the same time of day and under similar conditions to those at the time of the accident to give the most accurate and meaningful information.

Critical evidence a scene of accident visit can produce includes information on:

  1. Road layout – including width of lanes, bends, crossings and lights to establish what the parties involved could have seen at the time of the accident.
  2. Surrounding environment – including anything which might affect driver visibility, whether the area is heavily populated, number of pedestrians at the time of the day the accident occurred, any other specific hazards.
  3. Traffic flow and speed limit – can help judge whether the defendant should have been able to take evasive action at the speed they should have been travelling.
  4. Distances – these can be deceiving, so it is important to understand the direction of travel of all parties and what they could and could not have seen.
  5. Common practices of motorists on the particular stretch of road – e.g. whether bus lanes are being used by other vehicles etc.
  6. Road markings – such as hatchings and signage, which can help to establish whether they may have been reason for confusion over road use.

Non-local solicitors may rely on technology such as Google Maps to judge road conditions, which often miss key details, such as a slight bend in a road that appears straight on a map, or where the images used for Google Maps are not up to date.

Non-local solicitors may also rely on a local agents they do not know personally to visit the site for them and produce a ‘locus report’ or accident reconstruction report. While locus reports and accident reconstructions can be highly useful in disputed claims, it is critical that they be produced accurately and reliably.

For this reason, it is generally safer to work with a local lawyer who has an established working relationship with the road traffic accident experts who produce these reports.

Producing a locus report

A locus report provides clear, detailed information on the place where an accident occurred. It will typically include photos, sketches, diagrams and other types of visual information, as well as a written report on the area.

Locus reports are often critical pieces of evidence during a disputed road traffic accident claim, helping to reduce any uncertainty or leeway for dispute over the traffic conditions or other factors that may have led to the accident in question.

Using accident reconstructions

Accident reconstruction experts will examine the vehicles involved in an accident, as well as looking at the scene of the accident, reviewing evidence from witnesses and any other relevant information to build up a clear picture of what occurred during the accident.

By looking at the damage to the vehicles, the distance the vehicles moved after the impact, any damage to the surrounding environment and other details, an accident investigator can often establish important details, such as how fast the vehicles involved were moving at the time of the accident.

They will then use this information to put together a reconstruction of exactly what they believe occurred in the moments leading up to and during a road traffic accident.

Increasingly accident reconstructions use video and 3D animation to help visualise the events leading up to an accident. This evidence can often be highly compelling in disputed liability cases.

Speak to your local personal injury lawyers in Reading

If you have been injured in a road traffic accident, our specialist personal injury solicitors in Reading have the local knowledge and contacts to help you build the strongest possible case, so you have the best chance of securing fair compensation.

We work with a number of trusted local agents who can produce detailed, reliable locus reports, as well as accident reconstruction experts to help us fight cases where liability for an accident is in dispute.

Our personal injury team have many years of experience handling road traffic accidents for people in Reading and the surrounding area, including Berkshire, Oxfordshire and Buckinghamshire. This gives us deep knowledge of local accident blackspots and challenging traffic conditions, allowing us to give you the strong local expertise you need for a successful claim.

To start a road traffic accident claim with Boyes Turner or to find out more, please get in touch by calling the team on 0800 124 4845 or emailing at claimsadvice@boyesturner.com.

Reading Half Marathon 2019 for Headway UK

On Sunday 17 March, Kim Smerdon, Claire Roantree and Martin Anderson from our Personal Injury team ran the Reading Half Marathon to help raise over £1,000.00 for Headway Thames Valley.

Headway Thames Valley is a great local charity, which provides help and support to help people to rebuild their lives after suffering a brain injury.  They also do important campaigning work to raise awareness of the causes and effects of brain injury. Their dedicated team provides help and rehabilitation therapies across the Thames Valley.

A brain injury does not only affect the victim, but also their family, friends and colleagues and Headway Thames Valley also provide information, support and services to families and carers.

Fortunately, the weather was relatively kind, which was a relief given the storms the night before. There was also huge crowd support all the way along, which helped us make it to the finish line in the Madejski Stadium.

Kim Smerdon, head of the Personal Injury team at Boyes Turner and a trustee for Headway Thames Valley said

“as someone who has dedicated much of my career to acting for clients with brain injuries, this is a cause which is particularly close to my heart.  Headway Thames Valley give vital support to brain injury victims and their families when it is most needed and I hope that the funds raised will help them to continue their great work”

If you or a family member has suffered a brain injury, we may be able to help. Get in touch with a member of our experienced personal injury claims team to discuss making a claim by emailing them at piclaims@boyesturner.com.

Making a claim after a child suffers a brain injury as a result of an accident

When a child suffers a brain injury as a result of an accident, it shatters the lives of the whole family. We understand the long and difficult journey that families can face when a child is recovering from a brain injury following an accident.

Child brain injury claims

Making a claim on behalf of a child with a brain injury can be a daunting process for families. We aim to provide information that can support you and your family on this journey and get the best results following an accident to ensure your child’s future.

Frequently asked questions

Why should I make a claim?

A child may suffer long lasting and permanent effects after a brain injury, which could impact on their ability to lead an independent life, through no fault of their own. By making a claim for their injuries caused by an accident, plus any past or future financial losses and expenses, you will be ensuring that they are financially secure in the future and have the right support, care and treatment to maximise their recovery and independence.

At Boyes Turner, we strive not only to achieve the right amount of compensation to provide financial security for a child and their family but to ensure that every brain injured child and their family has access to rehabilitation to enhance their level of recovery at the earliest opportunity.

Who should I instruct to deal with my child’s brain injury claim?

We recommend that you instruct a firm of solicitors who have expertise and a proven track record of acting for children who suffer a brain injury. Check if the firm has accreditation with the Law Society and Association of Personal Injury Lawyers and/or is an approved solicitor for Headway.

How is a child brain injury claim funded?

In personal injury claims Legal Aid is not available for children’s claims. You may have existing legal expenses insurance under a Household and Contents insurance policy and we can help you to check the policy. Otherwise, we can offer a Conditional Fee Agreement (no win, no fee).

Your child will recover their full compensation. 

In clinical negligence claims involving cerebral palsy and other acquired brain injuries, Boyes Turner has a Legal Aid Franchise to fund cases that meet the Legal Aid criteria

What is the process for making a claim?

Once instructed we send a letter of claim to the third party’s insurer (the party responsible for the injury) who then has a period of time to investigate the claim. There are 3 main aspects to prove in a personal injury claim:

Liability (fault or negligence)

If your child has suffered a brain injury as a consequence of someone else’s actions or negligence, then you will be entitled to bring a claim against the other party (referred to as the defendant). Many of our cases involve children injured in road traffic accidents either as passengers in a vehicle or pedestrians and cyclists hit by cars. We also act for children who have suffered a birth injury as a result of hospital negligence or who suffer an injury in a public place. Sometimes a defendant might argue that a child was partly to blame (for example by running out into the road) and this is known as contributory negligence.

Causation (that the brain injury was caused by someone’s negligence)

Once a defendant admits fault or responsibility for an accident, the next stage is to gather medical evidence which proves that the brain injury has been caused by the negligence of the defendant. 

We work alongside the very best medico legal experts to prove the nature and extent of the individual child’s brain injury, and how this has and will continue to impact on a child in their future. To ascertain this we may instruct a number of experts including neurologists, educational psychologist, neuro-psychiatrists, physiotherapists, speech and language therapists and occupational therapists. The type of experts that we instruct will depend on the type of symptoms a child suffers from as a result of their brain injury and this varies for each child.

Quantum (the value of the claim)

Once expert evidence has been obtained and we understand the nature and extent of the child’s brain injury, we will then start to gather evidence that allows us to value the claim. The value of the claim depends on the individual needs of the child, both now and in their future. A brain injured child may require a care and case management expert to ensure the appropriate care package is provided or they may have difficulties with communication or mobility and require an occupational therapist and specialist equipment. If a child cannot communicate they may need assistive technology and communication aids.

What is rehabilitation?

Rehabilitation is the process by which an injured person makes the best and quickest possible medical, social and psychological recovery.

Sadly not every child will make a full recovery after a brain injury, but we believe that every child should have an opportunity to reach their maximum potential recovery, with the right access to rehabilitation. We aim to ensure that a child and their family have access to the ongoing treatment, care and support they need by securing early funding as part of brain injury claim. 

Who organises rehabilitation?

At an early stage in brain injury claim, we will appoint a child brain injury case manager; this is usually a healthcare professional such as a nurse, occupational therapist or physiotherapist. The role of the case manager is to support a child and their family in accessing care and rehabilitation to help the child grow up confidently and live a fulfilled life.

What is case management?

Case management is the holistic rehabilitation support that an individual child may need following a brain injury. It is a collaborative process which involves understanding the needs of the child and family, planning and implementing rehabilitation with a multi-disciplinary team of healthcare professionals, and providing the child and family with access to any services and support that they need to meet their individual health, social care, educational and employment needs.

A case manager may appoint and work with a number of different healthcare professionals to support the child and their family with their rehabilitation goals. 

It is extremely important that the child and their family are always at the heart of every decision made regarding the child’s rehabilitation, care and support.

What happens if my child has additional education needs as a result of their brain injury?

If your child has learning disabilities as a result of their brain injury then our dedicated Special Educational Needs team can help your child to secure the extra help and support they need, in the school they choose.

What happens when my child’s brain injury claim is settled?

Once a settlement has been agreed the Court must approve the financial settlement and how it is to be managed.

As a child does not have capacity to handle their financial affairs either because they are under 18 or as a result of their brain injury (after the age of 18), a professional Deputy is usually appointed to help the family manage the child’s financial affairs. The settlement is paid into the Court of Protection and the professional Deputy works with the family and/or case manager to ensure that the funds are spent appropriately (in the best interests of the child).

At Boyes Turner we have a Court of Protection team who advise families on how to manage their financial affairs once a settlement has been agreed.

What should I do next?

We know that for many families, the thought of a bringing a claim may seem daunting. However it is vitally important to secure the future of your child.

We aim to make the process as straightforward as possible from the first meeting to negotiating an out of court settlement, or going to court if required. Each step is always explained, along with why it’s needed and how the family will be involved.

Every brain injury claim is supported by independent medical experts to give you the best prospects of success and we have a range of claim funding options which we can discuss with you so that you don’t have to worry about funding your claim. Get in touch with a member of our experienced personal injury claims team to discuss making a claim by emailing them at piclaims@boyesturner.com.

Interim payments - what they are and how they work

Serious injury compensation claims are complex and can take time to reach settlement even when liability – the issue of who is at fault – has been resolved. Some cases, such as cerebral palsy or other brain injury claims can only be valued over time.

The child may be too young for their long-term needs to be assessed straight away or there might be uncertainties about the severity of their future disability which can only be determined when the child is older. In the case of a seriously injured adult, rehabilitation may be required before the claim can be finally settled. Meanwhile, the injured person and their family’s hardship is often increased by the financial worries caused by the additional costs of caring for a severely disabled child or losing the former breadwinner’s income. 

In cases where liability is admitted but settlement is still a long way off, we can often help relieve our clients’ hardship by applying to the court for what is known as an interim payment.

What is an Interim Payment?

An interim payment is a part-payment of compensation that is paid by the defendant during litigation to the claimant. The sum can vary significantly and is often used for rehabilitation, putting in place treatment or even to ease financial hardship. The amount of the interim payment should be comfortably less than the expected total value of the claim as it will be deducted from the total settlement awarded at the conclusion of the case.

When can an interim payment be requested and how?

An interim payment can be requested once liability has been admitted or proven against the defendant. This may take place early in the claim, sometimes even before proceedings have been issued or following a successful trial in respect of liability. 

Where an interim payment is needed, before applying to the court the claimant’s solicitors usually ask the defendant to make a voluntary interim payment, explaining how much is required and what it is intended for. If the defendant does not agree to make an interim payment or is unwilling to pay an amount sufficient to meet the claimant’s needs then the claimant’s solicitors will need to make an application to the Court, justifying the sum requested in the context of the overall value of the claim and the reason that the interim payment is needed.  Documentary evidence such as a witness statement and medical reports are usually provided in support.

Do you need to go to court?

If the claim relates to child or protected party (someone who is represented by a ‘litigation friend’ in the proceedings), the permission of the court must be obtained before an interim payment is made, even if the defendant agrees to make the payment voluntarily.  The claimant rarely needs to attend court for this hearing.

At this stage, a Court of Protection deputy may be appointed to oversee the management of the money for the claimant. At Boyes Turner, our clinical negligence and personal injury teams work closely with own Court of Protection specialists to ensure that our clients’ money is managed in accordance with the court’s requirements but easily accessible to meet their needs.

What are the benefits of an interim payment?

An interim payment allows you see what works for you and your family before settlement and helps demonstrate what you will need long term. This allows us to claim the most suitable provision for you for the future.

Each individual and family’s circumstances are unique, but our clients commonly use interim payments:

  • to buy and adapt a property, so that the family home is suitable for their disabled child’s needs;
  • to pay for a rental property whilst their existing property is adapted;
  • to purchase specialist treatment, aids or equipment which is not readily available on the NHS;
  • to purchase a wheelchair and regular seating assessments;
  • to put a care plan in place;
  • to put in place therapies, such as physiotherapy, speech and language therapy, pain management etc;
  • to assist with the additional costs of caring and providing for a family member with a disability.

At Boyes Turner we have helped hundreds of disabled clients and their families rebuild their lives after medical negligence and serious personal injury. The support we give our clients in obtaining and using interim payments ensures that they can focus on rebuilding and participating in family life, whilst we work to achieve settlement of their claim.

If you or your child have been severely disabled as a result of negligence, contact us by email at claimsadvice@boyesturner.com.

Cycling accident pair demand safety improvements after another incident at hotspot

Lawyers acting for two cyclists injured in separate incidents at the same Reading roundabout have joined their clients in calling for urgent safety improvements after another person was injured there.

Experts at Boyes Turner say the latest incident at the Vastern Road roundabout in the town centre adds to existing concerns over safety at the busy interchange, which has seen a number of accidents in recent years and left several cyclists injured.

The lawyers’ call for action was joined by a local teenager who spent two nights in hospital after being knocked off his bike in September last year and continues to suffer from injuries, including a fracture to his back, five months later.

A second cyclist injured at the same spot has also added his voice to the calls for improved safety, just over a year after he too was knocked off his bike at the Vastern Road site and also needed hospital treatment after suffering three fractures to his back.

And it comes just days after a motorist suffered serious injuries and was also left needing hospital treatment after another incident at the roundabout, which has been highlighted as a safety concern several times by local campaigners who say as many as 19 cyclists have been injured there in the past few years.

Adam Adrian, 19, from Caversham, had already safely negotiated most of the roundabout in busy traffic as he tried to turn right over Reading Bridge but was knocked off his bike and onto the road after being hit by a car.

An ambulance rushed him to hospital where he needed two nights’ treatment and had his arm put in plaster before being allowed home to begin his recovery from the fracture to his spine and injuries to his wrist and knee.

Doctors have since given Adam the devastating news that his spinal fracture will never heal fully, leaving the teenager facing an uncertain future as he tries to move on from the incident.

The former Highdown Secondary School student had been pursuing an acting career, with a place secured on a course at Chichester University, but has been restricted in any roles he can take since the accident due to the continued pain he suffers when moving, while his wrist injuries have also restricted his role in local rock band Before The Breakdown.

Julian Wigmore was also injured at the Vastern Road roundabout, when an SUV vehicle pulled out in front of him, catapulting the 66-year-old, also from Caversham, onto the bonnet of the car. He too was taken to hospital, where he was told he had fractured three vertebrae.

His injuries have left the bid manager two inches shorter and, despite rehabilitation arranged by his legal team, he continues to suffer pain a year later and is still unable to ride his bike on the road due to anxiety. He was also unable to work for a short period after the incident, which cost him a freelance contract.

Both Adam and Julian are now being helped by experts at Thames-Valley based Boyes Turner. Serious injury specialist solicitor Laura Magson said the latest incident at Vastern Road showed things were not improving and that it was time that action was taken by the local council.

“Adam and Julian’s stories are just two examples of people being injured at this same spot and questions have to be asked as to how many more people will have to suffer injuries or worse before something is done,”

she said.

“Cyclists in particular are vulnerable and far too many have already been injured at this roundabout, which has been singled out for attention by safety campaigners including ourselves before.

“Adam and Julian face a further fight to recover from the injuries and regain the lives they had before. The worry Adam faces while waiting to see if his fractured spine will repair fully is something no-one should have to endure at any stage in their life, let alone at just 19, and Julian also still suffers from his injuries a year on, despite important rehabilitation work.”

Laura added:

“Their stories should serve as a catalyst for action to prevent this happening to anyone else. We now want to see the authorities carry out an urgent review and make sure no-one else suffers what our clients have suffered. Safety has to come first.”

Adam said:

“The accident itself was horrific and it still affects me now, but the biggest frustration is not being able to just get on with my life. My acting ambitions and my music have all been affected by something which wasn’t my fault.

“However, when you then find out that you’re not the only person who has been injured at this roundabout, it’s even more frustrating, especially when you see more accidents like the recent one. I don’t want to see anyone else go through what I have gone through.”

Julian added: “All I was doing was cycling home and the next minute, my life had been turned upside down. A year on, I’m still in pain and still can’t do the things I could do before.

“Enough is enough. There have to be changes at this roundabout to stop anyone else being injured. One accident is too many but there have been a series of incidents there. Someone else will be seriously injured if action isn’t taken immediately”

Local cycle campaigners have previously highlighted the Vastern Road roundabout as a serious cause for concern and demanded action from council officials, saying statistics show that 19 cyclists have been injured at the interchange in recent years.

 

Delays in cranial neurosurgery highlighted by latest GIRFT report

The latest report to be published by Getting It Right First Time (GIRFT) reveals the deficiencies and opportunities for improvement in the way cranial neurosurgery services are provided by the NHS. In contrast to previous GIRFT reports which have focussed on learning from variation in practises between NHS Trusts, GIRFT’s cranial neurosurgery report highlights that patient pathway inefficiencies and delays are being experienced in all of the 24 NHS hospitals which perform cranial neurosurgery, to the detriment of patient care and the frustration of the neurosurgeons.

The report specifically states that it is not a call for additional financial investment. Many of its recommendations can be implemented by NHS Trusts with minimal effort yet deliver an immediate impact on surgical capacity and throughput, resulting in more procedures taking place and patients who need urgent surgery receiving it faster. Implementation of its recommendations will optimise the use of existing resources to avoid delays and cancellations, free up hospital beds, deliver a better and faster service to patients whilst saving the NHS up to £16.4 million each year. NHS Improvement’s deadline for implementation of GIRFT’s cranial neurosurgery recommendations is June 2019.

What is cranial neurosurgery?

Cranial neurosurgery is a sub-specialty of neurosurgery which covers a range of surgical procedures performed on the brain or on the nerves in the skull. It includes the care and treatment of serious conditions and emergencies, such as traumatic brain injuries, intracranial bleeding and brain tumours, where timely surgery can save lives.  

Cranial neurosurgeons also carry out elective (non-emergency) surgery, such as relieving pain caused by nerve damage, and have a key role in monitoring patients with head injury.

In England, cranial neurosurgery is carried out in only 24 NHS hospitals which, together, admit 75,000 neurosurgery patients each year. In many of these cases, the patients were admitted for investigation, such as an MRI or CT scan or for monitoring after a head injury but did not have surgery. 40% of cranial neurosurgery admissions were for emergency treatment, most commonly for cranial trauma (head injury).

Cranial neurosurgery patients often need a lengthy stay in hospital owing to the severity of their condition and the longer recovery period from highly invasive surgery. For many, their care takes place in a critical care unit followed by extended monitoring on a ward, before moving on to rehabilitation. The average length of stay for patients following non-elective cranial neurosurgery was 19.4 days. 14% of patients stayed longer than 28 days.

Areas of concern arising from the report

GIRFT found that, without exception, all 24 NHS Trusts experience patient throughput delays which the frustrated neurosurgical teams believe are preventing them from seeing more patients and treating them sooner. After their treatment, patients are staying under the care of cranial neurosurgery longer than is clinically necessary, delaying the admission and treatment of new patients and resulting in high cancellation rates of those already admitted for elective surgery. 

Two-thirds of trusts fail to meet national 18-week referral-to-treatment targets for admitted neurosurgical patients, with eight trusts treating fewer than 60% of patients within the 18 week deadline. One in ten patients with subarachnoid haemorrhage or SAH (bleeding between the membranes surrounding the brain) do not receive surgery within the target time of 48 hours from diagnosis. This is a serious failing because any delay in treating SAH exposes the patient to the risk of severe brain damage or death.  

Even where cranial neurosurgery is not urgent, unnecessary stays in hospital cost the NHS more money, take up beds that delay treatment for other people and increase distress and infection risk to the patient.

The bottlenecks are experienced at every stage in the patient’s pathway. Patients have to wait for critical care beds to become available and these may be occupied by post-surgical patients awaiting discharge because the cranial neurosurgical centre has difficulty moving the patient on to other hospitals, rehabilitation centres or discharging them to a home setting with adequate rehabilitation support. The problem is compounded for tertiary (specialist treatment) hospitals because they are contractually obliged to accept referred patients requiring a specialist cranial neurosurgical procedure, whereas district general hospitals are not, and with their own stretched bed capacity and lack of rehabilitation resources, they can be unwilling or unable to take their post-surgical patient back.

Recommendations

The GIRFT cranial neurosurgery report recommends several ways in which hospitals can improve patient pathways to reduce delays and cancellations, speed up access to vital treatment, start post-operative rehabilitation sooner and improve patient experience:

  • Admitting patients on the day of surgery rather than in advance, particularly for minimally invasive procedures which don’t need anaesthetic and surgery for some brain tumours, to free up clinical care beds for more patients.
  • Reorganising the way operating theatres are used by designating one (existing, not new) theatre for acute procedures with open slots to cater for emergency admissions. This will  avoid disruption, cancellations or delays to patients already booked for elective procedures who are currently having to make way for emergency patients with higher clinical priority.
  • Speeding up discharge from cranial neurosurgery by making commissioning changes to compel referring hospitals to take their patients back once the patient is clinically ready. The success of this depends on better integration with community services to provide adequate and timely physiotherapy, OT and other rehabilitation support.
  • Avoiding thousands of neurosurgery admissions for non-surgical procedures, such as scans and post-operative checks, and consultant time spent in communicating scan results, which could be carried out by other multidisciplinary team members in outpatients or the patient’s home by phone or video-link.
  • Combining multiple consent and pre-admission clinic appointments to reduce the number of appointments that the patient needs to attend.
  • Avoiding delays by electronic information-sharing of patients’ scans and records between district general hospitals and the cranial neurosurgery centre, to avoid patients having to undergo repeated scans or long waits to be seen by a consultant because their information is not readily available.  

The GIRFT team envisaged that freeing up consultants from many of their 20,000 appointments each year will improve the use of resources, speed up discharge, reduce admissions and increase critical care bed capacity for when it is clinically required.

Freeing up just one extra bed per NHS trust per day would allow thousands more patients to receive the care of cranial neurosurgeons each year with no additional increase in resource – a goal that GIRFT believe is possible for each of the 24 NHS Trusts to achieve.

GIRFT estimate that implementation of their cranial neurosurgery recommendations will result in improved patient experience and outcomes whilst saving the NHS £16.4 million per year.

If you or a family member have suffered serious injury as a result of medical negligence during cranial neurosurgery call our specialist medical negligence solicitors by email mednegclaims@boyesturner.com.

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