Coronavirus

Changes to our investigations during COVID-19

We’ve made some changes to the way we carry out maternity investigations due to the COVID-19 pandemic.

We have reviewed our approach to minimise the impact our work has on NHS maternity services during this time.

The main changes are:

  • A review of what we investigate. We no longer routinely investigate maternity cases involving cooled babies where there is no apparent neurological injury following cooling therapy. However, it is important to note that NHS trusts should continue to refer all cases that meet HSIB criteria to us.
  • We are no longer carrying out face to face interviews. Where possible we are using video technology such as Skype or Microsoft Teams to speak to the families and NHS trust staff involved in our investigations.

Many of our maternity investigators are midwives who work with us on secondment from their NHS trust. We recognise the current increased pressure on maternity services and have made a commitment to enable our team members to return to clinical practice at their trust, should there be a request to do so.

If you’ve got any questions or concerns, please contact us by email at maternity@hsib.org.uk.

Information for families, patients and carers

We’ve made some changes to the way we carry out maternity investigations due to the COVID-19 pandemic.

The following frequently asked questions aim to help explain these changes to families. If you’ve got any questions or concerns that are not answered below, please contact us by email at maternity@hsib.org.uk.

Will my maternity case still be referred to HSIB?

Yes. NHS trusts are still required to make a referral to us as part of a national action plan to make maternity care safer.

Will my referral be progressed?

Due to the outbreak of COVID-19, it has been necessary for us to review the investigations we conduct. This means that we are not able to complete all investigations as set out in the 2018 HSIB Maternity Investigations Directions. Your referral will be reviewed against a temporary criteria that has been agreed with the Department of Health and Social Care.

If you have agreed for us to contact you, we will discuss this further with you and explain what will happen next regarding your case.

What part of the criteria has HSIB changed?

Since 23 March 2020, we no longer routinely investigate maternity cases involving cooled babies where there is no apparent neurological injury following cooling therapy. This would normally mean a brain MRI showing no hypoxic damage (a type of brain injury that occurs when there is a disruption in supply of oxygen to the brain) and the baby demonstrating no ongoing neurological signs or symptoms.

Will HSIB still be conducting interviews with families to gain their account of what happened?

Following government advice, we will not be able to meet families face to face. However, speaking with you about your care is still very important to us. We will contact you and discuss the best way to do this, using technology where possible.

Will HSIB still interview staff at the hospital that referred my case?

We will continue to interview key staff and will do this remotely. This may take longer than usual due to the COVID-19 situation.

Will HSIB still be completing investigation reports?

We will continue to write our investigation reports once our enquiries are completed. We will discuss with you the best way to share the draft report with you.

Will HSIB be continuing my case that was referred before the outbreak of COVID-19?

Due to the outbreak of COVID-19 many working practices have changed. We have stopped all face-to-face meetings and replaced these with phone or video calls. We will now review referrals against a temporary criteria that has been agreed with the Department of Health and Social Care. This may affect our decision to progress an investigation or the time it takes to complete your investigation. We will contact you and explain what this may mean for your particular circumstances.

Information for trusts and staff

We’ve made some changes to the way we carry out maternity investigations due to the COVID-19 pandemic.

The following frequently asked questions aim to help explain these changes for NHS trust staff. If you’ve got any questions or concerns that are not answered below, please contact us by email at maternity@hsib.org.uk.

Why is HSIB continuing to carry out maternity investigations during the outbreak of COVID-19?

As requested by the Department of Health and Social Care we will continue to investigate the more serious maternity cases, which meet the Each Baby Counts (EBC) or MBRRACE-UK criteria.

Why is HSIB not progressing all cases?

We have been reviewing our processes and approach to investigations to ensure we minimise the impact our work has on maternity services.

Additionally, in recognition of the pressure of COVID-19 on the NHS and maternity services we have made a commitment to enable our Maternity Investigation Team, some of whom have been called back to clinical practice, to do so as soon as they are required.

What part of the criteria has HSIB changed?

Since 23 March 2020, we have no longer been routinely investigating maternity cases involving cooled babies where there is no neurological injury following cooling therapy. This would normally mean a brain MRI showing no hypoxic damage and the baby demonstrating no ongoing neurological signs or symptoms.

Do trusts still need to refer all incidents which meet the EBC or MBRRACE-UK criteria to HSIB?

Yes. We ask that trusts continue to refer all cases that meet the criteria set out in the 2018 HSIB Maternity Investigations Directions. These cases will be reviewed on an individual basis. In cases where there appears to have been no harm to the baby and no concerns are raised by the trust or family, we will log the event and not progress an investigation further. We will also inform trusts that there is no expectation for them to carry out a full investigation.

During the outbreak of COVID-19 do trust staff still need to take part in interviews?

We are taking a pragmatic approach with interviews. Where possible we will still invite staff to be interviewed remotely using video technology such as Skype or Microsoft Teams. We value staff input while respecting the clinical challenges on the frontline.

During the COVID-19 pandemic will consideration be taken when reviewing clinical practice that may fall short of normal national guidance?

Yes. Consideration will be taken when reviewing incidents which occur during the outbreak of COVID-19. For example, the impact of wearing personal protective equipment. We will take a pragmatic approach to each incident and where possible benchmark against new local or national guidance.

If I have a concern or query who can I contact?

You can contact us by email at maternity@hsib.org.uk.

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