What Is... an Early Notification Clinical Negligence Report?

In maternity care, early identification of potential harm is essential. When severe birth injuries occur, families need clarity and support, and healthcare organisations need timely insight so lessons can be learned. The NHS Early Notification Scheme was created with these aims in mind, and at the centre of the process sits the early notification clinical negligence report.

This report plays a crucial role in identifying whether care met acceptable standards and whether early admission of liability may be appropriate. But what exactly does the report involve, and why has it become such an important part of the medico legal landscape?

Understanding the NHS Early Notification Scheme

The NHS Early Notification Scheme was launched to ensure that potential avoidable severe brain injuries at birth are reviewed rapidly. Instead of waiting for litigation to emerge years later, NHS Resolution begins investigating within the first 30 days of life.

This approach allows much earlier engagement with families, faster learning for healthcare teams, and, where indicated, early resolution. A key component of this process is an independent expert report that explores whether a breach of duty may have occurred during labour, delivery, or immediate neonatal care.

What Is an Early Notification Clinical Negligence Report?

An early notification clinical negligence report is a structured, provisional expert opinion that evaluates whether the standard of care delivered by nurses, midwives, or other maternity staff met the threshold of reasonable professional practice.

These reports are commissioned within weeks of an adverse perinatal incident, based on

contemporaneous medical records, HSIB findings, and national guidance and are prepared by independent senior clinicians with expertise in maternity or neonatal care.

The expert assesses whether care met the expected standard by applying legal tests such as Bolam and Bolitho. In cases where details allow, the expert may also comment on early indicators of causation.

When Is a Report Triggered?

The Early Notification Scheme is activated in cases where there are early clinical red flags that may indicate a serious birth-related brain injury. This includes:

• Suspected hypoxic ischaemic encephalopathy

• Stillbirth or neonatal death

• Apgar scores between 0 and 3 at 5 minutes

• Neonatal intensive care admission over 48 hours for neurological concerns

These criteria prompt a structured review long before a formal negligence claim is

considered.

What Does the Report Include?

Although each case is unique, an early notification report usually contains:

• A factual reconstruction of events based on available documentation

• An analysis of care against national guidelines from organisations such as NICE and the Royal College of Obstetricians and Gynaecologists

• An independent opinion on whether there may have been a breach of duty

• Early commentary on causation where appropriate and possible

  
  

The report is confidential and non-disclosable during this early phase. It informs the NHS internal review process and helps NHS Resolution determine whether early admission of liability is appropriate.

Why These Reports Matter

The introduction of early notification reports represents a significant cultural shift in clinical negligence. By reviewing incidents promptly, the system aims to reduce unnecessary and prolonged litigation, improve patient safety by identifying learning points early, support families at a time of considerable distress and provide clinicians and organisations with timely, constructive feedback.

For legal teams, these reports offer a clear early assessment of potential breach of duty and may help shape future case strategy.

Apex Experts and Early Notification Work

At Apex Experts, our panel includes midwives, neonatal nurses, intensive care nurses, and senior clinical specialists with extensive experience in maternity and perinatal care.

We understand the importance of speed and accuracy in these cases. Our team routinely works to short deadlines and provides:

• Independent, structured analysis

• High quality reports aligned with CPR Part 35 requirements

• A clear audit trail referencing national standards and evidence-based guidelines

• Transparent reasoning that supports fair and informed decision making

We operate nationally and support instructions across the UK through a secure, efficient case management process.

Conclusion

An early notification clinical negligence report is far more than an administrative requirement. It is a meaningful opportunity to understand what happened, identify whether standards were met, and support families and clinicians at an early stage.

By combining clinical expertise with legal rigour, these reports help ensure that potential failures are identified quickly and addressed appropriately.