If you have been contacted by the Maternity and Newborn Safety Investigations (MNSI) programme after your NHS maternity or neonatal care, this means that your maternity hospital has told MNSI about your birth injury.
NHS trusts must tell MNSI about maternity safety incidents which result in HIE brain injury, stillbirth or the death of a newborn baby, or fatal injury to the baby’s mother, so that MNSI can carry out an investigation and then report their findings to NHS Resolution.
Parents can feel vulnerable and overwhelmed in the weeks that follow a birth injury. If MNSI have contacted you, we recommend that you speak to one of our birth injury solicitors for advice and support before sharing your birth story and medical records with MNSI’s investigation. Before agreeing to an investigation, it is important that you understand the roles and relationships between your hospital, MNSI and the NHS’ legal defence team at NHS Resolution, and what this could mean for your family if your child is entitled to compensation.
On this page you will find answers to some of the questions that families ask us about MNSI investigations. You can also talk to one of our solicitors about your baby’s birth injury, free and confidentially, by contacting us.
FAQs
What is MNSI?
MNSI is the Maternity and Newborn Safety Investigations programme. Since October 2023, MNSI have investigated certain types of serious injuries that have been caused to mothers and babies during NHS maternity care.
All NHS trusts in England must report these serious maternity safety incidents to MNSI so that they can carry out an investigation. After each investigation, MNSI make safety recommendations to improve the maternity services at the NHS trust where the birth injury took place as well as more widely across England’s entire maternity healthcare system. MNSI also take what they learn from all their investigations and look for recurring themes, so that they can recommend improvements for NHS maternity services.
Why have MNSI contacted me?
If MNSI have contacted you, this means that your maternity or neonatal care hospital has told MNSI that your baby or their mother recently suffered a serious birth injury.
Your healthcare team at the hospital will have told you about MNSI and asked for your consent to share your contact details. MNSI must contact you to ask whether you agree to an investigation taking place. They must also ask for your consent before accessing your maternal (mother) and neonatal (baby) medical records. You can agree to the investigation or withhold your consent, depending on whether you want MNSI to investigate the maternity and neonatal care that your family received.
What types of birth injury are investigated by MNSI?
MNSI investigate birth injuries which occurred during NHS maternity care, where a full-term baby (born after 37 weeks of pregnancy):
- is diagnosed in the first seven days of life with severe brain injury, involving either:
- moderate to severe hypoxic ischaemic encephalopathy (HIE);
- treatment with cooling;
- or signs of hypoxic birth injury (decreased central tone/floppiness, loss of consciousness, fits or seizures);
- dies after the start of labour but before birth (intrapartum stillbirth);
- is born alive but dies in the first week of life (early neonatal death).
- is diagnosed in the first seven days of life with severe brain injury, involving either:
MNSI also investigate maternal deaths, where a mother dies whilst pregnant or within six weeks (42 days) after the pregnancy ends (by birth, miscarriage or termination) and where the death was directly or indirectly related to their maternity care.
All NHS trusts which provide maternity services must tell MNSI whenever one of these incidents occur.
MNSI don’t investigate:
- HIE birth injuries where the baby’s MRI brain scans or neurological examinations show no obvious evidence of ongoing brain injury (such as after cooling), unless the family or the NHS trust request an investigation;
- brain injury to a baby which is caused by congenital conditions or health issues unrelated to the maternity care;
- neonatal death of a baby whose mother did not go into labour;
- maternal deaths caused by suicide.
Should I agree to MNSI’s investigation?
It is up to you whether you choose to agree to an MNSI investigation or decide to withhold your consent. Before making your decision, it may help you to understand what happens to your information after the investigation has taken place.
If MNSI carry out an investigation, they will produce a report which they will share with your family and the NHS trust which provided your maternity care. MNSI will also notify the NHS’ legal defence team at NHS Resolution, who will begin preparing to defend any potential birth injury compensation claim arising from your baby’s injury, via the Early Notification (EN) scheme.
If you do not want MNSI to have access to your family’s medical records or to interview you and carry out an investigation, MNSI will let your hospital know. The NHS trust responsible for your hospital care may decide to carry out their own serious incident investigation.
Your choices, and any opinions that MNSI, your hospital or NHS Resolution express about your care, should not prevent or deter you from seeking independent legal advice about making a birth injury compensation claim. MNSI’s investigations are not intended to identify negligence or attribute blame, and any subsequent investigations that are carried out by NHS Resolution’s Early Notification (EN) scheme take a defensive approach to help NHS Resolution defend (oppose) patients’ medical negligence compensation claims.
Our specialist birth injury lawyers (and our medical experts) often disagree with NHS Resolution’s conclusions and go on to achieve substantial settlements for our birth-injured clients. The best way to find out whether your child or family is entitled to compensation is to talk, free and confidentially, to one of our experienced, claimant-specialist (for the patient) birth injury solicitors.
What happens during an MNSI investigation?
If your baby’s birth injury meets the Maternity and Newborn Safety Investigations (MNSI) programme’s investigation criteria, your maternity hospital must report the injury to MNSI. Your healthcare team should tell you that they are reporting your birth injury to MNSI and ask for your consent to pass your contact details to MNSI.
If you agree to the hospital sharing your contact details with MNSI, an MNSI investigator will contact you and ask for your permission to access your family’s medical records. It is your choice as to whether you agree to let MNSI access your medical records and carry out an investigation, or choose to withhold your consent. If you do not agree to MNSI’s investigation, the NHS trust responsible for your maternity care may decide to carry out their own serious incident investigation.
At the start of an investigation, MNSI will arrange for you to meet with their investigator, so that they can explain the investigation process to you, discuss your involvement and answer your questions. You will still be free to opt out of the investigation at any time, but if MNSI have already accessed your family’s medical records (with your consent) and begun their investigation, they will proceed with the investigation even if you no longer wish to be involved.
During the investigation, MNSI’s investigator will interview you and key members of your family, either in person or by video call, to obtain your account of what happened during your pregnancy, birth and neonatal experience. You will not be allowed to have your own solicitor with you at these interviews. For this reason, we strongly recommend that you speak to one of our solicitors, to seek advice on how to protect your child’s or your family’s entitlement to compensation, before sharing your recollections of your birth experience with MNSI.
MNSI’s investigators will also interview the maternity and neonatal staff who were involved in your care. They will liaise with the NHS trust throughout the investigation and may encourage you to participate in meetings or communication with the NHS trust.
During the investigation, MNSI’s investigators may seek medical advice before preparing a draft report. They will share a copy of the investigation report with your family and with the NHS trust which was responsible for your maternity care. If anything in the report is inaccurate, you should ask MNSI’s investigator to correct it. The final report will then be shared with you, the NHS trust and any healthcare staff involved in your care. At the end of the investigation, you may be asked to attend a meeting with MNSI’s investigator and the NHS trust to discuss what happens next. MNSI will also notify the NHS’ defence team at NHS Resolution.
How long does an MNSI investigation take?
MNSI expect most of their investigations to be completed within six months, but in some cases the investigation may take longer. You do not need to wait for the outcome of MNSI’s investigation to seek legal advice about making a claim from an independent, claimant-specialist, birth injury solicitor.
Will my child receive compensation if MNSI find mistakes in their birth or newborn care?
The Maternity and Newborn Safety Investigations (MNSI) programme is not a compensation scheme. MNSI cannot make payments of compensation to injured patients or their families, and does not investigate birth injuries from a legal perspective.
The best way to find out whether your child or family can claim compensation after a birth injury or maternal death is to seek advice from Boyes Turner’s experienced birth injury solicitors. Your enquiry will be handled free and confidentially and without obligation. We handle birth injury and neonatal brain injury claims for severely injured children on a no win no fee basis, with 0% success fees.
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