The Maternity and Newborn Safety Investigation programme (MNSI) is responsible for patient safety investigations of NHS maternity care in England. They were initially established under the Healthcare Safety Investigation Branch (HSIB) and as of October 2023, became known as MNSI, being part of the Care Quality Commission.

What unites the aim of both HSIB and MNSI is the desire to bring about safer maternity care; the National Maternity Safety Ambition, as launched in 2015, aimed to halve the rate of stillbirths, neonatal deaths and maternal deaths by 2025.

Under MNSI, all NHS Trusts in England are required to tell them about patient safety incidents involving maternity care. They investigate certain cases of:

• early neonatal deaths, intrapartum stillbirths and severe brain injury in babies born at term following labour in England
• maternal deaths in England.

With investigations concerning babies, they can investigate babies who have been born at full term (at least 37 weeks) following labour who have suffered one of the following outcomes:

• intrapartum stillbirth – this is where the baby was died during the labour and was born with no signs of life
• early neonatal death – this is when the baby died within the first week of life.
• potential severe brain injury – this when such an injury was diagnosed within the first seven days of life, when the baby was therapeutically cooled and has been diagnosed with moderate to severe encephalopathy, consisting of altered state of consciousness (lethargy, stupor or coma) and at least one of the following:

1. 1. Hypotonia
   2. Abnormal reflexes including oculomotor or pupillary abnormalities
   3. Absent or weak suck
   4. Clinical seizures

With investigations concerning maternal deaths, they investigate direct or indirect maternal deaths of women while pregnant or within 42 days of the end of pregnancy.

Direct deaths include those resulting from obstetric complications of pregnancy, labour and after the birth. Indirect deaths include those from previous existing disease or disease that developed during pregnancy, and which was not the result of direct obstetric causes but was aggravated by the effects of pregnancy whilst pregnant or within 42 days of the end of pregnancy.

MNSI investigations replace the internal investigation carried out by the healthcare organisation and they work closely with those who received care, their families and healthcare staff affected by patient safety incidents. Such independence provides reassurance to those who have suffered patient safety incidents, given that fear that an internal investigation will be biased in some way.

The aim of MNSI is to safeguard people’s health, wellbeing and human rights by investigating care that has been provided and identifying failings and potential improvements that can be made. Their commitment is to protect adults, children and young people who engage with the MNSI programme from harm and to bring about meaningful change to avoid the same mistakes in maternity care being repeated.

What they do not do however is to attribute blame or liability and this is where a claim for medical negligence may assist. We recognise how important it is for there to be acceptance of failings by medical professions and for them to own up to what they have done wrong; it of course does not change what happened but it can help in terms of processing what you have been through.

As part of a claim for medical negligence, it is sought to attribute blame by securing admissions of liability from healthcare professionals; a claim involves detailed investigations in respect of identifying any failings in the care received and the harm suffered as a consequence. As well as securing financial compensation, we seek much needed answers and justice for those who have been let down.

We have assisted many clients who have received reports such as from MNSI and HSIB which highlights failings in the care received. It is however not necessary for there to be such a report in order to bring a claim; for example, MNSI have a strict criteria that they apply when deciding what to investigate and as such, cannot investigate every potential case.

If you feel that you have been let down when receiving maternity care, please contact our experienced team to discuss how we many be able to help.