Rising maternity claims call for specialist help
One of the largest areas for clinical negligence claims surrounds maternity. According to NHS Resolution, in 2022/23 maternity claims represented 41% by value of all clinical negligence claims at a cost of £1.1bn.
This rise means specialist assistance with a maternity claim has never been needed more with TLA recently adding a new expert to its panel.
Virginia Ash is an advanced practice midwife with a specific master’s degree in the field dealing with triage, day assessment and work in an advanced practice clinic creating patient plans and non-medical prescription along with diagnostic reasoning and history taking. In the most senior clinical midwifery role, advanced practice midwives lead the management and development of new services.
She explains: “Unlike other midwives, I am able to diagnose, and I am allowed to titrate patients’ medication and start them on new medication.
“I was a labour ward coordinator for eight years and I still do it part time, attending obstetric and neonatal emergencies reviewing patients in triage and at the day assessment unit.
“My role offers flexibility across triage and the DAU where I can be redeployed as needed, leaving my usual area to provide one-to-one care for the highest-risk or most complex patients wherever the unit needs me most."
Patients in these areas can be suffering from a wide variety of conditions requiring specialist care.
Virginia says: “Complexity ranges from abnormal obstetric emergencies to life-threatening situations. I've cared for women with sudden onset severe pre-eclampsia leading to cardiac failure, and complex placenta praevia with major haemorrhage. Where a patient presents with needs that sit at the intersection of obstetrics and intensive care, I provide one-to-one care, the kind of focused, specialist attention those cases demand."
Virginia practices at the Ashford and St. Peter's Hospitals in Surrey.
"We're not a big unit, but we are a very high-risk environment. Alongside fetal medicine and the maternal cardiac team, we have a level three neonatal intensive care unit, meaning we deliver babies at any gestation. I run a hypertension clinic, diagnosing women who present with raised blood pressure and putting them into management.
“Our team is line-managed by doctors rather than midwives, and I support midwives on the labour ward across everything from normal labour care to patients presenting in triage with chest pain, pre-eclampsia, reduced movements and vaginal bleeding," she adds.
“I run a hypertension clinic and as soon as hypertensive cases come in, we diagnose them and start them on medication. They are then streamlined into which obstetrician, and which midwives need to see them.
Because of the nature of her job, entering the medicolegal world as an expert seemed a logical step for Virginia.
"Case review is a core part of my role, whether that's redesigning a patient's current care pathway or reflecting on what could have been done differently. The prospect of applying that same analytical rigour in a medicolegal context is a natural extension of work I'm already doing."
Aside from her day-to-day work, Virginia is involved in quality improvement projects surrounding the treatment of sepsis and fluid balance/bladder care, as well as carrying out the ITU admissions audit.
She has lectured undergraduate midwifery students at the University of West London and delivers mandatory training across the Trust, including sessions on obstetric emergencies and Group B Streptococcus.
Virginia has also facilitated study days and induction programmes for junior doctors, training for doctors in emergency medicine and newly qualified midwives and regularly leads multidisciplinary teaching sessions, including obstetric emergency simulations and regularly attends medical teaching forums to support her continued professional development.
Away from her work, Virginia enjoys reading and spending time with friends, but her main passion is travel.
She says: “I love to travel - the more I can get away, the better whether it be long haul, short haul or domestic. I also have a dog who is my best little bud!”
For further information contact Senior Case Manager Kelly Booker for Virginia’s CV kelly@tla-medicolegal.com