December 2022

Brain injury at birth negligence claims

Posted on 29 December 202223 March 2025 by Sarah O'Sullivan

It is very rare for babies to suffer a serious brain injury at birth. However, the effects can be absolutely devastating and lifelong for babies and their families.

Some signs and symptoms of brain damage can be detected shortly after birth. However, this is not always so and some symptoms may not be apparent until several years later.

Medical negligence claims – baby brain injury due to midwife or doctor negligence

Sometimes, basic errors in care during an otherwise routine pregnancy and labour can, unfortunately, cause or contribute to a devastating birth injury. If the way your baby’s birth was managed caused a brain injury, you may be able to make a claim on behalf of your child to secure financial compensation for their future needs. Research carried out by the Royal College of Obstetricians and Gynaecologists (RCOG) shows that 854 babies suffered a severe brain injury in 2015. Of these babies, 76% might have had a different outcome with better care.

The 2021/22 HSIB Maternity Investigation Report highlighted problems with the inconsistency in guidance across the NHS, and in some areas, a complete lack of any guidance at all. This has led to inconsistency in maternity care across England. Guidelines should protect the health of the mother and baby, and ensure that any problems are detected at an early stage. They cover, for example:

what an initial assessment of the woman should include
the frequency of maternal observations (blood, temperature and pulse)
how the baby’s heart rate should be monitored and how to interpret the results
how frequently vaginal examinations should be performed
the use of pain relief
what should be done if things are not progressing as they might
interventions that may be taken to help deliver the baby.

Doctors and midwives are only human, but unfortunately, when they make mistakes there can be devastating consequences for babies and their families. Sometimes, medical professionals fail to follow the right procedures during labour. For example, any untoward changes in the baby’s heart rate, could suggest that the baby is in distress and, depending on the level of concern, may mandate an expedited delivery. If a caregiver fails to correctly interpret the baby’s heart rate and delivery is delayed, this may mean that the baby has been starved of oxygen for longer than should have been the case and that this has caused brain damage.

Examples of mismanagement after birth may include:

poor management of resuscitation shortly after birth
a failure to treat jaundice
a failure to treat low blood sugar levels promptly.

The most common mistakes tend to occur because of lack of experience, lack of training, poor communication between staff (for example, during a shift change), insufficient staffing levels and fatigue and stress (for example, if the delivery ward is particularly busy midwives might need to look after multiple labouring women at the same time).

If your baby has a brain injury and you are worried about the care you or your baby received, a birth injury claims solicitor can help you find a way forward. Brain-injured babies may have long-term and complex needs, and it is important that any solicitor has the necessary expertise in these cases to help you get the best for your child. Many children with brain injuries go on to lead full and independent lives, but some children may require lifelong care and specialist support (such as adapted housing, equipment and therapy) to help them live their lives to the fullest. At Tees we are committed to helping families get the support and security they need. Our birth injury claims specialists understand what you’re going through, and we can help you get answers about your care. We’ll listen to your experiences, and help you find out what happened.

Caring for women in labour

There are protocols and guidelines that caregivers should follow when caring for women in labour. These are in place to protect the health of the mother and baby and ensure that any problems are detected at an early stage. They cover, for example:

what an initial assessment of the woman should include
the frequency maternal observations (blood, temperature and pulse)
how the baby’s heart rate should be monitored and how to interpret the results
how frequently vaginal examinations should be performed
the use of pain relief
what should be done if things are not progressing as they might
interventions that may be taken to help deliver the baby

Common causes of brain injury at birth

If the brain does not develop properly or if there is damage to the developing brain, this may cause a wide range of physical problems, in addition to behavioural and learning difficulties.

The most common brain injury related to birth trauma is Cerebral Palsy. Cerebral Palsy can occur before birth, during birth or soon after birth.

Problems before birth

Sometimes cerebral palsy can occur before labour and birth. Some things increase the risk of a baby having a brain injury, for example:

problems with the mother’s blood pressure (‘pre-eclampsia’), thyroid, or maternal seizures
maternal infections during pregnancy
multiple births
premature births

Problems during labour

Sometimes cerebral palsy occurs because a baby is starved of oxygen during labour. This is called birth asphyxia. It means that the baby’s oxygen supply or blood flow to the brain was interrupted during birth. Serious complications (acute events) during the early stages of labour or during established labour can interrupt the baby’s oxygen supply. For example:

the placenta separating too early from the uterus (‘placental abruption’)
problems with the umbilical cord
the baby getting stuck in the birth canal and shoulder dystocia (where the baby’s head is born but the shoulder gets stuck).

Serious physical injuries can cause brain injury. If the baby suffers a skull, neck or spinal injury (such as a fracture) this can be very serious. Physical injuries can be caused by physical injury to the mother during pregnancy or by instrumental deliveries such as forceps deliveries.

Doctors might recommend an instrumental delivery if the baby needs help to be born. In very rare situations an instrumental delivery can cause brain injury if the instruments injure the baby’s skull (which is very soft), neck or spine. Such injuries are rare, and may be associated with improper or negligent use.

Problems after birth

Sometimes a baby is born in poor condition and it is important that they receive prompt and appropriate resuscitation. If this does not happen, unfortunately, the baby may be starved of oxygen for too long and may have permanent brain damage.

Other complications after birth include jaundice and low blood sugar levels (‘hypoglycaemia’). Jaundice is relatively common in babies, especially premature babies. It is the yellow colour seen in the skin of many newborns. Jaundice happens when too much bilirubin (a chemical naturally produced by the body) builds up (‘hyperbilirubinemia’). If infant jaundice is treated immediately, there usually isn’t a reason for concern. However, if left untreated, high levels of bilirubin in a baby’s brain can cause a serious condition called acute bilirubin encephalopathy. A very low blood sugar level, if untreated, can also cause cerebral palsy.

For many parents, understanding what happened during their child’s birth – and why – can be extremely important. Whatever caused the baby to be born with a brain injury, it’s an incredibly difficult situation for any parent to go through.

Signs and symptoms of brain injury in babies

The signs and symptoms of brain injury vary and depend on the severity of the injury. Generally speaking, the more serious the injury, the more obvious the symptoms.

Doctors use a grading scale to classify the severity of brain injuries at birth. There are 3 grades: mild (Grade 1), moderate (Grade 2) and severe (Grade 3). More severe injury normally means the initial symptoms and long-term effects will be more serious.

A mild injury (Grade 1 hypoxic ischaemic encephalopathy (‘HIE’)) may not be obvious immediately after a baby’s birth. Parents of babies with mild brain injuries may notice their baby is irritable and has problems sleeping or feeding. Other signs include hyper-alertness or if the baby’s eyes are wide open. Normally, the symptoms of a Grade 1 injury last for the first 24 hours after baby’s birth. If your baby’s birth was particularly difficult, or you suffered complications during delivery, your caregivers may ask you to look out for these symptoms.

Severe brain injuries can cause serious symptoms immediately after birth. These may be immediately noticeable. For example, babies who are born very poorly may be pale and floppy when they’re born.

Symptoms of a moderate (Grade 2 HIE) injury include:

lethargy (low energy, lack of movement)
reduced muscle tone
decreased or absent reflexes (for example, the sucking or gag reflex)
clinical seizures
pale in colour

Babies who suffer a severe (Grade 3 HIE) injury may exhibit the following symptoms:

lack of response to stimulation
unable to breathe independently
low or no heartbeat
lack of muscle tone
pale in colour
clinical seizures.

In very sad cases, a hypoxic brain injury can even lead to a baby’s death.

Treatment for brain-injured babies at birth

When caregivers suspect a baby may be born in a poor condition, a paediatrician should be called. If an emergency situation arises, help should be summoned quickly. However, this often means that midwives, obstetric doctors and paediatric doctors rush to the mother’s bedside. It can be a very frightening experience for the mother, and those supporting her during labour. Ideally, mothers should be told about the potential for such a situation during their pregnancy (however unlikely it may be).

Resuscitation

A paediatrician will be present for the birth in order to resuscitate the baby (if necessary).

Depending on the seriousness of the baby’s condition, they will usually be admitted to a Special Care or a Neonatal Intensive Care Unit. Although this can be frightening for parents, it means that poorly babies get the care and support that they need to help their recovery.

Neonatal Therapeutic Hypothermia (infant cooling)

Neonatal Therapeutic Hypothermia (infant cooling) is a relatively new way of treating brain-injured babies at birth. It involves lowering the baby’s body temperature. Research suggests that this can improve the chances of babies starved of oxygen at birth from developing serious brain injuries, such as cerebral palsy.

Oxygen deprivation to the brain can cause a ‘cascade’ of neurological injuries. It causes gradual death of brain cells which in turn can cause brain injury and, in very sad circumstances, it can cause the baby’s death. Cooling therapy works by slowing down your baby’s metabolism, which slows and prevents the death of brain cells following oxygen deprivation. Cooling cannot, however, reverse the brain injury that has already occurred.

If your baby suffered a serious case of oxygen deprivation, they may be ‘actively cooled’. Your baby may be placed on a special cooling mat, or have cooled packs placed around them, to reduce their body temperature. The baby will be looked after in the neonatal care unit and cooled to 33C for 3 days after birth. Alternatively, your baby may be ‘passively cooled’, a process which involves taking early steps not to warm the baby up. Doctors may recommend removing the baby’s bonnet or turning off the heater to keep her/him cooler.

Both treatments are time-sensitive, and guidelines recommend cooling to start within 6 hours of birth. Although infant cooling is relatively new, early research suggests it is effective in improving the chances of brain-injured babies.

Unfortunately, not all brain-injured babies are candidates for infant cooling. Doctors might not recommend it if the baby is premature, has a very low birth weight or has a serious problem with their heart or lungs.

Imaging

If your baby suffered a brain-injury at birth, your doctors should offer an MRI scan or CT scan of the head. These tests examine the baby’s brain and can show signs of injury to the brain. Scans provide doctors with a detailed image of your baby’s brain and skull, and can show if there is bleeding or swelling, ischaemic brain tissue or fractures to the skull.

Prognosis for babies with a brain injury

Every baby is different and their prognosis will depend on the extent of the damage, where the damage occurred and what treatment they received.

It is usually hard to say what the likely course of any future disability may be until the child is older and how, and to what extent they have responded to therapies and support. However, in many cases there are long-term physical, in addition to learning and/or behavioural difficulties. In some cases, the child may also suffer epilepsy.

Children with cerebral palsy usually need life-long support from a multi-disciplinary team, which may include a Paediatrician, a Neurologist, a Neuropsychologist, an Orthopaedic Surgeon, Physiotherapists, Occupational Therapists, Speech and Language Therapists, social workers, educational psychologist, a mental health specialist. It can be very difficult to access but such therapies and support are known to significantly improve outcomes.

Some children will grow up to be capable of independent living and meaningful employment. Others, sadly, will not.

Life expectancy also varies enormously. Many children with a mild brain injury will have a normal life expectancy. Those at the more severe end of the spectrum will, sadly, have a considerably shorter life expectancy. If you have any questions or concerns about your child’s prognosis you should talk with your caregiver.

If your child has a brain injury and you are concerned about the care you or your baby received talk to our birth injury claims specialists. We’ll listen to your experience and help you find out what happened.

Brain injury at birth terminology

Below is a useful glossary of terms which you might hear in connection with brain injuries at birth.

Where appropriate, these terms are explained specifically in the context of brain injuries at birth.

Hyperbilirubinemia: a condition whereby there is too much bilirubin in the blood
Hypoglycaemia: low blood sugar levels
Hypoxia: where part of the body (in this case, the baby’s brain) does not receive enough oxygen
Hypoxic ischemic encephalopathy (HIE): where the baby’s brain does not receive enough oxygen or blood and it causes a problem with the baby’s health
Hypothermia: a very low body temperature
Neonatal encephalopathy (NE): abnormal signs of brain injury shortly after the baby’s birth
Neurological: relating to the nervous system (the brain, spinal cord and nerves).

Disclaimer: All content is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor, any other health care professional or for the legal advice of your own lawyer. Tees is not responsible or liable for any diagnosis made by a user based on the content of this site. Tees is not liable for the contents of any external internet sites listed, nor does it endorse any service mentioned or advised on any of the sites. Always consult your own GP if you’re in any way concerned about your health and your lawyer for legal advice.

The legal rights of unmarried couples living together

Posted on 28 December 202222 March 2025 by Sarah O'Sullivan

Living together without getting married is a common choice for many couples. However, it’s essential to understand the legal differences between cohabiting and being married. Unlike married couples, unmarried partners don’t have the same legal protections if the relationship ends or one partner passes away.

In this guide, Joshua Coombe, Partner and Family Law Solicitor at Tees, outlines the key legal rights of unmarried couples and how to protect yourself.

What does cohabiting mean?

Cohabiting refers to couples living together without being married or in a civil partnership. While it’s a popular choice, cohabiting couples have fewer legal rights than their married counterparts.

A cohabitation agreement can be a practical step to clarify finances, property rights, and responsibilities in case the relationship ends.

Common law marriage: Myth or reality?

The idea of common law marriage is a widespread misconception. In the UK, common law marriage has not existed since 1753. No matter how long you live together, you won’t acquire the legal rights of a married couple.

Financial rights of unmarried couples

Unmarried couples have no legal financial responsibility towards each other if they separate. Unlike divorce, there is no entitlement to spousal support. However, parents have a financial responsibility for their children, which can be enforced through the Child Maintenance Service.

Parental rights for unmarried parents

Mothers automatically have parental responsibility.
Fathers only have parental responsibility if they are named on the birth certificate or are married to the mother.
Joint registration at birth provides legal rights and responsibilities for both parents.

Property rights for unmarried couples

If a couple breaks up, property ownership is typically determined by whose name is on the title deeds or lease. If one partner contributed financially without being named, they may have a claim under trust law, but this can be legally complex.

A declaration of trust can help avoid disputes by clearly defining ownership rights.

Inheritance rights for unmarried couples

Unmarried couples have no automatic inheritance rights if a partner dies without a will. The deceased’s estate will be distributed according to intestacy laws, which do not recognize unmarried partners.

However, under the Inheritance (Provision for Family and Dependants) Act 1975, a surviving partner may be able to make a claim if they were financially dependent on the deceased.

How to protect yourself as an unmarried couple

To safeguard your interests, consider the following steps:

Cohabitation agreement: Clearly set out financial responsibilities and property ownership.
Make a will: Ensure your partner is provided for in the event of your death.
Life insurance: Provide financial support for your partner if you pass away.
Pension review: Check that your pension can be passed to your partner.
Tax advice: Unmarried couples do not benefit from the same tax exemptions as married couples. Specialist advice can help you manage this.

Legal reform and the future for cohabiting couples

In August 2022, the House of Commons Women and Equalities Committee recommended significant legal reforms to improve protections for cohabiting couples. While the Government rejected most proposals, the campaign for change continues.

Until reforms are implemented, seeking legal advice and planning for the future is essential for cohabiting couples.

Need legal advice? At Tees, we offer expert advice on cohabitation agreements, wills, property disputes, and parental rights. Contact us today to ensure your rights are protected.

Advice for employers on home working

Posted on 9 December 202222 March 2025 by Sarah O'Sullivan

The expectation for flexible working is becoming more and more in demand. According to the office for national statistics, more than 8 in 10 workers who had to work from home during the coronavirus pandemic said they planned to do hybrid work.

Government proposals around changing the rules around flexible working requests include reducing the formal content required for a request, day one rights, as opposed to eligibility currently subject to 26 weeks’ service and allowing up to 2 requests a year. The debate continues around finding arrangements that work for employees and employers and with employers often having to approach how they deal with requests and principles of flexible working, carefully, to reduce the risks of claims and attract and retain good calibre candidates to jobs.

In the current economic climate, businesses may be reassessing their requirements with consideration being given to reducing office space and rental costs, which may result in more companies considering a home-based workforce for the long term.

As we continue to debate what the ‘new normal’ looks like, it is evident that this is something of a moving target with expectations, trends and business requirements seemingly changing quickly. Against this background, it is worthwhile considering what the legal implications are for employers on some of the key considerations around home working.

Contracts of employment

Many employees will be working under contracts of employment with no specific provision to work from home, and the place of work will most likely be stipulated as the employer’s premises.

Unless there is a written term in the contract of employment permitting home working, employers would need the agreement of the employee in order to insist on home working. Imposing a unilateral change without the agreement of those affected employees could constitute a breach of the employment contract. What happens in practice, though, may also be relevant, whether that is around the employer and/or an employee wanting to revisit the ‘normal’ place of work and how work is delivered post Covid-19.

It is recommended that employers check the wording of the ‘place of work’ clause in their employment contracts as the wording may include a degree of flexibility in the favour of the employer, which can allow for a change in place of work on a temporary or perhaps even permanent basis.

If the contract contains wording allowing for flexibility and changes then the employer may not be in breach of the terms by enforcing a permanent switch to home working. Employers should note that it is still important for employers to act reasonably when implementing such a clause, otherwise, they risk breaching mutual trust and confidence – This is a term implied by law in all employment contracts and breach of it is commonly used in constructive unfair dismissal claims. It is also worth keeping in mind that terms can become part of the contract by “custom and practice”. If in doubt, employers should seek legal advice on their particular documentation and issues arising.

In any event, employers are well advised to ensure they communicate with staff in advance and where appropriate, consult as well as set aside reasonable time before implementing changes to the place of work to allow employees time to prepare and adjust.

Where consultation is needed on employment contract changes

Where there is no flexibility to the place of work clause the employer will need to adopt a different approach. Employers will need to discuss the possibility of working from home with employees and consult with them in order to get their agreement to home working along with the necessary change to the terms of their contract. Again, communication is key and a lack of communication is often a key part of disputes arising.

Call our specialist solicitors on 0808 231 1320

Dealing with a refusal to agree to contract changes

If however, employees in this situation maintain a refusal and the employer can demonstrate that:

there are good business reasons for switching to a home-working model,
it has undertaken appropriate consultation and
it has followed a fair procedure;

then it may be possible for an employer to dismiss.

In appropriate circumstances, such dismissals can be considered fair with the employer relying on “Some Other Substantial Reason” as the potentially fair reason to dismiss, provided the employer can demonstrate that the dismissal was reasonable in all the circumstances.

This should be a last resort if there is a failure to agree and the alternatives have been considered. Such dismissals are subject to due process and bring with them the risk of, amongst other things, unfair dismissal claims for eligible employees. Employers who approach such matters without due care will be exposed to claims and again, seeking professional advice early is prudent.

Employers who are faced with this scenario and are looking to dismiss should look to offer those refusing employees re-engagement on the new amended terms, including the homeworking provisions. Consideration should also be given to the numbers of employees affected: if this is 20 or more then collective consultation may need to be undertaken with potentially severe penalties if the right steps are not followed.

Duties towards employees when working from home

Where employees are working from home, employers should ensure that they are treated in the same manner as all other employees. Home-based employees are entitled to the same rights and benefits as any employee working at the employer’s premises.

An employer has both statutory and common law duties towards its employees and is responsible for an employee’s health and safety, “so far as is reasonably practicable”. In practice, this means that employers should conduct a suitable risk assessment of all work activities carried out by homeworkers to identify any possible hazards. Employers will then need to consider these obligations to decide what measures need to be put in place.

Confidentiality and data protection issues when working remotely

In addition to the health and safety aspects of home working, employers will need to consider how to safeguard business confidentiality and data protection requirements with increased chances of breaches taking place when outside of the employer’s premises.

Careful consideration is needed given the potential damage and loss that could be caused through unauthorised breaches, including significant fines that can be imposed by the Information Commissioners Office for breaches of data protection legislation – which has been strengthened since 2018.

It is also key for employers to ensure that they have suitable arrangements in place to help maintain contact with other staff, including office-based and home-workers, in order to limit issues that could arise through increased isolation of working remotely.

Where reasonable adjustments may be necessary

Where an employee has a disability, then consideration should be given to whether the provision of some equipment is required in order for the employer to comply with their duties under the Equality Act 2010 to make reasonable adjustments.

Right to requests for flexible working

It is still the case that employers are not required to agree home working requests from staff. There is no right to work from home and instead, presently, employees with 26 week’s service have the right to request flexible working arrangements.

Sports Connection Foundation receives Tees Better Future Fund grant

Posted on 2 December 202230 March 2025 by Sarah O'Sullivan

Tees Better Future Fund is very pleased to announce that the Sports Connection Foundation in Essex is the second community project to receive a Tees Better Future Fund Grant.

Sports Connections Foundation uses the power of sport to inspire, empower, educate and transform the lives of children and young people.

Founded 12 years ago by ex-professional footballer Junior McDougald, Sports Connections Foundation now uses 4 different distinct programmes to transform the lives of disadvantaged children:

Sporting Wishes – special sporting memories for children with life-limiting conditions.
ProKick Schools Challenge – providing Primary Schools with a football-related, sponsored activity which raises awareness of less fortunate children in the world and promotes physical activity.
Inspire Through Sport International – provides funding and vital educational resources to an impoverished orphanage and a nursery in Burkina Faso, Africa.
Inspire Through Sport – provides sport inspired youth work and sports camps with additional enrichment activities and coaching and mentoring for children and young people referred to SCF as being disadvantaged in some way.

These programmes have helped over 550,000 children so far and the number continues to grow every day.

Through their connections and partnerships, SCF gives young people, from a range of different backgrounds, access to Industry Professionals, Mentors & SCF Ambassadors who will help to develop skills, build self-esteem and confidence, and raise aspirations and help to create role models for the next generation.

The £5000 grant from Tees will help fund a new ‘Inspire Through Sport’ project to provide mentoring sessions, positive play and therapeutic intervention, Theme Positive Activity and a school holiday programme to 30 children who are facing the challenge of poor mental health, social isolation and economic deprivation. These children, it is feared, may struggle in the transition from primary school to secondary school.

Thirty children will be picked from across three different schools in the Primary Schools of the Cresco Multi-Academy Trust – Great Berry, Janet Duke and Noak Bridge Primary Schools in Basildon in Essex.

SCF Youth Workers will lead 1-1 sessions and small group sessions with youth workers in early 2023. From these sessions, SCF Youth Workers will be able to identify personal growth goals for each child and over the sessions will work with the child to communicate and express their emotions healthily and build resilience and self-confidence, assisting their mental health and contributing positively to improving their quality of life.

All 30 children will be offered an enrichment activity – a trip to an event or venue which they have helped to choose. This will provide them with the opportunity to mix with others that they would otherwise not have met and an experience that they otherwise would not have been able to access.

The conclusion of the project will be a combined summer camp at the secondary school that the children will most likely progress to. They will be able to focus on group sports, team building and personal development. They will be provided with food and drinks to help alleviate pressure on the families during the camps.

Executive Partner and Co-chair of the Tees Better Future Fund, Janine Collier commented “We were inspired by the vision that Sports Connection Foundation had for the Inspire Through Sport Project- the vision to use sport to engage and inspire disadvantaged children to help them make that transition from primary school to secondary school. This is such a key time in any child’s development, we hope that supporting those who may otherwise struggle through this time will raise confidence, build skills and enable them to thrive, not just survive in the transition. The project also increases access to sports and exercise for children and will help improve physical and mental health through activity.

We are looking forward to getting to know the children involved in the programme and to hearing how this project has helped shape the way they approach the challenges that they face, their progress at school and, their mental and physical wellbeing.