Sarah O'Sullivan, Author at Tees Law

NHS Trusts respond after accepting liability for avoidable death of mental health patient

Posted on 14 March 202418 May 2025 by Sarah O'Sullivan

Two NHS Trusts that accepted liability for the preventable death of Jack Farrington have responded to the Regulation 28 Prevention of Future Deaths Report, outlining changes that they have since made to improve patient safety.

Solent NHS Trust and Portsmouth Hospitals NHS Trust have accepted full liability for the preventable death of Jack Farrington, a 26-year-old man who took his own life while detained under section 2 of the Mental Health Act in January 2020.

Trust Failings and Areas for improvement

The Trusts’ failings were found to have contributed to Jack’s ability to abscond from the hospital. Key areas requiring improvement include:

Assessment and recording of patient information
Information sharing
Accountability
Implementation of measures to ensure patient safety

Actions taken by the NHS Trusts

Portsmouth Hospitals NHS Trust’s response

Portsmouth Hospitals NHS Trust stated that it is developing a new system to provide the Emergency Department team with more comprehensive information about patients’ needs and risks before their arrival.

Solent NHS Trust’s response

Solent NHS Trust announced that it is transitioning from paper-based forms to an electronic system integrated with the existing online platform, improving the accuracy and accessibility of patient information.

National NHS response

Professor Sir Stephen Powis, National Medical Director of NHS England, highlighted that Summary Care Records now include details of long-term conditions, significant medical history, and specific communication needs by default, unless a patient has opted out.

Jack Farrington’s story

Jack Farrington, who lived with bipolar disorder and schizophrenia, tragically died after absconding from Queen Alexandra Hospital in Portsmouth. He fell from a bridge over the A3 London Road in January 2020.

Legal action and family’s response

Jack’s parents, Joseph and Catherine Farrington, pursued a civil action against both Trusts with the support of Tees Law. The legal claim concluded in January 2024.

Chantae Clark, from Tees Law, commented on the significance of the case:

“This case underscores the pressing need for improvements in mental health care and highlights the importance of robust oversight and accountability across the NHS and mental health services.”

Findings from the inquest

An Inquest concluded that Jack was not capable of forming an intention to end his life. When he was lucid, he showed a desire to recover and sought medical assistance.

Timeline of events leading to Jack’s death

30 December 2019: Jack called 999 during a psychotic episode and was voluntarily admitted to Queen Alexandra Hospital (QAH).
Initial Risk Assessment: Jack received a ‘Mental Disturbance Primary Survey’ with a risk score of 8, the highest level, requiring Level 5 (black) supervision.
First Absconding Incident: While waiting for further assessments, Jack absconded through an emergency exit.
Second Absconding Incident: After being returned to the hospital by the Police, Jack absconded again the following day.
Detainment and Transfer: Jack was sectioned under Section 2 of the Mental Health Act and transferred to the Hawthorn Ward under Solent NHS Trust.
Insufficient Risk Consideration: Despite his history of absconding, his risk was not properly addressed by the Hawthorn Ward.
Seizure and Return to QAH: On 2 January 2020, Jack suffered a seizure and was returned to QAH, where he was placed in the Emergency Department’s “Pitstop” area.
Final Absconding Incident: Jack absconded once again and tragically took his own life.

Coroner’s prevention of future deaths report

The Coroner issued a Prevention of Future Deaths Report, warning of the risk of future deaths without appropriate action. Key concerns included:

Inadequate handovers
Poor record keeping

The Report was directed to Solent NHS Trust, Portsmouth Hospitals NHS Trust, and NHS England.

Conclusion

Chantae Clark of Tees Law emphasised the importance of the legal process in driving change:

“Whilst the Inquest process and pursuing legal action cannot undo the pain caused by Jack’s tragic death, I hope that the conclusion of this case, coupled with the Coroner’s Prevention of Future Deaths Report, serves as a catalyst for change.”

Jack’s family, supported by Tees Law, remain committed to ensuring that lessons are learned to prevent similar tragedies in the future.

What is professional negligence?

Posted on 12 March 202426 May 2025 by Sarah O'Sullivan

If you have instructed a professional and consider that the professional has been negligent, you may want to recover the losses you have suffered.

Claims can be brought against various professionals, including surveyors, architects, financial advisors, accountants, and solicitors. The term “professional” is undefined, but if you consider the person you instructed to act as a professional and you suffered loss as a result of their negligence, you can consider a professional negligence claim against them.

Usually, professionals are required to have professional indemnity insurance. If you begin a professional negligence claim, one of the first points to establish is whether the professional is insured. This is to ensure that if you succeed with your claim, you will be able to recover your financial losses. If the professional is not insured, then you need to be certain that they, or their business, have sufficient financial means to make a claim worthwhile. We can help you to consider the financial viability of bringing a claim from the outset so that you do not end up further out of pocket.

What needs to be confirmed to establish a professional negligence claim?

The key elements of the claim are:

Duty: in simple terms, to bring a claim, the professional must have owed you a duty. This can be contractual (maybe set out in a written agreement stating what the professional is meant to do) or based on the common law duty to use the skill and care of a reasonably competent professional in the relevant field (this does not need to be set out in writing).
Breach: the professional must have breached the duty. Perhaps he or she did not carry out your instructions, or maybe you were given advice that no other reasonably competent professional would have given. You may need evidence from an expert to prove the breach occurred.
Causation: you must be able to show that you relied on the professional’s negligent advice, and if it wasn’t for that advice, you would not have suffered damage. This may need to be evidenced by a witness statement.
Loss: assessing loss is more complicated than you may expect. There may be a difference between the full loss you have suffered, and the loss that is recoverable from the professional. This is because the law says that you can only recover losses that fall within the scope of the professional’s duty. Also, different losses are recoverable depending on different bases of claim.

The professional may argue that the recoverable loss should be reduced, because you have not mitigated your loss (essentially you have a duty to minimise your loss if you can, although you are not required to take onerous steps) or because you were also negligent, and your negligence contributed to the loss. The professional may also argue that another party was equally responsible for the loss.

If your claim is successful, you can seek to recover a reasonable proportion of the legal costs you have incurred.

I want to progress a claim against a professional: what next?

In the first instance, it is strongly recommended to instruct a solicitor with expertise in this area. If the professional’s indemnity insurance policy is responding to your claim, it is very likely that the insurer will instruct an experienced solicitor from its panel to defend the claim and try to prevent you from making the full recovery you deserve (or any recovery at all).

If you do not instruct a solicitor, be aware that the Courts have been clear: individuals acting for themselves in litigation will be held to the same high standards as qualified solicitors.

Funding the costs of instructing a professional negligence solicitor to act for you can be daunting, but Tees Law is on hand to explain your options openly and honestly.

Time limits: the clock is ticking

If you decide to proceed with a claim, the first thing to establish is whether you are in time. All professional negligence claims have time limits. Once the applicable time limit (referred to as a limitation period) expires, you cannot proceed any further. See our article for further information on Time limits.

If you think you may have a claim against a professional who has acted for you and would like advice from a specialist professional negligence solicitor, please contact Alice Evelegh-Taylor at Tees on alice.evelegh-taylor@teeslaw.com to discuss your claim.

Tees celebrates collaborative initiative Breaking Down Barriers to Law

Posted on 1 March 202429 March 2025 by Sarah O'Sullivan

In a groundbreaking move towards fostering social mobility in the legal sector, Tees proudly announces its active participation in the first phase of the Breaking Down Barriers to Law initiative, unveiled at the parliamentary launch in February 2024.

The Breaking Down Barriers to Law: Phase 1 report, is a product of collaborative efforts by the Purpose Coalition and a consortium of leading law firms and signifies the initial stage of a comprehensive action plan to enhance social mobility within the industry. This strategic approach focuses on four critical areas: outreach, access, recruitment, and progression, addressing challenges faced by individuals from disadvantaged and underrepresented backgrounds. Tees, alongside other leading firms, delved into these focus areas during roundtable workshops, exploring challenges and sharing effective measures implemented to overcome them.

Highlighting best practices from around the country, participating law firms, including Tees, have showcased initiatives such as outreach activities to primary and secondary schools and name-blind recruitment practices. These efforts collectively contribute to dismantling barriers and providing a more equitable playing field for all aspiring legal professionals.

The collaborative discussions have resulted in a set of recommendations for both short and long-term actions. Short-term goals include establishing outreach links with educational institutions in social mobility cold spots and implementing data collection mechanisms to ensure fair progression at all levels. Long-term recommendations encompass the development of a collective social media campaign demystifying the legal sector and providing additional support resources for apprentices, trainees, and paralegals.

Hannah Burling, Director of People, expressed enthusiasm, stating, “Being part of Breaking Down Barriers to Law is an incredible opportunity for us to make a tangible impact on social mobility in the legal sector. We are committed to creating pathways for individuals from diverse backgrounds to thrive and succeed in the legal profession.”

Ashton Hunt, Group Managing Director at Tees, added, “This collaborative effort exemplifies our commitment to positive change. We believe that a more inclusive legal sector benefits everyone, and we are eager to contribute to the ongoing success of this initiative.”

The Right Honourable Justine Greening expressed pride in the Breaking Down Barriers to Law Taskforce, emphasising the impactful collaboration among participating firms. Acknowledging the challenges faced by the legal sector in addressing social mobility, she commended the dedication to positive change and highlighted the significance of continued collaboration and partnership.

Chair of the Breaking Down Barriers Commission, Nick Forbes CBE, noted the positive impact of partnership efforts in the Breaking Down Barriers to Law project. Forbes recently highlighted the laser-like focus on essential elements crucial for creating inclusive career pathways, encouraging other legal sector entities to consider similar steps for fostering equality of opportunity.

Tees solicitors celebrate Agricultural Law Association fellowships

Posted on 22 February 202429 March 2025 by Sarah O'Sullivan

Two of Tees’ Agricultural team Alexander Waples and Chris Claxton-Shirley have recently achieved Fellowship of the Agricultural Law Association (ALA).

The Agricultural Law Association is the UK’s largest inter-professional organisation devoted to the law and business of the countryside.

The course included topics such as property, tax, regulatory issues, and important legal issues that affect farmers and rural business across England and Wales. Gaining Fellowship status is the highest qualification possible.

Alexander Waples in the commercial and agricultural property team, having worked with Tees since 2015. He acts for a wide range of landowning clients, including individuals, partnerships, corporate entities as well as landed estates. Alexander is also a key part of the Tees’ renewable energy team.

Chris Claxton-Shirley, in the Private Client team, advises on a range of issues from succession and tax planning to the administration of estates.

Partner Letty Glaister, who heads up the Agriculture Team, said; “This is great recognition of Tees’ dedication to the agriculture legal sector and ensuring our experts have the in-depth knowledge needed to advise our rural clients.

“The agricultural community is an integral part of our firm and having solicitors with the Fellowship title shows we are constantly investing in learning so that we can provide the high-quality service our clients expect.”

Membership of the ALA is open to anyone training or qualified in the advisory professions and to others with an interest in the subject. The ALA exists to promote the understanding and development of the law and practice in agriculture, environment, food, and related issues and to provide a forum for professionals serving those sectors – lawyers, surveyors, accountants, bankers, farm business consultants and others – to support each other in their specialisms.

Comprehending environmental offences within the United Kingdom

Posted on 22 February 202420 March 2025 by Sarah O'Sullivan

Environmental offences in the United Kingdom refer to infringements of statutes and regulations devised to safeguard the environment and endorse sustainable actions. Grasping the concept and categories of environmental offences, their repercussions on society, and the legal structure encompassing them, is imperative for fostering consciousness and advocating responsible conduct.

Types of environmental offences

Environmental offences encapsulate a range of activities detrimental to the environment, such as pollution, unlawful waste disposal, deforestation, and wildlife trafficking. These offences can trigger extensive repercussions, including damage to ecosystems, loss of biodiversity, and adverse health impacts on both humans and wildlife.

Regulation of environmental offences

In the United Kingdom, environmental offences are regulated by a sturdy legal framework that strives to avert, detect, and prosecute individuals and corporations involved in harmful practices. Noteworthy legislation includes the Environmental Protection Act 1990, the Wildlife and Countryside Act 1981, and the Control of Pollution (Amendment) Act 1989.

This legal framework equips authorities with the necessary means to probe into and act against those accountable for environmental offences. Penalties for such offences can range from fines and seizure of assets to imprisonment, depending on the severity of the violation.

By spreading awareness about environmental offences, their impact, and the legal consequences, we can motivate individuals and businesses to adopt more sustainable practices and contribute to the protection and preservation of our environment.

Implementation and Penalties for Environmental Offences

The execution of environmental offences is primarily accomplished by the Environment Agency, which holds a pivotal role in overseeing and regulating activities that could harm the environment. As the key environmental regulator, the Environment Agency possesses the authority to investigate, enforce, and prosecute those who commit environmental offences.

When enforcing environmental laws, the Environment Agency has the power to impose various sanctions and penalties. These measures are designed to hold offenders accountable for their actions and deter future violations. Common sanctions for environmental offences can include fines, civil sanctions, enforcement undertakings, and even imprisonment in severe cases.

The process of enforcement and deciding on environmental offences involves several stages. Initially, the Environment Agency gathers evidence through inspections, monitoring, and investigations. Once sufficient evidence is obtained, a decision is made on whether to pursue enforcement action. This decision is based on factors such as the severity of the offence, the potential harm caused, and the compliance history of the offender.

If enforcement action is taken, the Environment Agency may issue warnings, cautions, or formal notices to the offender. In more serious cases, prosecution may be pursued, leading to court proceedings and potential sanctions. Throughout the enforcement process, the Environment Agency aims to achieve compliance, restore any damage caused to the environment, and prevent further harm.

Increased awareness of environmental protection in recent years has increased the focus on enforcement action for breaches of environmental law.

A criminal prosecution is usually the most serious sanction that a regulator can use for an environmental offence. It can give the courts considerable scope to punish offenders and to deter others, including by use of imprisonment and unlimited fines.

Directors should know environmental liability can be both civil and criminal sanctions. In terms of criminal breaches, liability can be attached both to a corporate entity and individual directors or other officers of the organisation; if the corporate offence were committed with the consent or connivance, or attributable to the neglect of the director or officer.

Who prosecutes?

The principal environmental regulators are the Environment Agency (EA), Local Authorities and the Health and Safety Executive.

Other bodies that can become involved in the prosecution of wildlife and habitat offences are Natural England, The Marine Management Organisation and the Crown Prosecution Service.

The regulator is usually both the investigator and the prosecutor. A prosecution can have several negative effects on a business, including criminal penalties, including the imprisonment of company directors, unlimited fines, remediation costs and reputational damage through poor publicity. There can also be commercial damage and restrictions imposed on licenses or permits.

Alternatives to prosecution

As an alternative to prosecution, the EA may be able to impose a civil sanction. To impose civil sanction under the Regulatory Enforcement and Sanctions Act 2008, the criminal standard of proof applies, so the EA must be satisfied beyond reasonable doubt that an offence has been committed.

The types of civil sanctions that may be applied are fixed or variable monetary penalties or various types of notices. The notices can include compliance, restoration or stop notices.

The EA publishes a full list of every breach and offence regulated by the EA and the enforcement action available in respect of each offence.

The EA may administer a formal caution as a deterrent in the circumstances that it could bring a prosecution if the offender admits the offence and consents to be cautioned. The EA must keep a record of the formal caution and it will be produced in court if the offender is later found guilty of a further offence. Where an offender refuses to accept the formal caution, the EA will generally prosecute for the original offence.

Examples of environmental offences in the UK

There have been several consequential cases of environmental offences in the United Kingdom that have had a profound impact on the environment and society at large. These cases serve as significant examples of the consequences of violating environmental regulations and the measures taken to prevent such offences.

A remarkable case is the Thames Water pollution incident in 2016. The company was found guilty of discharging approximately 1.4 billion litres of untreated sewage into the River Thames, causing severe harm to aquatic life and the overall ecosystem. Consequently, Thames Water was subject to a record-breaking fine of £20 million, sending a strong message that environmental offences will not be tolerated.

Another significant case is the Volkswagen emissions scandal in 2015, where the car manufacturer was found to have manipulated vehicle emissions tests. This deception resulted in increased air pollution and health risks for the public. The outcome of the case included substantial fines and compensation claims, as well as a damaged reputation for Volkswagen.

These cases underline the importance of holding individuals and organizations accountable for their actions regarding environmental protection. The impact of these offences extends beyond immediate environmental damage, affecting public health, wildlife, and the overall sustainability of our planet.

Lessons have been learned from these incidents, leading to stricter regulations and increased vigilance in environmental monitoring. The enforcement of these regulations plays a vital role in preventing future offences and safeguarding the environment. Businesses and individuals need to understand their legal obligations and take proactive measures to ensure compliance.

Understanding prostate cancer and medical negligence

Posted on 14 February 202416 May 2025 by Sarah O'Sullivan

Prostate cancer is a common form of cancer that affects men, particularly those aged 50 and above. However, it’s not the disease alone that poses a threat to the patient’s health. Inaccurate diagnosis, delayed treatment, and medical negligence can exacerbate the condition, leading to life-threatening complications.

What is prostate cancer?

The prostate is a small walnut-sized gland part of the male reproductive system. It is located between the bladder and the penis, encircling the urethra. Its primary function is to produce a thick white fluid that forms semen when mixed with the sperm produced by the testes.

The prostate gland is susceptible to cancerous growth, leading to prostate cancer. Prostate cancer develops when the cells in the prostate gland mutate and start to multiply out of control. These cells can then spread from the prostate to other parts of the body, particularly the bones and lymph nodes, in a process known as metastasis.

Prostate cancer in the UK

According to Cancer Research UK prostate cancer is the most common cancer in men, with around 48,500 new cases diagnosed every year. The disease is more prevalent in older men, with most cases being diagnosed in men aged 50 or older. It is also more common in black men and less common in Asian men for reasons currently unknown. Lifestyle factors such as diet and exercise also contribute to an individual’s risk of developing prostate cancer.

Symptoms of prostate cancer

Prostate cancer typically develops slowly, often without noticeable symptoms in the early stages.

Once the prostate is large enough to affect the urethra, symptoms may include:

Increased need to urinate
Straining while urinating
Feeling that the bladder is not completely empty
Blood in the urine or semen
Erectile dysfunction
Pelvic discomfort

These symptoms alone do not confirm prostate cancer but should not be ignored.

Diagnosis and treatment

There is no single test for prostate cancer. The diagnosis is typically based on a combination of the following tests:

Blood tests, including a prostate-specific antigen (PSA) test
Digital rectal examination (DRE)
Magnetic Resonance Imaging (MRI) scan
Biopsy

Depending on the stage and grade of the cancer, as well as the patient’s overall health and patient preferences, treatment options may include:

Watchful waiting or active surveillance
Surgery to remove the prostate (radical prostatectomy)
Radiotherapy (external beam or brachytherapy)
Hormone therapy
Chemotherapy

The choice of treatment is a collaborative decision between patients and their healthcare professionals, considering the risks and benefits of each option.

Early detection of prostate cancer significantly improves treatment outcomes and overall prognosis.

Medical negligence and prostate cancer

Medical negligence is a term used to describe a situation where a healthcare provider fails to provide the standard of care that a competent professional would have provided, resulting in harm to the patient. In the context of prostate cancer, medical negligence can occur in various ways:

Delayed diagnosis: Factors contributing to misdiagnosis of delayed diagnosis may include not listening to a patient’s concerns; failing to correctly interpret symptoms; inadequate screening; misinterpretation of test results; and failing to refer the patient to a specialist.
Misdiagnosis: Misdiagnosing prostate cancer as a urinary tract infection, an enlarged prostate, or prostatitis.
Inappropriate treatment: In some cases, patients may receive inappropriate or unnecessary treatment for prostate cancer due to errors in diagnosis or management decisions.
Surgical complications: Surgical intervention, such as radical prostatectomy, carries inherent risks of complications including urinary incontinence, erectile dysfunction and bowel dysfunction. However, instances of surgical negligence, such as improper surgical technique can compromise patient outcomes.

The impact of medical negligence

When prostate cancer is detected early, the chances of successful treatment are high. However, if there are significant delays in diagnosis or treatment due to medical negligence, the cancer can spread, becoming life-threatening. In such cases, the patient may be entitled to make a medical negligence claim.

Making a medical negligence claim

If you or a loved one has been impacted by medical negligence, consider seeking legal advice. A medical negligence claim can help you receive compensation for the physical, emotional, and financial harm you have suffered due to the negligence.

These claims are complex, so it’s vital to select a legal expert in this field.

At Tees our specialist medical negligence solicitors can guide you through the process, offering clear, straightforward advice at each step.

This article is intended for informational purposes only and does not constitute legal advice. Always consult a qualified legal professional for advice on your specific situation.

The importance of court approval in fatal accident claims involving children

Posted on 7 February 202418 May 2025 by Sarah O'Sullivan

Understanding the importance of court approval in fatal accident claims involving children: Lessons from Bayless v Norfolk and Norwich University Hospital NHS Foundation Trust

The recent High Court case of Bayless v Norfolk and Norwich University Hospital NHS Foundation Trust ([2023] EWHC 2986 (KB) (23 November 2023)) underscores the critical role of court approval in fatal accident claims involving children. This case offers valuable insights for claimants, defendants, and legal professionals, highlighting the consequences of failing to obtain court approval for settlements.

Key facts of the case

The case concerned the tragic death of Mr. Stephen Bayless, who passed away due to a misdiagnosis by the Norfolk and Norwich University Hospital. His widow, acting as the claimant, pursued a claim for dependency under the Fatal Accidents Act 1976 and the Law Reform (Miscellaneous Provisions) Act 1934 on behalf of herself and their two children. A settlement was reached in 2019, and compensation and costs were paid.

Following the liquidation of the law firm representing the claimant, she instructed Tees to bring a secondary victim claim for psychiatric injury on behalf of herself and the children. The defendant Trust applied to strike out the new claim, arguing that it was settled in 2019 or constituted an abuse of process.

Why Court Approval Matters in Child Claims

Under Rule 21.10 of the Civil Procedure Rules 1998, any settlement involving minors must receive court approval to be legally binding. In Bayless, the 2019 settlement had not been approved by the court, rendering it ineffective. This oversight left both the claimant and the defendant at risk.

Application of the Henderson v Henderson rule

The defendant Trust relied on the principle from Henderson v Henderson (1843), which prevents parties from bringing multiple claims that could have been addressed in a single proceeding. However, the court rejected this argument. Because the settlement lacked court approval, it could not prevent the claimant from pursuing her personal injury claim.

The Court’s decision on the strike-out application

Mr. Justice Pepperall dismissed the Trust’s strike-out application, finding that:

The 2019 settlement did not compromise the claimant’s personal injury claim as it was not initially asserted.
The lack of court approval meant the settlement was invalid.
The claimant had acted in good faith without knowledge of her psychiatric injury at the time.

Consequences of failing to obtain court approval

The absence of court approval had several consequences:

The claimant retained the right to pursue further claims.
The Trust faced the risk of the claimant withdrawing from the 2019 settlement.
Even if the parties agreed to proceed with the previous settlement, court approval would still be necessary.

Responsibility for procedural compliance

While the Trust criticised the claimant’s former legal representatives, the court highlighted that the Trust’s own solicitors were equally responsible for ensuring court approval was obtained. Both parties share a duty to adhere to procedural rules when settling claims involving children.

Costs order and final ruling

When the Trust withdrew its strike-out application, the court ordered it to pay the claimant’s legal costs. Mr. Justice Pepperall found that the Trust’s failure to properly investigate the issue was a primary factor in the unnecessary litigation expenses.

“The Trust withdrew an application that it ought to have realised, on proper investigation, was always liable to be dismissed. In doing so it has put [the Claimant] at unnecessary cost and it should now pay her costs on a standard basis.”

Lessons for legal professionals

The Bayless case is a stark reminder of the importance of court approval in fatal accident claims involving children. Legal professionals must ensure that:

Court approval is obtained for all settlements involving minors.
Clear documentation and communication are maintained throughout the process.
Procedural compliance is verified to prevent unnecessary legal disputes.

By adhering to these principles, claimants and defendants can protect their interests, avoid costly litigation, and ensure fair outcomes in fatal accident claims.

If you have questions about court approval in fatal accident claims or need legal advice, consulting with our experienced solicitors could provide the guidance you need.

Guide to medical negligence in skin cancer cases

Posted on 7 February 202416 May 2025 by Sarah O'Sullivan

One of the most devastating experiences anyone can go through is the diagnosis of cancer. Although there are many forms of cancer, delayed diagnosis or negligent treatment of skin cancer can have significant consequences.

This article aims to provide an in-depth understanding of medical negligence in the context of skin cancer, emphasising the importance of prompt diagnosis and appropriate treatment.

Definition of skin cancer

Skin cancer is a medical condition categorised by the uncontrolled growth of abnormal skin cells. It generally develops in skin areas exposed to the sun but can also manifest in places that are not ordinarily exposed to sunlight.

Skin cancer is one of the most common types of cancer globally and is the fifth most common cancer in the UK, with about 16,200 new cases each year, so understanding its types is crucial for awareness and early detection.

The three most common forms of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal Cell Carcinoma (BCC)

Description: Basal cell carcinoma is the most common and least aggressive form of skin cancer. It arises from the basal cells, which are in the deepest layer of the epidermis (the outer layer of the skin).
Appearance: BCCs often appear as a change in the skin and are slow growing. They might look like a pearly or waxy bump, a flat, flesh-coloured or brown scar-like lesion, or a bleeding or scabbing sore that heals and returns.
Common Locations: Typically develops in areas frequently exposed to the sun, such as the face, ears, neck, scalp, shoulders, and back. Those with fair skin who burn easily are most at risk of suffering from BCC.
Treatment: Treatment options include surgical removal, topical treatments, radiation therapy, and in some cases, photodynamic therapy, or laser surgery. BCC’s are generally not considered life threatening, but can return if not adequately treated.

Squamous Cell Carcinoma (SCC)

Description: Squamous cell carcinoma is the second most common form of skin cancer. It originates from the squamous cells that make up the middle and outer layers of the skin.
Appearance: SCC can appear as a red firm bump, a scaly patch, or a sore that heals and then reopens. It can become more aggressive than BCC if not treated.
Common Locations: Often found on areas of the body damaged by UV radiation from the sun or tanning beds, including the rim of the ear, face, neck, arms, chest, and back, but can occur on other parts of the body. Immunosuppressed individuals are particularly at risk of developing SCC.
Treatment: Early-stage SCC can often be treated with minor surgery or sometimes with topical medications. More advanced cases may require more extensive surgical procedures, radiation, or chemotherapy. If found and treated early, SCC can be cured.

Melanoma

Description: Melanoma is the most dangerous form of skin cancer. It develops in the melanocytes, which are the cells that produce melanin, the pigment that gives skin its color. According to a study performed by Brighten and Sussex Medical School in 2021, incidence rates of skin cancer (cutaneous malignant melanoma) have increased more than 550% in males and 250% in females since the early 1980s in England.
Appearance: Melanomas can occur anywhere on the body, not only in areas exposed to the sun. They are characterized by the appearance of a new mole or a change in an existing mole, which follow the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolving).
Common Locations: Can develop anywhere on the body, including less exposed areas such as the soles of the feet, palms, and under the nails.
Treatment: Treatment will first involve surgical removal of the affected tissue. Then, depending on the stage and location, further treatment may be offered such as pharmacological immunotherapy, targeted therapy such as chemotherapy or radiation therapy.

Causes and symptoms of skin cancer

Ultraviolet radiation from sunlight or tanning beds is the primary cause of skin cancer. Factors such as age, skin type, number of moles on the body, and family history of skin cancer can also increase the risk. Immunosuppressed individuals are also at higher risk of developing skin cancer. Symptoms may include new skin growths, changes in existing moles, and skin sores that do not heal.

Diagnosis of skin cancer

The importance of a timely and accurate diagnosis cannot be overstated when it comes to managing skin cancer effectively. Typically, a medical professional, well-versed in the field, will conduct a thorough physical examination. This will usually be a GP or a dermatologist. Further tests can include examination under a dermatoscope, or an excision biopsy, which is where a portion of the affected tissue is surgically removed, under local anesthetic, and sent to a lab for testing. The significance of an accurate diagnosis is paramount, as any delay or error in diagnosis can lead to the cancer spreading. If cancer spreads, it becomes more challenging to treat, which can result in more extensive and invasive treatment.

Treatment of skin cancer

The treatment options for skin cancer depend on the type, stage, and location of the cancer, as well as the patient’s overall health. Surgery is the most common treatment method, usually under local anaesthetic. However, other treatments, such as chemotherapy, radiation therapy, or immunotherapy, may also be used.

Types of skin cancer claims

Skin cancer claims can range from misdiagnosis claims where a patient was wrongly diagnosed with a different illness, to negligent treatment claims where the prescribed treatment was incorrect or inadequate for the patient’s condition. Regardless of the type of claim, it is essential to establish that the negligence directly caused or contributed to the patient’s harm.

What constitutes medical negligence?

Medical negligence refers to a breach of duty of care by a healthcare professional, which causes harm to a patient. In the context of skin cancer, negligence can occur in various forms – from delayed or incorrect diagnosis to inappropriate or substandard treatment. Such negligence can adversely affect the patient’s health and prognosis.

Making a claim for medical negligence

Bringing a medical negligence claim can be daunting, especially when dealing with a serious condition like skin cancer. However, with the right legal guidance, the process can be managed effectively. The claim process involves establishing the negligence with the help of independent medicolegal experts, determining the extent of harm, and calculating the compensation.

What to expect in a skin cancer compensation claim

Compensation in skin cancer negligence cases can help cover treatment costs, loss of earnings, and other expenses incurred due to the negligence. It can also assist with therapy or counselling required to cope with the emotional distress caused by negligence.

Choosing the right solicitor for your claim

Choosing a solicitor with expertise in medical negligence cases, particularly skin cancer cases, can significantly influence the outcome of your claim. They can provide the necessary legal advice, help gather evidence, and negotiate with the defendant on your behalf.

No win no fee skin cancer claims

Many solicitors offer a ‘no win no fee’ service, which means you only pay a fee if your claim is successful and is often deducted from your compensation. This arrangement, also known as a Conditional Fee Agreement, makes legal support more accessible to those who might otherwise struggle to afford it.

Support for skin cancer patients

Several organisations provide support and resources for skin cancer patients and their families. These include Cancer Research UK, Macmillan Skin Cancer Support, and the NHS Cancer Support Services. These services offer vital help and advice, from understanding your diagnosis and treatment options to coping with the emotional impact of cancer.

How Tees can help

Medical negligence in skin cancer cases can have significant consequences, potentially transforming a treatable condition into a life-threatening one. If you or a loved one have suffered due to such negligence, it’s important to understand your legal rights and consider seeking compensation. With the right legal guidance, you can navigate through this challenging journey and secure the justice and compensation you deserve.

Our No Win, No Fee arrangement ensures you don’t pay any legal or associated costs unless your case is successful. If you win, most of your legal costs are paid by the Defendant. A small portion of your compensation may be used to cover legal costs not paid by the Defendant. The majority of our clients choose this option for peace of mind and affordability.

If you have recently been diagnosed with skin cancer, and have concerns about the care provided, please talk to us. Our specialist solicitors will listen and help you find the best way to move forward.

Understanding uterine sarcoma and instances of medical negligence

Posted on 6 February 202416 May 2025 by Sarah O'Sullivan

Uterine sarcoma is a rare form of cancer that affects the uterus or its supporting tissues. It is a complicated disease to diagnose, and when not detected early, can have severe consequences.

In certain instances, it has been observed that medical negligence has led to a delayed diagnosis of uterine sarcoma. This article aims to help you understand uterine sarcoma, the importance of early diagnosis, and how medical negligence can occur in this context.

What is uterine sarcoma?

Uterine sarcoma is a malignant condition where cancerous cells form in the muscles of the uterus or other supporting tissues. This disease is different from endometrial cancer, which originates in the inner lining of the uterus. Uterine sarcoma is a rare kind of cancer that forms in the uterine muscles or the tissues that support the uterus. There are several subtypes of uterine sarcoma and they are categorized based on the specific type of cells affected. The main types of uterine sarcoma are:

Leiomyosarcoma: This is the most common type of uterine sarcoma and it originates in the smooth muscle cells of the uterus. Leiomyosarcomas are often aggressive and tend to spread to other parts of the body.
Endometrial Stromal Sarcoma (ESS): ESS develops in the connective tissue (stroma) that supports the endometrium, the lining of the uterus. This type of sarcoma is less common than leiomyosarcoma and generally has a better prognosis.
Undifferentiated sarcoma: This is a rare and aggressive type of uterine sarcoma where the cancer cells do not resemble normal uterine tissue. It is often diagnosed at an advanced stage and can be challenging to treat.
Adenosarcoma: Adenosarcoma is a rare form of uterine sarcoma that consists of both malignant (cancerous) and benign (non-cancerous) components. It typically arises in the lining of the uterus and may have a better prognosis compared to some other uterine sarcomas.

Uterine sarcoma is distinct from the more common uterine cancers, such as endometrial cancer, which arises from the lining of the uterus.

Risk Factors and Signs

The onset of uterine sarcoma can be influenced by several factors. One of the most significant risk factors includes past treatment with radiation therapy to the pelvis. Furthermore, it has been noted that the use of tamoxifen for breast cancer treatment can also increase the risk of developing uterine sarcoma. A rapidly growing uterine fibroid in a peri-menopausal or postmenopausal woman should raise suspicion of sarcoma.

Patients with uterine sarcoma may experience:

Abnormal vaginal bleeding, especially postmenopausal or irregular bleeding between periods.
Pelvic pain or discomfort: persistent pelvic pain or discomfort may occur, although it is a nonspecific symptom and can be caused by various conditions.
A feeling of fullness or pressure in the pelvic area: this can occur due to the presence of a tumour affecting the uterus or surrounding tissues.
Abdominal or pelvic mass: uterine sarcomas can cause the uterus to become larger than usual, leading to a noticeable abdominal or pelvic mass.
Changes in bowel or bladder habits: in some cases, uterine sarcoma can cause changes in bowel or bladder habits, such as constipation or increased frequency of urination if the tumour presses against nearby organs.
Painful intercourse
Backache or leg swelling: in some cases, uterine sarcoma may spread to nearby tissues and organs, causing symptoms such as back pain or leg swelling.

These signs and symptoms, however, can be caused by various other gynecological conditions. Therefore, it is essential to consult a doctor if any such conditions are encountered.

Diagnosis of uterine sarcoma

Diagnosing uterine sarcoma involves several tests and procedures. A health history check and a general physical and pelvic examination are typically the first steps.

Other diagnostic tests include a pelvic and transvaginal ultrasound exam, followed by pelvic MRI. An endometrial or transvaginal biopsy can be attempted. If the results of an endometrial biopsy are not clear, a Dilatation and curettage (D&C), where tissue samples are removed from the inner lining of the uterus is usually done. A hysteroscopy (a procedure used to examine the vagina, uterus, fallopian tubes, and bladder) can also be helpful. However, diagnosis is often reached after a surgical specimen.

Stages of uterine sarcoma

Once a diagnosis is confirmed, the stage of the cancer is determined. The stage of the disease is crucial in determining the treatment plan. The stages of uterine sarcoma are:

Stage I: Cancer is found in the uterus only.
Stage II: Cancer has spread beyond the uterus but has not spread beyond the pelvis.
Stage III: Cancer has spread into tissues in the abdomen.
Stage IV: Cancer has spread beyond the pelvis.

Treatment options for uterine sarcoma

Treatment for uterine sarcoma typically involves surgery, chemotherapy, radiation therapy, and hormone therapy. The treatment plan is usually based on the stage of the cancer, the type and size of the tumour, and the patient’s overall health. Patients should consult with a gynaecological oncologist to determine the most appropriate treatment plan for their specific condition.

Medical negligence in uterine sarcoma cases

In certain instances, medical negligence can lead to delayed diagnosis or misdiagnosis of uterine sarcoma. Medical negligence refers to a situation where a healthcare professional provides substandard care, which can lead to harm or injury to the patient.

In the context of uterine sarcoma, medical negligence can involve:

Failure to carry out appropriate tests.
Misinterpretation of test results – for example, an ultrasound scan or MRI may be reported to show a fibroid, rather than uterine sarcoma.
Failure to refer the patient to a specialist.
Delay in diagnosis or misdiagnosis.

When medical negligence leads to a delayed diagnosis, the cancer may progress to a more advanced stage, making treatment more challenging and leading to a poorer prognosis.

Legal recourse for medical negligence

Uterine sarcoma is a complex disease that requires prompt and accurate diagnosis for effective treatment. Medical negligence leading to delayed diagnosis can significantly impact the patient’s prognosis and quality of life.

If you believe that you or a loved one has suffered due to medical negligence in the diagnosis or treatment of uterine sarcoma, you may be entitled to make a medical negligence claim. This can help you receive compensation for the physical, emotional, and financial damages you have suffered due to the negligence.

Legal processes can be complex and daunting, so it’s crucial to seek expert legal advice. At Tees, our specialist medical negligence solicitors can guide you through the process, helping you gather the necessary evidence and build a strong case.

Tees Better Future Fund Pledges £5,000 to Petals Charity, Offering Hope in the Face of Loss

Posted on 2 February 202429 March 2025 by Sarah O'Sullivan

The Tees Better Future Fund is pleased to announce Petals, the baby loss counselling charity, as a recipient of a £5,000 grant. This grant signifies a beacon of support for families navigating the heart-wrenching journey of pregnancy and baby loss.

Petals believe that every bereaved parent should have seamless and timely access to specialised mental health support in the aftermath of losing a pregnancy or baby during or shortly after birth. The devastation of pregnancy and baby loss can affect anyone and everyone, a form of bereavement that has not always been fully understood or acknowledged despite its profound, lifelong impact on parents.

NHS offerings often fall short in providing routine psychological support after such losses, so Petals steps in to help parents process their shock and trauma. The grant from the Tees Better Future Fund will further empower Petals to provide vital psychological support for 10 bereaved families in and around Chelmsford.

“At a time when demand for our specialist counselling service has never been so high, support such as this from the Tees Better Future Fund is key to enabling us to be there for more bereaved parents when they need us the most. We are delighted that thanks to this support we will be able to provide our vital service to more bereaved parents in the Chelmsford area in 2024.

Our clients tell us time and time again that our support has been life-changing, even lifesaving and having to turn anyone away goes against everything we stand for. We rely on charitable funding to extend this support to bereaved parents, no matter what type of loss they have experienced and all of us at Petals would like to send our thanks to the Tees Better Future Fund for this incredibly generous donation in support of our work.” Commented Karen Burgess, Petals Founder & CEO.

In 2022 alone, Petals delivered over 5,400 counselling sessions, marking a 19% increase from the previous year. The Tees Better Future Fund grant will contribute to ensuring that no bereaved parent is turned away, especially those whose requests for counselling exceed the capacity of current NHS partners.

The unique Petals counselling model is tailored to address the specific needs of parents experiencing mental health challenges following devastating events such as miscarriage, stillbirth, the death of a baby, or the termination of a wanted pregnancy for medical reasons.

Grief following pregnancy and baby loss is a complex and all-encompassing emotional distress that can lead to serious mental health issues if left unattended. Petals recognise the normalcy of reactions such as grief, anxiety, depression, and PTSD and strive to create a safe space for parents to process their pain and move toward reconciliation and hope for the future.

“Ensuring that bereaved parents receive the essential mental health support they need after the loss of a pregnancy, or the death of a baby is a cause close to our hearts. Unfortunately, such vital assistance is not readily available within the NHS. We are thrilled to share the news that, through a grant from Tees Better Future Fund grant, we can partner with Petals, the baby loss counselling charity.

This funding will specifically provide specialist psychological support to 10 families whose maternity care fell under the Broomfield Hospital, Chelmsford. Without this lifeline, these families would otherwise be left to navigate the challenging journey of grief in solitude. Our contribution aims to ensure that no parent facing such heartbreak walks alone on this difficult path.” Commented Janine Collier, Co-chair of the Tees Better Future Fund.

Petals collaborates with the Maternal Mental Health Service (MMHS), bereavement midwives, and mental health teams to ensure their unique counselling model reaches those who need it most. The charity’s dedication to breaking down the barriers surrounding baby loss is evident in its collaboration with other well-known charities such as Teddy’s Wish and Cosmic Charity.

Grief is a deeply personal experience, and Petals understands that not all clients may progress through their model in a standard number of sessions. However, thanks to the Tees Better Future Fund grant, Petals can extend its support to grieving parents who might otherwise not receive any assistance, particularly those based in and around Chelmsford and receiving healthcare at Broomfield.

The Tees Better Future Fund is proud to stand alongside Petals as they continue their invaluable work, offering solace and support to bereaved parents in the Chelmsford community and beyond.

Patient safety during maternity care called into question

Posted on 30 January 202418 May 2025 by Sarah O'Sullivan

Tees’ Clinical Negligence team advocates for campaigning for patient safety concerning antenatal, maternity, and neonatal care.

BBC Panorama exposes maternity care failures

A BBC Panorama documentary aired on Monday, 29 January 2024, highlighting maternity care issues at Gloucestershire Hospitals NHS Foundation Trust, including the Cheltenham Birth Centre.

A tragic loss: Margot Frances Bowtell

Tees’ client, Laura Harvey from Gloucester, lost her baby, Margot Frances Bowtell, at just three days old. Laura recalls her experiences with Gloucestershire Hospitals NHS Foundation Trust in 2020 after the hospital admitted liability for failures in her care that led to Margot’s death.

Margot was born on 14 May 2020 at the midwife-run Cheltenham Birth Centre and passed away on 17 May 2020 due to a hypoxic brain injury sustained during delivery.

Investigation and accountability

The care Laura and Margot received was provided by two midwives, who are no longer working at the Trust. Both midwives are now under investigation by the Nursing and Midwifery Council (NMC) regarding the circumstances surrounding Margot’s death.

A report by the Healthcare Safety Investigation Branch (HSIB) identified multiple care issues, including a failure to update Laura’s risk assessment after she experienced reduced fetal movements and a bleed at 34 weeks pregnant. As a result, Laura was admitted to a midwife-led, low-risk ward instead of the consultant-led unit she needed.

Missed opportunities for intervention

During labor, Laura experienced further episodes of bleeding. However, these were not escalated to the on-call obstetricians, nor was the information properly handed over between midwives during the shift change on 14 May 2020. HSIB concluded that a referral to the obstetric-led unit for continuous monitoring of Laura and Margot was necessary.

Gloucestershire Hospitals NHS Foundation Trust admitted liability for failures in Laura’s care that caused Margot’s death.

Legal advocacy and expert commentary

Sarah Stocker, Associate at Tees, stated:

“The midwives involved did not follow both national guidance and the hospital’s own clinical guidance on several occasions during Laura’s labor. If the midwives had acted in the hours before Laura gave birth, she would have been transferred to the appropriate ward for obstetric-led care. With continued monitoring, Margot would have been delivered at the first sign of fetal distress and would still be with us today.”

Laura Harvey’s perspective

Reflecting on the midwives and ongoing investigations, Laura Harvey said:

“As a family, we want and more importantly deserve to know why both midwives made the decisions they did and why they chose to directly ignore and not follow the Trust’s own standard practice procedure. It was not just one point where they failed to escalate my care; it was a series of failures.”

A positive experience after loss

In December 2023, Laura safely delivered a baby daughter at Gloucester Hospital, under the care of the Rainbow Team. This time, she experienced exceptional care.

Calling for safer maternity practices

Laura Harvey continues to advocate for better maternity care, emphasising the importance of following safety procedures:

“There are midwives who are working hard and following the safety procedures in place to bring babies into our world, going above and beyond to help everyone.

It should not be a postcode lottery where you give birth and the care that you receive. Midwives and doctors need to follow the national set of safety procedures.

We need to highlight the Trusts that are excelling and share knowledge with those currently struggling. Most importantly, we need to share and learn from what happened to Margot to prevent it from ever happening again.”

Demystifying spousal maintenance

Posted on 25 January 202418 May 2025 by Sarah O'Sullivan

Spousal maintenance, also known as spousal support or alimony, is a financial payment made by one spouse or civil partner to the other on a regular basis to help meet their financial needs. While the legal term is “periodical payments,” many people refer to it as spousal maintenance for ease of understanding. In this article, we’ll use the term spousal maintenance, and note that “spouse” includes civil partners as well as husbands and wives.

What is the purpose of spousal maintenance?

The primary goal of spousal maintenance is to assist the financially weaker party as they transition to financial independence. In some cases, if financial independence is not achievable, payments may continue until one party passes away, although indefinite maintenance orders are now less common.

Courts carefully consider several factors to determine both the amount (known as the “quantum”) and the duration (known as the “term”) of spousal maintenance. Let’s explore who qualifies, how payments are calculated, and other essential details.

Who can apply for spousal maintenance?

Anyone going through a divorce or dissolving a civil partnership can request spousal maintenance. However, it is not a guaranteed part of a financial settlement. The court’s primary objective is to achieve financial independence for both parties where fair and possible.

It’s important to note that the higher-earning spouse will not automatically be required to pay spousal maintenance. Factors such as the length of the marriage, each party’s financial resources, and their earning capacities are all taken into account. Crucially, spousal maintenance is needs-based, not income-equalising.

How is spousal maintenance calculated?

There is no strict formula for calculating spousal maintenance. Instead, the court relies on detailed budgets prepared by both parties. These budgets should outline all essential monthly expenses, including mortgage or rent, utilities, groceries, fuel, and clothing, as well as discretionary expenses like holidays and entertainment.

Payee’s Budget: Demonstrates the financial shortfall the receiving spouse needs to cover their reasonable expenses.
Payer’s Budget: Establishes whether they have sufficient surplus income to meet the requested maintenance payments.

Both parties may need to adjust their expectations, as maintaining two separate households is often more expensive than maintaining one. Spousal maintenance is generally viewed as a temporary support mechanism, encouraging the payee to become financially self-sufficient.

How long does spousal maintenance last?

While courts in England and Wales are known for their generosity with spousal maintenance orders, permanent or “joint-lives” orders are increasingly rare. The court often imposes a fixed-term order, giving the recipient time to achieve financial independence.

If the parties can reach an agreement through solicitor negotiations, this can be formalized in a court order. If not, the court will make a determination. Documentation is crucial to ensure any agreed payments are enforceable.

What happens if my ex refuses to work?

Both parties are generally expected to maximize their earning capacity. If a spouse refuses to seek employment without a valid reason, the court may impute an income to them, assuming they could reasonably earn a specified amount.

What events can impact spousal maintenance?

1. Death

Spousal maintenance usually ends upon the death of the paying party unless the order specifies otherwise.

2. Remarriage

If the payee remarries, spousal maintenance automatically ceases.
If the payer remarries, maintenance payments remain unaffected.

3. Cohabitation

Cohabitation by the payee may be grounds for reducing or terminating spousal maintenance, but it is not automatic unless specified in the court order.

4. Change in Circumstances

If either party’s financial situation changes, an application can be made to the court to vary the maintenance order. For example, the payer may request a reduction if they lose their job, while the payee may apply for an increase if their financial situation deteriorates.

How does child maintenance impact spousal maintenance?

Child maintenance is handled separately from spousal maintenance. Child-related expenses (such as school uniforms and extracurricular activities) are accounted for in a different budget.

For most families, child maintenance is calculated using the Child Maintenance Service (CMS) formula. In some cases, such as when the paying parent has a high income or lives abroad, the court may have the authority to determine child maintenance. Even if child maintenance is included in a court order, either party can apply to the CMS for a recalculation after 12 months.

Final thoughts

Spousal maintenance can be a complex and sensitive issue, with outcomes varying significantly depending on individual circumstances. Seeking legal advice is essential to ensure you understand your rights and responsibilities. Whether you are negotiating an agreement or pursuing a court application, professional support can help you achieve a fair resolution.

For more guidance on spousal maintenance or other family law matters, contact a qualified solicitor to explore your options.