Report18th September 2023

Independent review: Disagreements in the care of critically ill children

The Secretary of State for Health and Social Care commissioned us to undertake an independent review of disagreements that arise in the care of critically ill children in England.

Child and infant healthInfrastructure and culture

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The care and treatment of children who are critically ill often involves complexity and uncertainty, and disagreements can arise between parents and healthcare staff about the best course of action. Sometimes these disagreements become entrenched, and are taken to the courts for a decision. Legal action can be a long process, and one that protracts disagreements further. High-profile court cases in the UK have highlighted the distress and heartbreak that these kinds of disagreements cause for everyone involved.

In December 2022, the Secretary of State for Health and Social Care commissioned us to undertake an independent review of disagreements that arise in the care of critically ill children in England, following a Government commitment in the Health and Care Act 2022.

The focus of this review is on the relationship between parents/carers and healthcare teams in the care of a critically ill child and why, in some cases, the relationship breaks down. The review also looks at how disagreements, once they have come to light, can be resolved as collaboratively and sensitively as possible with all involved able to have their voices heard.

In September 2023, this review was laid before Parliament. We are encouraging the Government to act on our recommendations which, if addressed together, will help improve the experience families and healthcare professionals have of navigating disagreements.

Thank you to all those who contributed to this review and helped to inform our work.