Issues raised by the Sunday Times investigation add to the scrutiny facing the trust, which runs Queen’s Medical Centre and Nottingham City Hospital.

The key findings

• 7.62%: the trust’s adjusted 30-day mortality rate for hip fracture patients in early 2026, compared with 4.9% nationally.
• More than 36 hours wait for surgery for more than half of patients at the peak of delays.
• 20% higher risk of dying within a year: the increased risk linked to delays caused by limited surgical capacity, according to research.

The investigation also follows the reported death of a 77-year-old patient who fractured her hip after falling from a trolley in A&E and died two weeks later

What this means for patients

A study published in The Bone & Joint Journal in August looked at 5,414 patients treated for hip fractures in Nottingham between 2016 and 2023. Of these, 1,490 waited more than 36 hours for surgery because of limited surgical capacity. Researchers found that these patients had a 20% higher risk of dying within a year.

Hip fractures can be particularly serious for older people. They can affect mobility and independence, while complications following the injury can increase the risk of death. Prompt surgery is an important part of treatment.

National guidance recommends hip fracture surgery on the day of admission or the following day, where possible. Some patients need medical treatment before an operation, but concerns have been raised about delays caused by limited surgical capacity.

Further issues for Nottingham patients

The trust has commissioned the British Orthopaedic Association to carry out an independent review. This latest investigation adds to wider scrutiny of services at the trust:

• Maternity care: an independent review published in June 2026 identified serious failings affecting more than 500 mothers and babies.
• Children’s spinal surgery: the Trust launched a review into the level of medical monitoring children waiting for surgery.
• A&E services: in October, the trust declared a critical incident after record attendances led to long waits, including patients waiting in corridors.

These are separate issues, but together they raise questions about the standard of care across the trust’s services. Patients and families need confidence that they will receive safe, appropriate care when they need it.

Concerns about your hospital treatment?

If you or a loved one has concerns about care received in hospital, Middleton Law’s medical negligence experts can help you understand your options. Call or email us today to discuss your concerns.

Making breast screening more accessible

Mammograms are an important tool in detecting breast cancer, both for people invited for routine screening and those referred by a healthcare professional. However, not everyone invited for routine screening attends. For some people, pain or difficulties with positioning can make a mammogram uncomfortable or difficult.

Breast Cancer Now, the charity behind Wear It Pink Day, funds research into ways to address these barriers. This includes research into the pain experienced by different patients and the potential use of an AI-powered robotic arm to help people position themselves for screening.

Could AI help detect breast cancer earlier?

The UK-wide EDITH project (Early Detection using Information Technology in Health) is investigating how artificial intelligence (AI) could be used in breast cancer screening.

Mammograms are usually reviewed by two radiologists. The EDITH project is exploring whether just one radiologist can perform this screening assisted by AI.

The outcome of these research projects remains to be seen, but they highlight the importance of making screening available and accessible to as many people as possible.

Knowing what to look out for

Screening is not the only way breast cancer is detected. It’s important to know what is normal for your breasts and to look out for changes, such as a new lump or swelling, changes to the skin or nipple, or a change in the size or shape of a breast. Most breast changes are not cancer, but you should contact your GP if you notice anything unusual – NHS Guide to Checking Your Breasts

When can a delay in breast cancer diagnosis amount to negligence?

There are several stages in a patient’s breast cancer journey, from investigating symptoms and arranging referrals to making a diagnosis and starting treatment. Delays can occur at any of these stages.

A delay in diagnosis, referral or treatment does not necessarily mean negligence has occurred. Depending on the stage and behaviour of the cancer, a delay may have no effect on the outcome. In other circumstances, however, it can cause significant harm.

Healthcare professionals should recognise symptoms that require prompt investigation or referral and act within the relevant timescales. If an avoidable delay has caused harm, there may be grounds for a medical negligence claim.

If you have concerns about treatment you received related to Breast Cancer services contact our expert team to discuss your circumstances – Call or Email us today.

The Infected Blood Compensation Scheme, administered by the Infected Blood Compensation Authority (IBCA), provides compensation to people who meet the scheme’s eligibility requirements. IBCA applies the ‘balance of probabilities’ test when assessing an infected blood claim. In simple terms, this means deciding whether something is more likely than not to have happened.

Some applications to the scheme are rejected for reasons that are not always easy to understand. This can be devastating to infected people and to family members or unpaid carers affected by the infection.

However, a rejected application is not necessarily the end of the matter, and it may be possible to challenge an IBCA decision.

The infected blood scandal affected thousands of people who were infected with Hepatitis C, Hepatitis B or HIV through NHS-supplied blood, blood products or tissue.

 For historic claims, establishing how an infection was acquired can be difficult. Some events happened decades ago and medical records may be incomplete or no longer available.

A recent case handled by Middleton Law demonstrates why careful examination of the available evidence can be key when an infected blood claim is questioned.

Why was the infected blood claim questioned?

We acted for a vulnerable client with a longstanding history of serious liver-related illness associated with Hepatitis C.

The medical records showed that the client had received a blood transfusion in the UK. However, the claim was initially questioned on the basis that the infection may have been acquired in another country.

The source of the infection was therefore central to the claim.

We…

• reviewed the medical records in detail, identifying the evidence relating to the transfusion and tracing the client’s medical history through to the later diagnosis and treatment.
• also considered the client’s history against the suggestion that the infection had been acquired elsewhere.
• argued that, on the ‘balance of probabilities’, the documented blood transfusion was the more likely source of the hepatitis C infection.
• Following our representations, the position was reversed and the claim was accepted. Interim payments were subsequently made.

What does ‘balance of probabilities’ mean?

The balance of probabilities means considering whether something was more likely than not to have happened and IBCA uses this when assessing a claim due to the historic nature of the issues and limited availability of records.

The question is therefore what conclusion the available evidence supports. In this case, we argued that the evidence pointed to the blood transfusion as the more likely source of infection.

Can you challenge an IBCA decision?

If you are dissatisfied with an IBCA decision, you can request an internal review. The review must be completed before an appeal can be made to the First-tier Tribunal. If the review decision gives you a right of appeal, you can then appeal the decision.

Independent legal advice can also help where there are questions about the evidence, medical history or how the decision was reached.

This case demonstrates the importance of looking closely at the underlying evidence in a historic infected blood claim. Here, the medical records provided a documented link to a blood transfusion, while the wider chronology raised questions about the alternative explanation for the infection. By examining those records in detail and putting the evidence into context, we were able to make a case for a different conclusion.

If you have received an IBCA decision that you believe does not reflect the evidence, or you are concerned about how your infected blood claim has been assessed, our specialist team can advise you Call or Email our experts today.

CICA is the government body responsible for administering compensation to eligible victims of violent crime in England, Scotland and Wales and it initially rejected the child’s claim entirely.

The Tribunal ruling provides persuasive authority for how CICA should assess certain claims when someone dies before receiving their compensation. The decision could make a real difference to other families in similar circumstances.

Challenging CICA’s Decision

The case concerned a parent who had applied to CICA for compensation following a period of abuse. CICA had assessed the claim offer amount, but the parent died from an unrelated cause before the award was accepted and paid.

When the child sought the compensation, CICA refused the claim in its entirety. It argued that the child needed to meet additional financial dependency requirements under a different part of the Criminal Injuries Compensation Scheme and refused the award as the parent had been on social security benefits at the date of death.

Lisa challenged that interpretation at Tribunal, arguing that the rules governing this type of claim did not impose that additional requirement.

Tribunal Ruling Now Provides Persuasive Authority

The Tribunal agreed with Lisa’s argument, allowed the appeal and set aside CICA’s decision.

Its ruling clarifies the distinction between different types of payments under the Scheme and confirms that the financial dependency requirement relied upon by CICA should not be applied to claims of this kind.

The decision provides important persuasive authority for claims under the Criminal Injuries Compensation Scheme, clarifying how the rules should be interpreted when someone dies from an unrelated cause before receiving their assessed compensation.

The case has now been referred back to CICA to calculate the payment due to the child.

Helping Families Challenge CICA Decisions

Losing a parent is difficult enough without having to navigate complex compensation rules or challenge a decision that may be wrong.

This case highlights the importance of looking carefully at the rules behind a CICA decision, particularly where a claim involves a bereaved family member. Challenging an incorrect interpretation can make a significant difference to the individual involved and potentially to others in similar circumstances.

Our specialists will help victims of crime and their families navigate the CICA claims process, from understanding their eligibility to pursuing a claim or challenging a decision. If you need advice or support with a CICA claim, Call or Email us today.

Every person with cerebral palsy has different experiences, needs and priorities. For children and their families, early access to much needed support, appropriate equipment and accessible accommodation can be an important part of managing everyday life.

For one family we represent we were able to obtain an interim payment following settlement of liability for a clinical negligence claim. This interim payment has helped the family to make some important changes possible.

Making changes to meet a child’s needs

The family had previously been living in unsuitable accommodation that was not suitable for their child’s needs. There was no space for the much needed equipment, and the property had no space for a lift meaning that the parents had to carry the child (aged 8) up and down the stairs multiple times each day. This was not only unsafe for the child but also dangerous for the parents and causing health problems for them both.

An interim payment has now enabled them to move into more suitable single level accommodation and obtain appropriate equipment such as a wet room and hoists throughout the property which removes the need for the parents to do any further lifting or carrying of the child.

For a child with cerebral palsy, having suitable and accessible accommodation and the necessary equipment that meets their individual needs can support everyday care, mobility, safety and independence.

Because we were able to obtain an interim payment before final settlement of the claim, it means the family has been able to make these changes now while the legal claim is still ongoing rather than at some point in the future when the claim concludes.

What is an interim payment?

An interim payment is a payment of compensation made before a clinical negligence claim has reached its conclusion. It will be deducted off any final settlement figure.

Where the circumstances and evidence support it, an interim payment can provide financial support for a child’s immediate or ongoing needs while the full value of the claim is assessed.

This can be used towards things such as suitable accommodation, specialist equipment, care, case management, rehabilitation or therapy.

Every child has different needs

The #UniqueANDUnited campaign highlights that there are 50 million people living with cerebral palsy worldwide, each with their own individual experiences, priorities and ideas about what needs to change.

For some, the change they want might be greater accessibility. For others, it could be better access to education, employment, technology or support.

For the family we represent, the key thing was having a home and equipment to support their child’s needs and this is already making not only a huge practical difference to the family, but is also allowing the child to perform to the best of his abilities, and he is now doing things that the family never thought he was capable of. This serves to illustrate that having the correct equipment and support really can make all the difference.

Supporting children and families

World Cerebral Palsy Day is about celebrating individuality, challenging the existing assumptions and listening to the voices of individuals who have cerebral palsy and their families. The campaign encourages people to share the changes they want to see and take action towards a more inclusive world.

For families affected by cerebral palsy following medical negligence, appropriate legal advice can sometimes help secure financial support while a claim is ongoing, as well as addressing longer-term needs.

If you believe your child’s cerebral palsy may have resulted from medical negligence, our clinical negligence team can provide advice about your circumstances and the options available – call or email today.

In some circumstances, a claim can be made on behalf of the estate of someone who was infected and has since died. But if the infection happened many years ago, there may be questions about the evidence available, medical records and who has authority to make the claim.

One of our recent clients contacted us to make a compensation claim on behalf of his late sister’s estate. She had been infected with Hepatitis C following a blood transfusion in 1982.

More than 40 years had passed, so the claim involved piecing together historic medical records and dealing with the requirements of her estate.

An interim payment of £310,000 was made in July 2026, followed by a total settlement of £1,036,835.81 in September 2026.

Can you claim compensation if the person who was infected has died?

The fact that someone who was infected has died does not necessarily mean that a compensation claim cannot be made.

Under the current infected blood compensation scheme, claims can be made in certain circumstances on behalf of the estate of someone who was infected and has since died. The person making the claim needs to have the appropriate authority to act for the estate.

This can be particularly important where the infection happened many years ago and the person who was infected may already have received payments under one of the previous infected blood support schemes.That was the situation in our recent case.

A claim dating back more than 40 years

Our client’s sister received a blood transfusion during surgery in 1982. She was diagnosed with Hepatitis C in 1998 and later developed cirrhosis of the liver.

Sadly she died in 2006. Her infection had previously been accepted under the Skipton Scheme and payments had been made.

This provided important evidence when we looked at the new compensation claim, but there were still questions to work through about the medical history, the progression of the illness and the evidence available so many years later.

What if the medical records are incomplete?

When an infection dates back several decades, it is understandable that families may worry that important records have been lost.

In this case, the available GP records were incomplete. However, they did confirm the 1982 blood transfusion.

We also obtained and reviewed other medical records and documents from the previous compensation scheme. Looking at these together helped establish the history of the infection and how the illness had progressed.

Incomplete records do not necessarily mean that there is no evidence to support a claim. It may be necessary to look at information from different sources and consider how the evidence fits together.

What happens when a claim is made through an estate?

When the person who was infected has died, there are additional practical issues to deal with.

The claim is made through their estate, so the person making the claim needs the appropriate authority to act. This can mean dealing with probate and other estate documentation alongside the medical evidence.

In this case, we dealt with the estate requirements while also gathering the evidence needed for the compensation claim.

For families, this can be another layer of complexity at an already difficult time.

What if the claim was started under an earlier scheme?

Many people affected by the infected blood scandal will already have had some involvement with one of the support or compensation schemes previously in place before the IBCA (Infected Blood Compensation Authority) was created.

Previous payments or decisions can be relevant evidence when making a claim through the current Infected Blood Compensation Authority (IBCA) scheme. They may provide information about the infection, its severity or the evidence that had already been accepted.

In our client’s case, the previous acceptance of his sister’s hepatitis C infection under the Skipton Scheme was an important part of the evidence we considered.

The new compensation scheme was also still being introduced when Middleton Law opened the matter in July 2024. We worked through the requirements as the process developed.

Our client had previously approached another organisation for help but, after around eight weeks without any apparent progress, decided to cancel the enquiry and contact Middleton Law. We were so pleased to be able to bring this to a successful conclusion for the client.

If someone who was infected has died, what should you do?

If you are dealing with the estate of someone who was infected with hepatitis C, hepatitis B or HIV through qualifying treatment, it may still be possible to make a compensation claim.

The circumstances of every case will be different. The infection may have happened decades ago, medical records may be incomplete, or there may already be evidence from an earlier scheme.

The important thing is to look at the evidence that is available and establish what is needed to make the claim.

If you are considering making an infected blood compensation claim for someone who has died, our specialist team can talk through your circumstances and explain how we may be able to help – Call or Email our experts today.

An outdated or inadequate Will can leave families facing uncertainty, delays and disagreements at an already difficult time. Changes to your family, finances or property may mean that your Will no longer reflects your wishes.

Reviewing your Will when your circumstances change helps make sure your money, property and other assets go to the people you want them to, and that your wishes are clearly set out.

When do you need to update your Will? 

You should consider reviewing your Will when your circumstances change. This might include:

• Marriage or divorce
• Having children or grandchildren
• Buying or selling property
• Significant changes to your finances
• The death of someone named in your Will
• Changes in your relationships or family circumstances

You don’t necessarily need a new Will every time something changes, but it is worth checking whether your existing arrangements still reflect your wishes.

Who should inherit? 

Your Will should clearly reflect who you want to benefit from your estate and what you want them to receive.

You should also consider what happens if someone you have named dies before you, particularly where they are a close family member.

Who should deal with your estate? 

Your executors will be responsible for dealing with your affairs after your death. It is important to consider whether the people you have appointed are still appropriate and willing to take on the role.

If you have children under 18, your Will can also include your wishes about who should look after them if you die.

Can a DIY or online Will cause problems?

A Will needs to be correctly drafted and properly executed to be legally effective. DIY and online Wills may not take account of your individual circumstances and can create problems if they are incorrectly drafted or witnessed.

Professional advice can be particularly important where there are complex family circumstances, property, trusts or significant assets.

Free Wills Month 

October is Free Wills Month, when participating solicitors – like us at Middleton Law – offer people aged 55 and over the opportunity to have a simple Will written or updated free of charge.

If you have never made a Will, or haven’t reviewed yours for some time, Free Wills Month provides an opportunity to check your arrangements and make sure your wishes are clearly recorded.

If you need to make or update your Will, our specialist Wills and Probate team can explain your options and help ensure your arrangements reflect your wishes – Call or Email our experts today. 

The Church of England’s Redress Scheme has moved closer to opening, with important developments taking place over the summer but for survivors of abuse, the wait is a long one.

The Church of England continues to state that the scheme is expected to open in the later part of 2026 and, while no specific opening date has yet been announced, several important steps have now been completed.

How close is the redress scheme to opening?

The legal framework for the scheme is now largely in place as the Abuse Redress Measure received Royal Assent in December 2025.

In July 2026, the Redress Scheme Rules were amended by the General Synod (CofE national assembly and legislative parliament). This set out important details including: the application process; eligibility; and appeals. The Rules were then laid before Parliament in July.

On 23 September 2026, Her Honour Heather Baucher, former Circuit Judge, was appointed as the independent Appeal Authority. Her Honour is independent and will determine appeals under the scheme.

These developments form part of the final preparations for the scheme to open.

What still needs to happen?

Although significant progress has been made, the scheme is not yet open.

Parliament still needs to approve the Rules and then there will be final operational preparations involving the Church of England such as putting systems and staffing in place and making sure the process is ready to operate.

The Church of England continues to state that the scheme should open later in 2026, but there is no confirmed launch date as this article is published.

What will the scheme provide?

The scheme is intended to provide financial and other forms of redress to eligible survivors of abuse connected with the Church of England.

There are two principal routes to eligibility:

• a ‘close connection’ pathway – where there is a sufficiently close connection between a role undertaken within the Church and the abuse; and
• a ‘failure to act’ pathway – where an appropriate person within the Church was aware of a risk and failed to take a step reasonably open to them to prevent abuse.

Eligibility will depend on the individual circumstances of each case.

There is no time limit between the abuse and an application, so the passage of many years does not necessarily prevent someone from applying. An application may also be possible where the alleged perpetrator has died.

Do I need a solicitor?

The scheme is designed so that survivors can apply without legal representation. However, independent legal advice can be helpful, particularly when dealing with the application process and any information requested by Kennedys.

The scheme provides up to £5,000 towards legal assistance for an eligible applicant. This is paid by the scheme and is not deducted from any redress awarded.

We would recommend that survivors consider what support they need and make an informed decision about whether legal representation would be helpful.

What can I do now?

It will be beneficial to take advice and prepare for an application before the scheme opens. An application will require information about your experiences and circumstances. Having a clear chronology and any relevant documentation or sources of information to hand may help the process.
This could include correspondence, safeguarding records, medical records, school or care records, police records or other relevant documents. Survivors do not need to obtain Church records themselves.

Middleton Law’s specialist abuse claims team has experience supporting survivors of institutional abuse, including claims through the Lambeth Children’s Homes Redress Scheme, Jesus Army Redress Scheme and Redress Scotland. We can help you understand your options, prepare for the Church of England Redress Scheme and identify the evidence you may need now.

If you experienced abuse within the Church of England, Call or Email our experts today

The case highlights an important issue with sexual abuse cases, in that many survivors do not come forward until many years or even decades after the alleged events. Delayed reporting is common and can be influenced by fear, shame, trauma, or concerns about not being believed.

Historic abuse allegations can still be investigated by the police and pursued through the courts many years later. In some circumstances, survivors may also have options to pursue compensation through the civil courts or other schemes, such as the Criminal Injuries Compensation Authority (CICA).

For those affected by similar experiences, seeking specialist advice can help find what legal options may be available, regardless of how long ago the events occurred.  If you have been affected by abuse and would like to discuss whether we can assist, please don’t hesitate to Call or Email our experienced team for confidential, no obligation advice.  

Most people will receive the care they need. But A&E departments are busy environments, and decisions often have to be made quickly. For patients and families, it can also be difficult to know what to do when they feel something is wrong but don’t feel able to challenge a decision or their concerns are not being taken seriously.

Today’s announcement that Martha’s Rule is being expanded to A&E departments across England

Martha’s Rule allows patients, families and staff to request an urgent review when they are concerned that a patient’s condition is getting worse and they feel those concerns are not being acted upon. The rollout to A&E will begin now and is expected to be completed across England by March 2028.

This announced plan comes at a time when A&E care is already under considerable pressure. BBC analysis of NHS Resolution figures found that A&E-related clinical negligence claims increased by 41% in five years, from 1,151 in 2020/21 to 1,623 in 2025/26.

Clinical negligence claims do not provide a direct measure of current patient safety but they do highlight the importance of what happens when symptoms are missed, treatment is delayed or concerns about a patient’s condition are not acted upon.

Issues that can arise during A&E care

Emergency Department staff work in demanding circumstances and often have to make decisions quickly. Problems can arise where:

• serious symptoms are not recognised;
• appropriate tests or scans are not carried out;
• a diagnosis is missed or delayed;
• a patient’s condition deteriorates without being recognised; or
• a patient is discharged without appropriate advice or follow-up.

Martha’s Rule does not change the standard of care patients should receive. What it does recognise is that patients, relatives and carers can sometimes see that something is wrong and may feel unable to challenge a decision or get their concerns heard.

The expansion of Martha’s Rule to A&E is intended to provide another route for concerns to be raised and an urgent review requested when necessary.

When delays or missed diagnoses may amount to clinical negligence

Not every mistake or delay in A&E will amount to clinical negligence.

The important questions are whether the care provided fell below the appropriate standard and whether this caused or contributed to harm.

Our clinical negligence cases can involve concerns about A&E assessment, diagnosis, treatment and related delays. Looking carefully at what happened can help a patient and their family understand whether their concerns were listened to, symptoms were properly assessed, the right investigations were carried out and appropriate treatment was given.

What if your concerns about A&E treatment were not heard?

Martha’s Rule is intended to help patients and families raise concerns while someone is receiving care. But if you have already left hospital and are worried that something was missed or treatment was delayed, you may still have questions about whether more could reasonably have been done.

If you are concerned about treatment you or someone close to you received in A&E, our experienced clinical negligence team can examine what happened and help you understand whether more could reasonably have been done and whether a negligence claim may be appropriate – Call or Email today.