Independent review: Disagreements in the care of critically ill children

Current Project

Published 08/12/2022

An independent review of disagreements in the care of critically ill children.

Infant foot with IV line

The Health and Care Act 2022 sets out a requirement for a review into the causes of disputes between parents or carers of a critically ill child and the healthcare teams responsible for the provision of care or medical treatment for the child.

On Wednesday 30 March 2022, Health Ministers committed to:

“commission a full independent review of the causes of disagreements between the providers of care and persons with parental responsibility on the care of critically ill children, how these disagreements can be avoided, and how we can sensitively handle their resolution.”

The Nuffield Council on Bioethics has been asked by the Department of Health and Social Care (DHSC) to carry out the review. We will agree the specification of the review with DHSC, however in all other areas will ensure the review’s independence, for example, in overseeing the design, implementation and reporting.

Central to the review will be the perspectives of families and healthcare teams themselves, alongside research evidence and ethical analysis. We aim to further understand the causes of disagreements in the care of critically ill children, how they may be avoided, and how to sensitively handle their resolution.  

In 2018-19, we explored the factors that might be contributing to how disagreements of this kind develop, and how they are being resolved, which we published in a briefing note.

This review will build on our existing work and draw on published evidence and the perspectives of people with lived and professional experience to further understand the causes of disagreements in the care of critically ill children. The review will inform national and regional learning and improvement and support the creation of good, collaborative relationships between parents and healthcare staff.

The review will be completed by October 2023.

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