University Hospitals Coventry and Warwickshire NHS Trust

4. Mrs G complains about the way she and her husband, Mr G, were treated by University Hospitals Coventry and Warwickshire on 20 April 2022 when they attended A&E with their foster child. Mrs G specifically claims that:

• when her foster child was admitted to A&E with a fractured femur, the patient history was not considered when making a diagnosis, which led to police and social services becoming involved • The paediatrician treating her foster child speculated about how the injury was sustained and included this speculation in a child protection report.

5. Mrs G says because of the terminology and wording the paediatrician at the hospital used, the police and social services had to intervene, leading to her and her husband’s arrest on suspicion of GBH and wrongful detention. As a result of this, the couple’s biological children were removed from their care for several months.

6. The incident and the events that have followed has led to Mrs G suffering from anxiety, Mr G suffering from PTSD and anxiety, and their biological child suffering from anxiety which has manifested in an eating disorder.

7. Mrs G is seeking an apology from the Trust for the way she and her family were treated. She is also seeking service improvements, particularly regarding second opinions from consultants when discussing causes of injuries in children. Mrs G is also seeking financial compensation.

8. Mrs G and her husband had been foster carers for six weeks, for a foster child (F) who was 20 months at the time of the events. On 19 April 2022, F became tearful when they bathed him and was clingy on and off throughout the night.

9. Mrs G rang 111 at 5am on 20 April 2022, who advised they attend the Emergency Department (ED).

10. Whilst at the ED, F had an X-ray which showed he had a spiral fracture of the left femur. It was commented that this was a non-accidental fracture. Mr and Mrs G were unable to explain the fracture. This then triggered a child protection referral, and F was removed from the F’s care.

11. The F’s were subsequently arrested, and their biological children were removed from their care as it was deemed that one of them had caused the injury.

12. Four months later at court, a radiologist said that there could have been other reasons for the fracture and that the patient’s history could also be contributing factors. Mrs G is bringing the complaint about the impact that the injury and the handling of it had on her.

17. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

A&E attendance – 20 April 2022

18. Mrs G complains that F’s patient history was not considered when he attended A&E with a fractured femur. She says this led to the involvement of the police and social services.

19. At the time of F’s attendance, there was no known history of any bone condition. In addition, even had this history been known, it would not have been visible to the radiologist at the time of the scans.

20. Our adviser explains that without any known bone condition or any other clinical history, the type of injury F sustained, a long bone fracture, would usually only be caused by twisting, falling from height, or a high energy impact injury.

21. As such, we do not see indications to suggest there was a failure to consider F’s history during the A&E attendance.

22.

Speculation as to how the injury occurred

23. The GMC guidance ‘Protecting children and young people’ sets out the responsibility of medical professionals. This says: ‘If you work with children or young people, you must have the knowledge and skills to recognise signs and symptoms of abuse and neglect, and to take appropriate and prompt action if necessary.’

24. In addition, the Trust’s internal ‘Child Protection Policy’ says: ‘The welfare of the child is paramount. [The] Trust has a duty to initiate the sharing of information when a concern has been identified and/or to co-operate as required with agencies to safeguard children.’

25. Our adviser has confirmed F’s type of injury, without details of how this occurred or relevant clinical history at the time, would be considered suspicious in a child of this age. As such, this would be classed as suspected physical abuse (SPA).

26. Our adviser also confirms an abnormal bone fracture would always be flagged, and this is the safe and correct best practice, in line with the above GMC and Trust guidance.

27. We have not seen evidence to suggest the Trust speculated as to how the injury occurred. Instead, the safeguarding lead for child protection’s role is to highlight to the relevant agencies when injuries like these occur and to provide a detailed report to social care and police. It is then the role of these agencies to investigate this further as needed and decide on any relevant next steps.

28. Overall, we do not see indications of failings in the safeguarding lead’s referral to the above agencies, in line with the information known at the time and the above guidance. We have not seen this included inappropriate speculation and can see the referral was made due to the unexplained injury, bruising, and a missing patch of hair from the F’s head.

29. We can also see the Trust have provided a thorough complaint response explaining what happened and why the referral was made. We therefore will not be taking further action.

Conclusion

30. We fully appreciate how difficult these events will have been for Mrs G and her family. We hope our statement provides some reassurance around the Trust’s actions and that we have clearly explained the reasons why we will not be taking further action.

1. We have carefully considered Mrs G’s complaint about University Hospitals Coventry and Warwickshire NHS Trust (the Trust).

2. Based on the information we have considered, we have decided not to carry out a detailed investigation into Mrs G’s concerns. This is because we have seen that the Trust followed the correct process in raising safeguarding concerns at the time. We are sorry if our decision causes any further distress as this is not our intention.

3. We thank Mrs G for the effort she has gone to in bringing her complaint to us. We know this has not been easy for her and her family we are sorry to hear all they have been through.