World Encephalitis Day is taking place this year on 22 February 2018. Encephalitis is an inflammation of the brain that affects up to 6000 people in the UK every year, with the most severe of these often arising as a result of clinical negligence in the diagnosis and treatment of the condition.
Tim Spring, partner and head of clinical negligence at Moore Blatch and chair of the Trustees at the Encephalitis Society, argues that greater awareness of the complexity and severity of encephalitis is needed, and is calling on NHS trusts to take more responsibility for errors that leave victims with life-changing injuries.
If left undiagnosed or untreated, even for as little as a day, encephalitis can cause severe brain injuries that can have life-changing implications
Encephalitis is a complex condition, and as such mistakes by doctors in diagnosis and treatment are not uncommon. Despite this, encephalitis claims are almost invariably defended, with NHS trusts rarely accepting liability for errors even if they lead to life-changing injuries.
There is no ‘silver bullet’ when it comes to treating encephalitis, and Tim argues that doctors need to display extra vigilance when assessing patients who may exhibit signs of encephalitis, to ensure that all possible causes of the condition are considered and addressed in a timely and effective manner. He is also calling on NHS trusts to overhaul their risk management systems, with less emphasis on defending claims for negligent treatment and a greater focus on learning lessons from mistakes, and ensuring that victims are able to secure the compensation they need to fulfil their long-term care needs.
Comment by Tim Spring, Moore Blatch and chair of the Trustees at the Encephalitis Society
Encephalitis is arguably one of the most complex, and least understood, medical conditions that healthcare professionals encounter. Today, on World Encephalitis Day 2018, we want to raise awareness of this peculiarly complex condition.
Encephalitis is an inflammation of the brain, which affects up to 6,000 people in the UK every year. If left undiagnosed or untreated, even for as little as a day, encephalitis can cause sufferers to develop severe brain injuries that can have life-changing implications.
The particular complexity of encephalitis arises from the multiple causes there are for the condition. Encephalitis can be caused by a variety of viral infections – most prominently the herpes simplex virus – or by an auto-immune disorder that causes the immune system to erroneously attack the brain. Recognising which cause is responsible for encephalitis, and appropriately addressing that cause, is essential to ensure the best possible recovery.
In my role as the Head of Healthcare and Clinical Negligence at Moore Blatch Solicitors, I have come across many cases over the years in which clients have suffered the life-altering effects of encephalitis as a consequence of a failure to promptly diagnose and provide effective treatment. In some cases, a less than 24 hour delay can make all the difference between recovery and life-long dependence on the support of carers.
There are a number of simple adjustments that can be made to the way encephalitis cases are approached that could go a long way to reducing the amount of costly errors made, and improve health outcomes for patients.
Treating encephalitis
Unfortunately, there is no ‘silver bullet’ when it comes to treating encephalitis. The wide range of causes means that healthcare professionals need to be alive to all possibilities when examining cases.
Increased awareness of the complexity, and potential severity, of encephalitis is needed amongst medical professionals in order to ensure that accurate diagnoses are made and the relevant treatment provided in good time, before the condition is allowed to develop to the point of serious brain injury.
While even the shortest delays in treatment can have catastrophic ramifications for patients with encephalitis, so too can inappropriate and sub-therapeutic treatment. Without a precise understanding of the particular cause of a given case of encephalitis, attempts at treatment – for example through use of antimicrobial medicines – can do as much harm as good. Correct diagnosis of the condition is therefore critical to successful treatment, and as such it is essential that doctors are knowledgeable about encephalitis, and are supported to make correct and timely diagnoses.
There are new and emerging approaches to diagnosing encephalitis that are helping medical professionals to reduce errors. The Encephalitis Society has in this context played an important role in contributing to research and organising conferences and seminars that bring together clinicians and experts with an international reputation.
The development of the Liverpool Algorithm has proved transformational in this area, by providing doctors with a clear framework for investigating and treating suspected encephalitis. By embracing new innovations and developing a clear understanding of the condition, medical professionals delivering best practice can help avoid some of the mistakes that have been made in the past. The state of the art in this area is changing from year to year and the Encephalitis Society continues to make an important contribution to this end.
Overhauling risk management processes
In addition to improving understanding amongst healthcare professionals of the complex nature of encephalitis, the management of such cases could also be improved by overhauling clinical risk management processes at NHS trusts.
As encephalitis can be challenging to diagnose and treat, it is essential that emphasis is placed on learning so that improvements can be made in future. It is only in this way that the number of diagnostic errors can be reduced.
Crucial to this is ensuring that healthcare professionals feel fully supported by NHS trusts, with the space and time to learn about the condition in a safe and constructive environment.
Conclusion
The treatment of encephalitis is constantly improving, with new understanding and innovations allowing doctors to provide more successful care for patients. Raised awareness, fostered by the work of the Society and by learning from situations in which things have sadly gone wrong, will continue to reduce the errors we see in encephalitis cases and ensure that health outcomes reflect the skill and effort of all involved in tackling this dreadful illness.
