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Open Review NHS patient safety safeguards for infants

Created by Miss Lisa Wilcock
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Review patient safety law to improve early recognition & escalation of serious illness in babies & young infants across NHS care. A review could look at establishing clearer, more standardised & consistent safeguards to help reduce avoidable harm. This could be known as "Ophelia's Law'.

Ophelia attended primary and urgent care settings on multiple occasions with ongoing chest and respiratory symptoms. Despite repeated presentations, she was discharged without escalation, observation, or further investigation. She later died in her sleep from pneumonia. This reflects a wider patient safety issue recognised in national reviews of child deaths and serious incidents: repeat presentations, fragmented assessments, and inconsistent escalation can result in missed opportunities.

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