Family's Campaign For Mediation Over Treatment

Doctors and nurses at a London children's hospital are being trained to spot signs that communication is breaking down with parents over what is best for their child.

The pilot project at the Evelina Hospital in central London was conceived after consultant paediatrician Dr Esse Menson decided to contact a mediator when conflict developed with the family of one of her patients.

"I really felt we needed external help to move things forward," said Dr Menson. "It was as a result of that case that we developed this programme to train staff to recognise conflict early and to offer mediation."

The child in that case was Isidora Dyer, now aged 15, from Kent.

Isi, as she is known, has Rett Syndrome which leaves her unable to walk or talk.

In 2011, she was admitted to hospital with a gastrointestinal problem and was moved to the Evelina, but problems escalated and communication between the family and doctors fell apart.

Her mother Etta Bonugli said: "It's horrific to sit and watch your child deteriorating and you feel like you are in prison and no one is listening to you and there is nothing worse."

She and husband Andy were anxious about mediation when first offered it but ultimately it helped them get their voice heard.

Mrs Bonugli said: "We felt that we had somebody who we could talk to who was not judgemental, who we knew would relay information accurately and when we had meetings together with the mediator and medical staff involved, it was a lot easier, there was a lot less tension in the room and if things did get heated there was someone there to cool things down."

It is the kind of intervention which may have prevented the conflict escalating in the case of five-year-old Ashya King , whose parents took him out of hospital when they were refused the treatment they felt was best for their son. The case ended up in court.

Sarah Barclay, who mediated in Isi's case and is co-director of the Evelina Resolution Project, aims where possible to avoid lawyers becoming involved.

"I think going to court for parents on one hand and the health professionals on the other can be quite a bruising process, quite a confrontational process," she said.

"In the end there has to be a winner or a loser. However you don't need to make it feel like that. In these cases if you can try to get in sooner and resolve things in a more amicable, mediated way then that's the best possible option."

Six hundred health professionals at Evelina Hospital have already been taught to spot when things are going wrong as part of the two year pilot scheme. So far 86% have said it has helped them spot problems early.

Now Etta and Andy Bonugli are campaigning so that all families are offered mediation when it is needed.