Boy's family got 'poor' bereavement care - report

A family who complained they could hear hospital staff laughing nearby as their son's life support machine was turned off were given "poor" bereavement care by an NHS trust, an investigation has found.

Five-year-old Muhammad Ayaan Haroon, known as Ayaan, died at Sheffield Children's Hospital in March 2023 after being admitted with breathing problems.

A draft report into his death, in response to the family's complaints over his care, has found while some of it had not met expected standards, any changes were unlikely to have altered the outcome.

But after seeing the draft, Ayan's father, Haroon Rashid, has called for another investigation as he and his family "simply can't trust this report".

Mr Rashid, 42, said he believed investigators had missed out key details from his son's last days.

The draft report, by Niche Health and Social Care Consulting, and seen by the PA news agency, said that during his life, Ayaan was admitted to Sheffield Children's Hospital on five occasions with respiratory illnesses - and on each occasion there was an escalation of his symptoms and the treatment he needed.

It stated that on 5 March 2023, Ayaan - who had a history of respiratory problems and a rare genetic condition called Hace 1 - became unwell at home and was admitted with a lower respiratory tract infection.

When his condition deteriorated, he was transferred to the paediatric intensive care unit (PICU), where he died on 13 March from what was known as overwhelming disseminated adenovirus bronchopneumonia.

Out of 736 complaint points submitted by Ayaan's family into the care he received at the hospital around the time of his death, investigators upheld 307 and partly upheld 171.

The draft report sent to Ayaan's family found that aspects of Ayaan's care did not meet expected standards.

Those included the fact he should have been started on high-flow oxygen therapy sooner and a four-hour delay in admitting him to PICU because of bed and staff capacity issues.

However, the report found that although some changes - such as earlier escalation to intensive care, earlier insertion of a chest drain and earlier intubation - may have marginally increased the five-year-old's chances of survival, they were ultimately unlikely to have changed the outcome.

The report also said the medical clinical handover on the inpatient ward onto which Ayaan was initially admitted was "chaotic and ineffective" and "had the potential for the sickest children not to be adequately handed over at the change of shift".

Meanwhile, it said there was "poor communication" around the likelihood of Ayaan's survival.

The report stated that bereavement care provided to the family was "poor" and the cultural sensitivity shown after his death was "substantially inadequate", and this "undoubtedly added to the trauma of the family".

Members of Ayaan's family had previously complained they could hear staff laughing in a nearby room during the five-year-old's final moments, and the report said that as the unit was busy there was no side room available "to support a private dignified death which, while unavoidable, added to the family's distress".

The investigation reported that staff did not find out if there were specific cultural wishes of the family when performing Ayaan's last rites and in the management of the child's body.

The fact that this was not covered in the NHS trust's policy "may be seen as indirectly discriminatory", the report said.

In conclusion, the draft document made 15 recommendations, including alternative strategies for ventilatory support on the ward where an intensive care bed was not available and guidelines on handling the "immediate post-death period".

It also recommended that consideration should be given to whether a member of staff who shared the same ethnic background should act as a link worker for the bereavement process, as well as a suggestion that unconscious bias training should be organised for all clinical staff.

Responding to the findings of the draft report, Mr Rashid, who also has three older daughters, told PA: "Although it's very critical of the care my son received, the main thing for us as a family is despite it saying his care was mismanaged, it still says the outcome would not have changed.

"We as a family can't accept that."

Mr Rashid said "a catalogue of catastrophic errors" had been made, which he believed had cost his son's life.

The goal of the second investigation he was calling for would be "for the truth" and "for genuine lessons to be learned", Mr Rashid added.

Dr Jeff Perring, executive medical director at Sheffield Children's NHS Foundation Trust, said: "We express our deepest condolences to Ayaan's family for their loss."

He said that during the investigation, "we have addressed a number of concerns from Ayaan's family and we are committed to working with the family to address the learning within the draft report".

"We are working alongside NHS South Yorkshire to make sure Ayaan's family have the support they need, as they review the draft report before it is finalised and published," he added.

A spokesperson for NHS South Yorkshire said: "We would again like to offer our sincere condolences to Ayaan's family for the loss and distress they have experienced.

"We're continuing to work very closely and support Ayaan's family and have met with Ayaan's father to share with him the draft report into Ayaan's care.

"As this report is still in draft we're currently at the stage where everyone, most importantly Ayaan's family, have the opportunity to fully read and provide feedback and comment before the final report is released."

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