Joanna Trewin

Practice Areas

• Inquests

• NHS E Homicide Reviews

• Inquiries – confidential and Public

• High-profile patient safety reviews

• Duty of candour,

• Disclosure (FOI / DPA)

• Witness support

• CQC regulatory advice

• Criminal Investigations including gross negligence manslaughter, corporate manslaughter, neglect.

• Clinical Governance and lesson learning

• Human Rights Act 1998 including Article 2 Inquests

• Advocacy

• National expert in organ retention and the use of human tissue.

• Adult and child safeguarding

• Child Protection

• Family Court

• Mental Health legislation

• Mental Capacity Act

• Best Interests

• Advance Decisions

• Mental Health Act Code of Practice

• Admission, detention and discharge under the Mental Health Act 1983.

• Children Act

• Healthcare Board advice

• Complaints advice

• Parliamentary and Health Services Ombudsman

• Witness statements

• Information governance, confidentiality and information law

• Media Management

Career

Hill Dickinson:

Trainee 1999-2001

Solicitor 2001 – 2005

Associate 2005-2007

Partner 2007 -

Head of Manchester Health and Public Law 2015

Deputy Head of Health and Public Law 2022

Deputy Head of Manchester Office 2022

Recognised as a Leading Individual for many years in the Legal 500 UK Directory 2024.

Joanna is currently ranked in Band 3 for Healthcare Contentious in Chambers and Partners 2024.

Client feedback includes:

“I can always rely on Joanna and she is very level-headed.”

“She provides timely and trusted advice and is very accessible.”

“Joanna Trewin – experienced and approachable.”

“Joanna Trewin – extremely efficient and provides an excellent service to clients.”

Professional Memberships

Liverpool Law Society

Manchester Law Society

Personal

Joanna was one of the first partners at Hill Dickinson to work part time and is proud to have developed a framework through which she has successfully grown her career to become a senior partner at the same time as raising two children. That framework has now been implemented across her team with flexible working the norm. This allows those with caring responsibilities, both male and female, the flexibility to juggle competing demands without being tied to the old fashioned and rigid 9-5.

This has also extended to ethnic diversity with a quarter of her team being BAME. Flexible working is also implemented to accommodate cultural requirements such as fasting or religious holidays and requirements.

Joanna has also developed several initiatives to help our healthcare clients to streamline cost, particularly given recent pressures on public finances. This has included mentoring senior clients to upskill their teams and implement efficient working practices.

Work Highlights

Having been with the firm since 1999, Joanna has 25 years’ experience advising healthcare organisations / senior executives on a wide range of legal issues, including the reduction of legal spend, through upskilling in house legal teams, undertaking process reviews to drive efficiencies and mentoring.

• Acting in the Thirlwall Inquiry (Lucy Letby) entailed supporting witnesses through the process from drafting witness statements to giving evidence and managing national media attention, such as journalists following witnesses down the street..

• Seconded to advise Alder Hey Children’s’ Hospital / NHSLA (2000-2005) on the legal issues that arose following the revelation of organ retention in 2000, This included; Confidential Inquiry, headed by Robert Francis QC, advent of the Human Tissue Act 2004 and Codes of Practice, which overhauled pathology practice, media management, briefing central Government / Secretary of State for Health. The litigation was settled as the first group mediation under the newly introduced CPR rules. Inquests were re-opened following a review of the historical collection of retained children’s hearts, raising concerns about the quality of care provided by the cardiac team dating back to the 1950s. Joanna is now a national expert in the legal framework surrounding the use of human tissue, having advised healthcare providers over the last 20 years, including the then NHSLA (now NHS Resolution) on the developing law and regulatory requirements.

• Participating in several high-profile patient safety reviews, for the Northern Care Alliance NHS Group, one of the largest NHS organisations in the country – eg a pathologist (2017-19), a spinal surgeon (2022 - ongoing). Patient safety reviews require proactive management to address and mitigate legal risks in a wide range of issues; duty of candour, disclosure (FOI / DPA), witness support, claims, CQC, police and lesson learning to prevent coronial Preventing Future Deaths reports and regulatory action. Inquest conclusions had to be re-opened and reviewed in complex, Article 2 Human Rights inquests, following allegations that the coroner’s pathologist had fabricated the causes of death. Joanna and her team undertook their own advocacy at inquest, saving the costs of external barristers. A senior associate was seconded to support the projects as a cheaper alternative to external governance organisations, allowing proactive resolution and mitigation of legal challenges.

• Acting for Morecambe Bay Hospitals NHS Trust (2012-2018) re the death of Poppi Worthington, whose parents were accused of causing injuries which resulted in her death. Extensive investigations were undertaken - a criminal inquiry, Family Court Proceedings. A long, complex, multi party inquest took place which examined the roles of all agencies. The learning led to national improvements to child protection across health and social care.

Joanna and her team undertook their own advocacy, with paralegals attending on the days which were not controversial, thereby saving costs.

• Advising the Northern Care Alliance NHS FT (2021 – 2023) in Pennine Care NHS FT v Mrs T, Mr T, Northern Care Alliance NHS FT and Amy (by her Childrens’ Guardian) [2022] EWHC 515 Fam regarding a patient sectioned under the Mental Health Act 1983, who was non-compliant with medical treatment for anorexia nervosa. This required a multi-agency approach, working with the mental health trust and other agencies, to apply to the High Court for authorisation to sedate the patient in ICU, for feeding whilst sedated. This was the first time this treatment plan had been attempted and it was unknown whether the risks outweighed the benefit to evidence best interests. The Court granted the order and treatment was initially successful. Further advice was provided with further admission to ICU, liaison with the new adult mental health trust and other agencies to agree a discharge plan for community care.

Joanna’s network and reputation facilitated joint inter agency working which helped to resolve the issues so that treatment could be provided swiftly, and legal costs kept a minimum through the proactive resolution of issues.

• Advising the Boards of the Northern Care Alliance NHS FT and Warrington and Halton Hospitals NHS FT on their clinical risk management strategy during the COVID 19 pandemic. This included drafting Board papers on steps that could be reasonably taken to mitigate clinical risks, claims, complaints and incidents. Interesting examples include whether veterinary ventilators could be used on humans and reasonable adaptations should be undertaken for vulnerable staff and patients where PPE was unavailable, or patients / visitors refused to wear masks.

Joanna brought together specialists to identify possible legal issues, to advise on steps that could be taken to mitigate the legal risks.

• Advised Warrington and Halton Hospitals NHS FT on their review of spinal services following several incidents. This entailed identifying clinical risks and ensuring a robust response to mitigate legal risks and prevent patient harm. Patient safety reviews require proactive management to mitigate legal risks; duty of candour, disclosure (FOI / DPA), witness support, claims, inquests, CQC, police and lesson learning to prevent coronial Preventing Future Deaths reports and regulatory action. Lesson learning was robustly captured in an action plan and implemented with evidence of improvement across the organisation.

• Instructed by St Helens and Knowsley NHS Trust in 2021/2 (now Merseyside and West Lancashire Teaching Hospitals NHS Trust) to advise on a response to a formal complaint by the relative of a patient who had died following a systemic error. The relative was also a CQC inspector. Undertook an inquiry into the allegations, drafting a response, including lesson learning. The Parliamentary Services Ombudsman and CQC also became involved and responses to those complaints were also drafted. By proactively investigating the allegations from the start, the legal issues were addressed and learning implemented to improve patient safety.

• Responding to a Parliamentary and Health Services Ombudsman’s inquiry to a complaint brought a doctor who’s relative had died at the Northern Care Alliance NHS FT. The instruction was complex in that an external inquiry had been commissioned and inquest opened which all intertwined with the response to the formal complaint and Ombudsman. Independent Expert evidence was obtained which contradicted the PHSO’s findings and the final complaint response report was amended with less damaging criticisms of the Trust.

• Instructed by Manchester University NHS FT to advise following a patient death and prosecution of Dr Khan for gross negligence manslaughter in 2020. Joanna provided support to witnesses giving evidence to Greater Manchester Police and the Trust’s internal inquiry. Legal advice was provided to manage the high profile, media coverage as well as settling the family’s civil claims and liaison with the coroner / GMC.

Education