Alison Leadsham is a Registered Nurse and Expert Witness with over 29 years of clinical experience, including more than two decades as a registered nurse across emergency care, acute medicine, critical care, tissue viability and elderly care. Her practice is firmly positioned within liability, providing a highly detailed and governance-led approach to the assessment of breach of duty and clinical standards of care.

Alison brings extensive expertise in clinical governance, patient safety and incident investigation. With over 15 years in governance-focused roles, she has led and conducted Root Cause Analysis (RCA) and PSIRF reviews, analysed adverse incidents and complaints, and reviewed Datix reports to identify contributory factors and systemic issues. Her work involves benchmarking care against national and local standards, including NICE, RCEM, NMC Code and Trust policies, enabling robust and defensible opinions on whether care met expected professional standards.

Her clinical background includes significant experience within A&E and urgent care environments, with over 15 years managing triage, prioritisation and high-acuity patient flow using Manchester Triage and rapid assessment models. She has particular expertise in reviewing cases involving delayed triage, missed deterioration and failures in escalation, supported by advanced knowledge of frameworks such as NEWS2, ABCDE and SBAR.

Alison also brings specialist knowledge in tissue viability, pressure ulcer prevention and wound care, including Waterlow and Braden risk assessment, avoidability analysis and review of pressure ulcer panel outcomes. Her expertise extends to frailty and falls management, where she assesses contributory factors such as deconditioning, polypharmacy and supervision failures. She is experienced in safeguarding investigations and in differentiating between individual clinical error and wider systemic or organisational failure.

Her senior leadership roles, including Modern Matron and Quality and Safety Advisor within NHS Trusts, provide a deep understanding of healthcare systems, governance processes and service delivery pressures. This experience underpins her ability to deliver balanced, structured and clinically grounded expert evidence in complex liability cases.

Fully trained in the Civil Procedure Rules, Alison provides independent expert evidence across claimant and defendant instructions. Her reports are objective, methodical and focused on delivering clear, reasoned opinions to assist the Court in determining matters of breach of duty, causation and standard of care in nursing and acute care settings.

Specialisms

• Emergency Department (A&E) nursing standards and triage (Manchester Triage, rapid assessment)
• Recognition and escalation of deteriorating patients (EWS, NEWS2, ABCDE, SBAR)
• Review of delayed triage, missed deterioration and escalation failures in emergency care
• Acute medical and elderly care nursing standards
• Falls prevention, frailty assessment and contributory factor analysis (polypharmacy, deconditioning, supervision)
• Tissue viability and pressure ulcer risk assessment (Waterlow, Braden)
• Avoidability analysis of pressure damage and wound-care management
• Clinical governance and patient safety investigations (RCA, PSIRF, Datix review)
• Breach-of-duty analysis against national and local standards (NICE, RCEM, NMC Code, Trust policies)
• Documentation review, risk assessment evaluation and reconstruction of clinical timelines
• Differentiation of individual clinical error and systemic or organisational failure
• Sepsis recognition, NEWS2 compliance and escalation pathway failures
• Safeguarding concerns, pressure ulcer panels, and falls safety investigations
• Impartial evidence provision, including Coroner’s Court proceedings

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Contact

Contact us at enquiries@harrison.associates