A draft pre-action Letter
If you decide to pursue a claim, send a pre-action letter to the relevant NHS organisation. Here’s a template you can adapt:
Subject: Letter of Claim – d (DES) exposure and consequent injury
To: [Legal Department, NHS Trust/Practice Name]
I write under the Pre‑Action Protocol for the Resolution of Clinical Disputes.
Parties
Claimant: [Full name, DOB, address]
Defendant: [NHS Trust/GP Practice name and address]Background and exposure
I was exposed to Diethylstilbestrol (DES) [directly while pregnant in year(s) … / in utero because my mother was prescribed DES in year(s) … at …].
Indication recorded: [e.g., miscarriage prevention / suppression of breast milk].
Prescriber(s) and location(s): [GP/hospital if known].
I enclose/await medical records (SAR submitted on [date]).Injury and loss
Diagnoses and symptoms: [e.g., clear cell carcinoma / cervical or vaginal abnormalities / infertility / miscarriages / psychiatric injury].
Treatment received and prognosis: […].
Financial losses to date: [travel, lost earnings, care, prescriptions, fertility treatment].Breach of duty and causation
I allege that DES was prescribed or continued when it should not have been and/or that there was a failure to provide appropriate advice/monitoring once credible evidence of harm had emerged.
I rely on publicly reported admissions and policy developments, including the Health Secretary’s acknowledgement that “the state failed” to act and that “effective redress and remedy” are being explored. I further rely on current NHS guidance identifying specific risks for DES‑exposed daughters.Documents requested
-Full GP and hospital records, including maternity notes, prescriptions, clinic letters and test results from [year] to [year].
-Any internal policies, circulars or alerts relevant to DES during the period of exposure and thereafter.
-Any Duty of Candour correspondence, internal investigations, and safety alerts relating to DES.Funding and experts
I intend to seek specialist clinical negligence advice. Please confirm your insurers/claims handlers and whether you will agree to disclose key documents early to narrow the issues.Next steps
Please acknowledge this letter within 14 days.
Yours faithfully,
[Name]
[Contact details]
If you or your parent were prescribed DES (Diethylstilbestrol, also known as Stilbestrol) by the NHS between the 1950s and 1980s, you may be feeling uncertain about what steps to take next. The recent ITV News investigation and the Health Secretary’s public admission that “the state failed” to act have brought renewed attention to the issue.
Many are now wondering how to protect their health, gather evidence, and seek redress. This guide is designed for regular British citizens, offering clear, actionable steps and practical examples to help you navigate this challenging situation.
Understanding DES and Its Impact
DES is a synthetic oestrogen that was widely prescribed in the UK from the late 1930s until the late 1970s. It was used to prevent miscarriage and suppress lactation, but later research linked it to rare cancers and reproductive problems in those exposed in utero—often referred to as “DES daughters.” The government has now acknowledged failures in regulation and is considering what “effective redress and remedy” might look like.
If you suspect DES exposure, it’s important to act now. The effects can be intergenerational, and while current NHS guidance focuses on “DES daughters,” there are calls for more research into long-term and wider family impacts.
Step 1: Start a Paper Trail
Begin by gathering as much evidence as possible. This will help you access appropriate screening, support, and, if needed, pursue a claim.
How to request records:
Submit a Subject Access Request (SAR) to your GP and any hospitals where you or your parent received care. Ask specifically for maternity notes, discharge letters, and prescription records from the 1950s–1980s.
If your parent has passed away, you can often request their records as next of kin. You’ll need proof of authority, such as a death certificate and evidence of your relationship.
What to look for:
Dates DES was prescribed
The reason for prescription (miscarriage prevention or suppression of breast milk)
Names of prescribing doctors or hospitals
Any brand names or pharmacy records
Example:
Sarah’s mother was prescribed DES in 1972 to prevent miscarriage. Sarah requested her mother’s maternity notes from the hospital and found a reference to “Stilbestrol” in the discharge summary. She also asked her GP for her own birth and paediatric records, which included a note about “in utero exposure.”
Step 2: Speak to Your GP About Screening
If you discover evidence of DES exposure, book a GP appointment to discuss your risk and screening options. NHS guidance recognises an increased risk of clear cell cancer of the cervix and vagina for “DES daughters.” Routine recall is recommended, but some areas offer annual colposcopy follow-up if DES exposure stigmata are present.
What to bring:
Print-outs of the GOV.UK cervical screening guidance (section 2.5 on DES)
Any records showing DES exposure
What to ask:
Am I eligible for enhanced screening or local colposcopy follow-up?
Are there any local policies for DES-exposed patients?
Can you refer me to a specialist if needed?
Example:
After finding her mother’s prescription records, Jane brought them to her GP and asked about annual colposcopy. Her GP reviewed the GOV.UK guidance and referred her to the local gynaecology clinic for further assessment.
Step 3: Keep a Diary of Symptoms and Costs
Documenting your health journey is vital, especially if you later need to make a claim or seek support.
What to record:
Symptoms, diagnoses, and treatments
Fertility investigations or miscarriages
Time off work, travel expenses, prescription costs
Any correspondence with healthcare providers
Example:
Tom kept a diary after learning about his DES exposure, noting his fertility investigations, travel to hospital appointments, and days missed from work. He saved all receipts and letters from his GP and specialists.
Step 4: Gather Critical Evidence
To build a strong case—whether for clinical negligence or a future redress scheme—collect the following:
Proof DES was prescribed (maternity notes, prescription cards, discharge summaries)
Your own medical records (birth, paediatric, gynaecology, colposcopy, histology, oncology)
Evidence of impact (employment records, care diaries, receipts)
Official statements (Health Secretary’s admission, MPs’ letters, Parliamentary answers)
NHS communications (Duty of Candour letters, safety alerts, internal policies)
A simple chronology of exposure, symptoms, and key events
Tip:
Always follow up phone calls with an email confirmation and keep copies of all correspondence.
Step 5: Consider Your Legal Options
There are two main routes for seeking compensation or support:
1. Clinical Negligence Claim:
You may have grounds to claim against the NHS if DES was prescribed or continued when it should not have been, or if monitoring and advice were inadequate after evidence of harm emerged.
2. Policy/Redress Scheme:
The government is considering a compensation or support scheme. Stay informed by following official announcements and Parliamentary developments.
Time Limits:
Generally, you have three years from the date of negligence or the date you first knew you were injured and that DES may have caused it.
For children, time runs from the 18th birthday.
For fatal claims, it’s three years from the date of death or date of knowledge.
Product liability claims have additional limits, but most DES-era products fall outside these windows, so clinical negligence is the practical focus.
Example:
Emily only discovered her DES exposure at age 40 after finding her mother’s old medical records. She noted her “date of knowledge” and began gathering evidence for a potential claim, focusing on missed opportunities for earlier screening.
Example Scenarios
Cancer diagnosis and treatment:
A DES-exposed individual develops clear cell carcinoma, requiring surgery and ongoing monitoring. They claim general damages for pain and suffering, plus special damages for lost earnings, travel costs, and care provided by family.Fertility complications:
A DES daughter faces infertility and psychiatric harm. She claims for fertility investigations, treatment costs, and time off work.Late discovery of exposure:
After finding her parent’s records, a woman realises she missed out on earlier screening. Her claim focuses on additional monitoring costs and related expenses.
Staying Informed and Supported
Bring GOV.UK cervical screening guidance to your GP and ask about local follow-up.
Keep up with Parliamentary developments and any announcements about a redress scheme.
Save all correspondence, records, and receipts.
No credit card required
