The MMF Story

The Medical Mediation Foundation was founded in 2010 by Sarah Barclay, a former award-winning BBC health and social affairs correspondent and Dr Simon Meller, a children’s cancer specialist. With their different backgrounds, Sarah and Simon had both had experience of seeing how conflicts between parents and health providers could lead to communication breakdown and impact the care of a child and the well-being of clinical teams. They could also see that there was very little available to help support either parents or staff when conflicts arose. Together Sarah and Simon began to explore mediation as a potential way forward.
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Our purpose

MMF is a not-for-profit organisation. We set out with two key aims: to provide specialist mediation to help resolve disagreements between parents and healthcare providers, and to create a training programme for paediatric health providers that would equip them to recognise and manage conflict with families with compassion and confidence.

The Programme has been designed to prevent and manage issues identified through MMF's research and through ongoing engagement with clinicians and health care providers.

The cost of not managing conflict
The clinical impact of conflict includes an increased frequency in difficult decision-making regarding the benefits versus the burdens of treatment and increasingly complex decisions regarding the merit of intensive or life-sustaining treatments.

This can lead to communication breakdown between clinicians, patients and relatives, and also between clinicians.

Several high-profile court cases in the UK and overseas, and recent cases in Australia and New Zealand, demonstrate the financial and emotional damage such complex cases can bring, and the lasting effects on all involved.

How we began

Our first research project explored the causes and warning signs of conflicts between parents and healthcare providers. MMF were awarded a grant by the UK Department of Health, from a fund which supported research projects relating to children with life limiting conditions.

Sarah and a colleague interviewed health providers, parents, medical ethicists and lawyers to establish the causes of conflict between providers and families and why they escalate.

The research findings provided the evidence base for MMF to create a model for medical mediation and to design a conflict management training programme for health and social care. 

The core components are:

  • training multidisciplinary teams to identify and understand the warning signs of conflict and to engage with families appropriately and empathically
  • supporting clinicians to intervene in situations where conflict is escalating using the structured pathway of the MMF Conflict Management Framework

The evidence base

Initial research found that if not recognised and managed early, paediatric conflicts tend to escalate through three distinct phase (mild, moderate, severe) and can have long-lasting impact.

Further research conducted as part of a pilot conflict management programme launched in 2013 at the Evelina Children’s Hospital reported that more than 448 hours of clinical time across two 12-week periods were taken up in managing conflict between staff and patients/families in the hospital.

Staff cited communication breakdown, disagreements over treatment and ‘unrealistic expectations’ as the most common causes.

Conflicts were most frequent in general paediatrics, neurology and neonatology.

Evolution into a formal framework

The Programme evolved further following a debriefing with staff who had been involved in the Ashya King case - a complex conflict case at Southampton Children's Hospital in the UK. The MMF team heard that staff would welcome a clear pathway to follow as a team, to help them manage such a case in the future.

In 2015 - with input from the Southampton team - MMF developed the Conflict Management Framework. The Framework was piloted on a children’s cancer ward in the Princess Margaret Hospital in Perth in 2017. The results showed reduced incidence of conflict and staff burnout and improved communication between staff and families.

Further testing was conducted during 2018 and 2019 across four UK sites. Outcomes from this additional testing were published in 2022 by the British Medical Journal Paediatrics Open: staff using the Framework were provided with clear guidance on managing conflict as a team; there was a significant reduction in time spent on managing conflict.

Creating sustained cultural change

The pilots in Perth and in the UK established the core elements essential to engender sustained cultural change and embed the Programme and the Conflict Management Framework as ‘business as usual’ conflict management practice.

They are:

  • adequate senior support and buy-in from medical and nursing staff
  • investment in champions who are visible and experienced
  • a critical mass of the trained workforce to build individual and team confidence in their abilities to manage conflict situations when they arise
  • a train-the-trainer programme to provide a cohort of key staff to deliver training in-house, ensuring the sustainability of the conflict management training

MMF today


MMF continues to innovate: our interactive E-learning course developed with NHS England is available to all healthcare staff in the UK. It launched in Australia in late 2023, branded as the Green Zone Course. And it is now avaialble to healthcare provideres worldwide through open registration on this site.

We now operate a truly global and comprehensive programme of specialist paediatric conflict management and mediation training for both open registration and bespoke workshops for individual organisations.  With a combination of face to face, online and E-Learning we are able to support healthcare providers wherever you are in the world. 

Ongoing evaluation, including by independent researchers such as Oxford University's evaluation of the True Colours Trust project ensures we are capturing how the programme is delivered and implemented.

Our faculty of specialist medical mediators continue to provide by invitation discrete, confidential support where organisations require independent mediation for individual case

In October 2023 MMF opened a branch of MMF UK in Australia, to service the increasing demand for our training in Australia and New Zealand - and to launch our interactive E-learning Green Zone Course, in partnership with Children's Healthcare Australasia.

Visit MMF's UK Website

for further information about the MMF Conflict Management Programme and our mediation services, as well as our calendar of events and workshops - some of which are virtual and are available to healthcare providers practising outside the UK.

Fast facts

  • Since 2010 MMF has trained almost 10,000 healthcare providers in the UK and internationally

  • Post training surveys have found that on average around 95% of participants agree that the training is 'extremely' or 'very' relevant 

  • A 3-month post training survey in Auckland in 2020 found that 69.9% of respondents (n73) had experienced conflict since receiving the training, of which 94.6% agreed that the training had helped them to de-escalate or resolve the conflict. 
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Testimonials

“Huge impact and as ward manager, I’m sharing and empowering my team with new skills.” "
SENIOR NURSE
"It has been very helpful to attend a course that is so relevant to the area I work in. Many other conflict courses aren’t specific enough for the challenges that arise working within paediatrics, particularly in an acute setting.” 
PAEDIATRIC CONSULTANT
"I cannot recommend highly enough this excellent online training in managing conflict between families and healthcare professionals. It should be compulsory for anyone working in PICU (and other areas)"
PROFESSOR STEPHEN PLAYFOR,
CONSULTANT PAEDIATRIC INTENSIVIST

Meet the MMF Team

Each member of the MMF team has a wealth of experience in conflict management from professional backgrounds including medicine and law. The team are passionate about sharing their knowledge and skills in resolving conflict.

MMF PEOPLE     

Sarah Barclay
MMF Founder, Mediator

Sarah founded The Medical Mediation Foundation in 2010. She has a Masters degree in Medical Law and Ethics from King’s College London and is a former award-winning BBC social affairs correspondent and presenter.

Sarah was the co-director of the pioneering conflict management project at the Evelina London Children’s Hospital which was awarded Program of the Year in the 2018 National Mediation Awards; Sarah was subseqeuently voted an ‘NHS Innovator’ by the Health Service Journal. 

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Dr Esse Menson
Mediator, Trainer and Coach

Esse became a consultant paediatrician in 2006, specialising in infectious diseases, HIV and immunology. She has been a mediator since 2014. 

While a consultant at the Evelina Hospital, Esse worked with MMF to develop the Evelina Resolution Project.

Esse has a certification in Compassion Training from the Centre for Compassion and Altruism Research and Education (Stanford, USA.

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Oscar Mathew
Director, Trainer and Mediator

Oscar is a qualified barrister and a former Senior Legal Adviser to the General Medical Council in the UK where he was involved in setting up the pioneering ‘Meetings With Doctors’ pilot program: to facilitate meeting with doctors under investigation to help them best respond to the allegations against them.

Oscar specialises in clinical team development, facilitation and workplace conflict resolution, helping teams to engage with difficult issues and bringing a balance of voices to a room.

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Our Partners and Clients around the world

Evelina Hospital London

Royal Children's Hospital Melbourne

Sydney Children's Hospital Network

Perth Children's Hospital

Starship Auckland

Christchurch Hospital
Matatiki - Child & Youth Health

The Medical Mediation Foundation is a not-for-profit organisation providing conflict management training and specialist mediation services to assist in preventing and managing disagreements between families and healthcare providers


Thank you!

© Copyright The Medical Mediation Foundation  2023
MMF is a not-for-profit company limited by guarantee, registered in the UK number 7398812 and Australia ABN 51 671 899 531

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