A healthcare professional and a mediator shaking hands with a client in a bright conference room, representing collaborative resolution.
A healthcare professional and a mediator shaking hands with a client in a bright conference room, representing collaborative resolution.
Health&Care Mediation

Specialist mediation for disputes in health, social care and the workplace.

Health and Care Mediation works with solicitors, NHS Trusts, local authorities and care providers to resolve contested situations in health and care – from treatment and care planning disagreements and Court of Protection matters to end-of-life decisions, judicial review, and workplace disputes where clinical, legal or personal complexity is at stake.

Why mediation matters in health and care

Disputes in health and care are rarely just about the decision in question. They sit at the intersection of statutory duty, clinical judgment, ethical principle, and highly personal stakes – and they escalate quickly when communication falters.

Mediation provides a structured, confidential, without-prejudice forum to resolve disagreements before they reach court – or alongside proceedings already underway. It demonstrates reasonableness and proportionality, preserves working relationships, and in many cases produces outcomes no judicial determination could reach.

Recent empirical research describes the mediation of medical treatment disputes as a form of therapeutic justice – finding that participants experience it as a space where all voices are heard and where resolutions can be tailored to the people involved. Cases from our practice were included in the study.

Medical clinicians and professionals having a joint discussion around a laptop and clipboard documents.

Instruction of a mediator is a proactive measure that:

  • Mitigates the risk of entrenched disputes and emergency hearings
  • Preserves professional relationships and patient or service-user wellbeing
  • Demonstrates compliance with pre-action protocols
  • Minimises cost and delay

What we mediate

We undertake a broad spectrum of disputes across health, social care, and the workplaces that serve them.

Health and social care

  • Treatment and care planning disagreements between families, clinicians and providers
  • Court of Protection matters (welfare, capacity, residence, contact, deputyship)
  • End-of-life and palliative care, including paediatric cases
  • Judicial Review and Pre-Action Protocol mediations
  • Mental Health Act and Mental Capacity Act matters
  • Discharge planning and Section 117 After-Care disputes
  • Learning disability, autism and complex care
  • Lasting Power of Attorney (LPA) disputes and elder mediation

Workplace and employment

With specialist focus on cases involving disability, mental ill-health, and neurodivergence:

  • Colleague, team and clinical staff breakdown
  • Bullying, harassment and discrimination allegations (Equality Act 2010)
  • Reasonable adjustments and disability matters
  • Post-grievance and post-investigation repair
  • Board, trustee, CEO and senior leadership conflict
  • Performance, sickness absence and return-to-work
  • Settlement, exit and pre-tribunal mediation

How we work

Our approach is calm, structured and bespoke. We rarely offer the standard one-day mediation; instead, we design proportionate, person-centred processes around the parties and the issues – which is why our outcomes are durable.

Trauma-informed, neurodivergence-aware, professionally rigorous

We bring trauma-informed practice, mental health awareness, and specialist understanding of neurodivergence to every case. We work proportionately to complexity – sometimes in a single session, often over weeks – with pre-mediation private meetings, phased dialogue, and reasonable adjustments throughout (interpreters, Easy Read materials, sensory and communication accommodations).

Alongside legal proceedings, or independent of them

We work before, during and after formal processes – pre-issue, post-issue, post-judgment, or in parallel with tribunal or court proceedings. Legal representatives remain central to advising their clients on rights, risk and duty; our role is to facilitate constructive dialogue, not to advocate or adjudicate.

Over-the-shoulder view of an individual with clasped hands during a consultation with a mediator.

Our process

  1. Initial enquiry. A complimentary 30 minute online consultation to discuss the matter, urgency, logistics and funding (including Legal Aid and cost-sharing).
  2. Proposal. A written proposal setting out structure, timescales and indicative costs, for parties to consider alongside their legal advice.
  3. Confirmation. Once accepted, a Booking Form is issued and mediation is scheduled. A deposit is taken prior to substantive work.
  4. Pre-mediation meetings. Confidential private meetings with each party – usually online.
  5. Joint sessions. Convened when parties are prepared, under a signed Agreement to Mediate confirming the without-prejudice status of discussions.
  6. Resolution. Outcomes belong to the parties and may be formalised by legal representatives where required.

Professional Training & Development for Accredited Mediators

Health and Care Mediation provides specialist training for accredited mediators developing a health and care specialism.

Available Formats

  • Bespoke in-house programmes
  • Workshops & multi-day courses
  • Online learning
  • Mediator mentoring
Arabella Tresilian

About

Health and Care Mediation is led by Arabella Tresilian, one of the UK’s most experienced mediators in this field, with over 130 cases conducted since 2017.

A CEDR Accredited mediator registered with the Civil Mediation Council and accredited by the International Mediation Institute (IMI), Arabella combines two decades of public sector management experience in health, education and care with personal lived experience as a family caregiver and service user. She is widely recognised for her trauma-informed practice, her work in Court of Protection mediation and paediatric end-of-life care mediation, and her specialist expertise in disputes involving disability, mental ill-health and neurodivergence.

Arabella trains the next generation of mediators in health and care dispute resolution, co-leads one of the UK’s only conversion courses for civil mediators moving into workplace practice, and was a 2024 Churchill Fellow researching culturally responsive communication in end-of-life care across South Africa, Peru and India. Her work has been featured by ITN News, Sky News, BBC Radio 4’s Inside Health, the Financial Times, the British Medical Journal, and the King’s Fund.

Health and Care Mediation draws on a wider network of specialist associates – clinical, legal, and condition-specific – to be brought into a case where additional expertise is required.

What instructing professionals say

“I thought the mediator was excellent. She brought a very empathetic, inclusive approach which made everyone feel listened to and we were able to make some constructive progress.” – Counsel for Local Authority, Court of Protection case

“Thank you so much for all you have done in this case to mediate between the parties. Your report has been extremely helpful and both parties have advised that the process went really well.” – Chief Lawyer, Adult Social Care, Local Authority, Court of Protection mediation

“Thank you very much for all your hard work over the last few months. You helped us to find a new perspective on this extremely complex dispute.” – Public law solicitor, Judicial Review mediation

“Thank you for the time you took with us to understand our position, and for the skill and sensitivity with which you led the mediation session.” – Children’s hospice director, High Court care dispute

Make an enquiry

If you are considering mediation – for a client, your organisation, or yourself – we welcome your enquiry. Initial consultations are complimentary, confidential and without obligation.

To contact us or refer a case, please complete our enquiry form below. We usually respond within one working day.