UK Inquiry Tracker

Costs of clinical negligence

Public Accounts Committee Open Inquiry

Opened: 10 Jul 2025 Parliament page

The PAC in its 2025 scrutiny the Department of Health and Social Care’s (DHSC) annual report and accounts 2023-24 called on government to reduce tragic incidences of patient harm. The PAC found it unacceptable that DHSC had yet to develop a plan to deal with the cost of clinical negligence … Read more The PAC in its 2025 scrutiny the Department of Health and Social Care’s (DHSC) annual report and accounts 2023-24 called on government to reduce tragic incidences of patient harm. The PAC found it unacceptable that DHSC had yet to develop a plan to deal with the cost of clinical negligence claims, with so much taxpayers’ money being spent on legal fees. Its report found that £58.2bn had been set aside to cover the potential cost of clinical negligence events in the 2023-24 accounts – the second largest liability across government after nuclear decommissioning. 19% of money awarded to claimants in 2023-24 went to their lawyers (£536m of the total £2.8bn paid out that year), on top of the fees payable for the Government Legal Team. The PAC last scrutinised the topic of clinical negligence in 2017 , saying at the time that bold action was required to address the impact of claims on resources available for frontline care and patients. Its report urged government at the time to end its complacency over the cost of clinical negligence, with the annual amount paid out having quadrupled over the preceding decade from £0.4 billion in 2006–07 to £1.6 billion in 2016–17. The National Audit Office reports on clinical negligence costs in 2025, with an investigation setting out the scale and drivers of changes to the value of long-term liabilities for clinical negligence claims and associated in-year payments, and likely future projections. Following the NAO’s report, the PAC will take evidence from senior DHSC and NHS officials . Likely topics will include what is being done to reduce patient harm and improve patient safety across the NHS, and the effective management of costs, including the reduction of legal fees. If you have evidence on these issues, please submit here by 23:59 on Thursday 6 November 2025. Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. You can request anonymity or confidentiality when you send evidence, but it is the Committee which decides what information to publish and how. It may treat submissions confidentially, even where you have not requested this. Please note that the Committee’s inquiry cannot assist with individual cases. If you need help with an individual problem you are having, you may wish to read the information on Parliament’s website about who you can contact with different issues . Show less

18 Recommendations

9 Conclusions

1 Report

1 Oral session

4 Letters

1 Event

Activity timeline 8 events

21 May
2026

Correspondence

Letter to the Permanent Secretary at the Department for Health and Social Care relating to Cost of clinical negligence, 21 May 2026

7 Apr
2026

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Sity-fourth report from Session 2024-26

30 Jan
2026

Report published

64th Report - Costs of clinical negligence

12 Jan
2026

Correspondence

Letter from the Chief Financial Officer at NHS England relating to the Committee’s evidence session into Costs of Clinical Negligence on 20…

15 Dec
2025

Correspondence

Letter from the Permanent Secretary at the Department for Health and Social Care relating to the Committee’s evidence session on 20 Novembe…

15 Dec
2025

Correspondence

Letter from the Permanent Secretary at the Department for Health and Social Care relating to the DHSC-NHSE Transformation programme, 11 Dec…

20 Nov
2025

Oral evidence

Oral evidence session

20 Nov
2025

Formal meeting (oral evidence session) · Room 8, Palace of Westminster

Committee event

Oral evidence sessions 1 session

20 Nov 2025

View on parliament.uk

Elizabeth O'Mahony · Department of Health and Social Care Helen Vernon · NHS Resolution Professor Aidan Fowler · NHS England Samantha Jones · Department of Health and Social Care

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
64th Report - Costs of clinical negligence	HC 1234	30 Jan 2026	27	Responded

Recommendations & Conclusions

27 results

2 Recommendation Accepted

64th Report - Costs of clinical ne…

Establish a national framework for patient safety with clear targets and improved complaints system.

The NHS has not done enough to tackle the underlying causes of harm to patients. The Department and NHS England’s approach to patient safety lacks coordination. Patients often pursue legal action to get answers and accountability due to a confusing … Read more The NHS has not done enough to tackle the underlying causes of harm to patients. The Department and NHS England’s approach to patient safety lacks coordination. Patients often pursue legal action to get answers and accountability due to a confusing and unresponsive complaints system. Neither the Department nor NHS England know how 3 much cost the NHS incurs treating patients it has harmed each year, but research suggests it could be significant. There is also evidence to suggest that a better initial response to harm, such as timely apologies or explanations, could reduce both the number of claims and cost of clinical negligence. We were also told during our informal private roundtable that effective compassionate, local resolution is both ethically right and fiscally responsible. Recent reviews have found that the NHS is overwhelmed by safety recommendations that it cannot action and one person we spoke to as part of our roundtable referred to the NAO’s findings on this as the NHS drowning in recommendations. Despite the Department’s stated commitment to improve patient safety and reduce harm, it has yet to outline any of the specific measures it will take to achieve this. It is also not clear how the abolition of NHS England will impact future patient safety arrangements and the little progress made to date. recommendation a. The Department must set a national framework for improving patient safety with clear targets for annual improvement. b. The Department must review the NHS complaints system and improve the number of cases that are resolved without recourse to litigation. c. The Department should estimate and track the costs to the NHS of treating avoidable harm. d. The Department should write to the Committee to set out progress in implementing the Dash Review and its assessment of the impact of abolishing the Health Services Safety Investigations Body (HSSIB) on patient safety. e. The Department and NHS England should have a clear system of accountability fo Show less

Government Response

The government states it has already implemented a national patient safety framework (2a) and reviewed the complaints system (2b) through the NHS Patient Safety Strategy (2019). For estimating costs of avoidable harm (2c), it explains that comprehensive tracking is not feasible but can demonstrate costs avoided through safety improvement work.

HM Treasury

Costs of clinical negligence

Activity timeline 8 events

Oral evidence sessions 1 session

Reports 1 report · click to expand

Recommendations & Conclusions

Establish a national framework for patient safety with clear targets and improved complaints system.

Establish a national system for sharing and analysing clinical negligence data to improve patient safety.

Publish the Amos Review and outline concrete plans to reduce maternity care harm and costs.

Develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex claims.

Develop estimates and set out measures to prevent double payment for negligence care.

Past committees consistently raised concerns about rising clinical negligence costs.

Clinical negligence costs have soared and are projected to rise further.

High-value maternity brain injury claims drive significant clinical negligence costs.

Department unable to discuss policy due to ongoing clinical negligence review.

Patient safety system suffers from duplication and minimal improvement amidst reforms.

Unknown but significant cost of avoidable patient harm to health services.

Confusing and poorly handled patient complaints system hinders early resolution efforts.

Health system overwhelmed by patient safety recommendations, hindering affirmative action.

Insufficient use of NHS data resources for patient safety insights and improvement.

Lack of centralised learning causes repeated patient safety incidents across trusts.

NHS Resolution exploring AI to analyse negligence claims data for insights.

Costs for infant and child injury claims, particularly maternity brain injuries, significantly increased.

Increasing clinical negligence compensation for children driven by legal precedents and long-term care needs.

Long settlement times for child brain injury claims are being addressed by early notification scheme.

Maternity workforce struggles and poor planning contribute to rising clinical negligence claims.

Claimant legal fees for clinical negligence have significantly increased as a proportion of total.

Alternative dispute resolution successfully increases claims resolved without litigation, saving significant legal costs.

Legal costs for low-value clinical negligence claims are disproportionately high compared to damages.

Plans to limit lawyer fees for low-value clinical negligence claims are stalled.

Presumption of private care in clinical negligence awards leads to double public payments.

No clear data on clinical negligence claimants accessing public services post-compensation.

Debate over 1948 Act's private care presumption requires dedicated inquiry into double recovery.

Government Response AI assessment · 27 of 18 classified

Correspondence 4 letters