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

10 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

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10 Recommendation Accepted

64th Report - Costs of clinical ne…

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

The NHS reports around 2.4 million patient safety incidents annually, most of which (70%) cause no harm to patients, but around 0.5% of patient safety incidents result in severe harm or death. The 2025 Dash review identified considerable overlap and … Read more

Government Response

The government states that the NHS Patient Safety Strategy (2019) already provides a national framework. They will update this strategy in 2026.

HM Treasury

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11 Recommendation Accepted

64th Report - Costs of clinical ne…

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

The cost to health services of treating cases involving clinical negligence specifically or cases of avoidable harm to patients is unknown. The Organisation for Economic Co-operation and Development estimates that treating cases where harm was avoidable costs developed countries 8.7% … Read more

Government Response

The government agrees to set a national framework for improving patient safety, but claims the NHS Patient Safety Strategy (2019) already sets such a framework and is achieving significant impact.

HM Treasury

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12 Recommendation Accepted

64th Report - Costs of clinical ne…

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

The 2025 Dash review of patient safety found that the current system for raising complaints and concerns is confusing, with issues often poorly handled and patients subject to delays and poor-quality responses. Research commissioned by NHS Resolution found that improving … Read more

Government Response

The government agrees to review the NHS complaints system and improve the number of cases resolved without litigation, aiming for implementation by Summer 2028, including updating complaints regulations and increasing use of AI.

HM Treasury

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13 Recommendation Accepted

64th Report - Costs of clinical ne…

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

In 2024, the Health Services Safety Investigations Body reported that the broader health system was drowning in patient safety recommendations rather than taking affirmative actions to improve it.26 NHS England told us that there are over 1,500 recommendations in the … Read more

Government Response

NHS England is required to collect information about what goes wrong in the health service and use this to provide advice and guidance and has introduced the Patient Safety Incident Response Framework (PSIRF) which is a contractual obligation for all Trusts.

HM Treasury

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16 Recommendation Accepted

64th Report - Costs of clinical ne…

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

Some clinical negligence firms are reportedly using artificial intelligence to triage claims more efficiently and effectively. NHS Resolution holds almost 30 years of experience and data concerning compensation claims.33 NHS Resolution told us it is starting to explore how technology … Read more

Government Response

NHS England is developing and evaluating AI models on Learn from Patient Safety Events (LFPSE) data to identify discrepancies and emerging themes and is assessing the feasibility of enabling secure, real-time analytics via the Federated Data Platform (FDP) to underpin a scalable national infrastructure for AI assisted safety surveillance.

HM Treasury

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17 Recommendation Accepted

64th Report - Costs of clinical ne…

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

Over the last 20 years the cost of settling claims involving infants and children has increased significantly. The highest-value claims are typically those associated with brain injuries suffered in maternity care. In 2024–25, costs for these claims were £1,554 million, … Read more

Government Response

The government agrees to learn lessons from failures in maternity care and address systemic failings, aiming for implementation by Winter 2026-27, including a national investigation, the National Maternity and Neonatal Planning Framework, best practice resources, and the Maternity Outcomes Signal System.

HM Treasury

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18 Recommendation Accepted

64th Report - Costs of clinical ne…

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

NHS Resolution told us that harmed children require care costs for decades into the future.37 Damages can include compensation for pain and suffering, care costs, future lost earnings, educational support and accommodation adaptations. They are calculated based on a claimant’s … Read more

Government Response

The Secretary of State announced a rapid, national, independent investigation into NHS maternity and neonatal care to help understand the systemic issues behind why so many women, babies and families experience unacceptable care and will bring together the findings of past reviews into one clear national set of recommendations.

HM Treasury

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19 Recommendation Accepted

64th Report - Costs of clinical ne…

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

NHS Resolution told us it settles around 120 to 130 brain injury cases involving children every year, but historically it has taken an average of 11 or 12 years to settle each claim.43 We asked NHS Resolution what action it … Read more

Government Response

HM Treasury

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20 Conclusion Accepted

64th Report - Costs of clinical ne…

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

Evidence from the Royal College of Obstetricians and Gynaecologists suggested that the maternity workforce is struggling under the pressure of delivering increasingly complex care, with more than half of births involving medical intervention, such as a caesarean section or the … Read more

Government Response

HM Treasury

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Government Response AI assessment · 27 of 18 classified

Accepted 10

Accepted in Part 2

Acknowledged 2

Deferred 10

Not Addressed 1

Rejected 2

Total 18 recs + 9 conclusions

Correspondence 4 letters

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

Parliament page

12 Jan 2026 To committee Letter from the Chief Financial Officer at NHS England relating to the Committee’s evidence session into Costs of Clinical Negligence on 20 November 2025, 06 January 2026

Parliament page

15 Dec 2025 To committee Letter from the Permanent Secretary at the Department for Health and Social Care relating to the Committee’s evidence session on 20 November on Costs of clinical negligence, 04 December 2025

Parliament page

15 Dec 2025 To committee Letter from the Permanent Secretary at the Department for Health and Social Care relating to the DHSC-NHSE Transformation programme, 11 December 2025

Parliament page