Clinical negligence harms learning
Clinical negligence litigation hindering patient safety learning by focusing on blame rather than system-wide analysis.
5,119 items
11 sources
8 inquiries
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
100match
#4 - Develop a plan to reduce patient harm and manage escalating clinical negligence costs.
It is unacceptable that the Department is yet to develop a plan to deal with the cost of clinical negligence claims, and so much taxpayers’ money is being spent on legal fees. The Department has set aside an astounding £58.2 billion to cover the potential costs of clinical negligence events occurring prior to 1 April 2024, the second...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#18 - 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 specific circumstances and to reflect differing needs throughout their remaining life. Compensation awards for these claims have also...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#3 - Establish a national system for sharing and analysing clinical negligence data to improve patient safety.
We are concerned there is far too little data on the factors behind clinical negligence, given its huge impact on people’s lives and NHS finances. Behind every clinical negligence claim is a tragic incident of patient harm. We were disappointed that neither the Department nor NHS England could adequately explain how the NHS uses its extensive data on...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#17 - Clinical negligence litigation inhibits learning culture and thorough investigations into serious incidents.
It is not within the scope of clinical negligence litigation to encourage the culture, or support the mechanisms, to identify learning from serious incidents. Neither can the process of litigation disseminate learning and enhance patient safety. Moreover, the experience of those who gave evidence to our inquiry illustrated that investigations after serious incidents are often inadequate and the...
Matched on
terms: clinical, learning, negligence
Committee recommendation
100match
#16 - Clinical negligence litigation hinders patient safety learning, contrasting with no-blame investigations.
Clinical negligence litigation stands in stark contrast to best practice in terms of patient safety. Gains are made by careful system-wide analysis rather than the search for individual blame. The creation of the Health Services Safety Investigations Body as a statutory body which will undertake no-blame safe space investigations maps out the direction of travel for reducing harm...
Matched on
terms: clinical, harm, learning, negligence
Committee recommendation
100match
#2 - Clinical negligence system hinders patient safety learning and improvement
Clinical negligence cannot and does not inform or disseminate learning or systematically contribute to patient safety improvements. It is not its purpose and too much information is filtered out at an early stage to ever make this a realistic prospect. Demonstrating individual fault is fundamental if compensation is to be awarded, but this is not a process consistent...
Matched on
terms: clinical, learning, negligence
Committee recommendation
100match
#1 - Clinical negligence system requires shift from punitive approach to encourage cooperation and learning.
In 2005 the New Zealand Parliament made a conscious choice to alter the legislation underpinning their system of clinical negligence because they wanted to change from a punitive system to one that would encourage the co-operation of hospitals and medical professionals. This is the lesson we need to learn in England. If NHS Trusts, medical professionals, patients and...
Matched on
terms: clinical, learning, negligence
Inquiry recommendation
98match
BRIS-119 - Abolish clinical negligence system, establish expert group for alternative patient compensation.
In order to remove the disincentive to open reporting and the discussion of sentinel events represented by the clinical negligence system, this system should be abolished. It should be replaced by an alternative system for compensating those patients who suffer harm arising out of treatment from the NHS. An expert group should be established to advise on the...
Matched on
terms: clinical, harm, negligence
Committee recommendation
98match
#4 - Publish the Amos Review and outline concrete plans to reduce maternity care harm and costs.
The Department’s failure to address problems with maternity care in England has led to avoidable harm and unnecessary costs. Over the last 20 years the cost of settling claims involving infants and children has increased significantly. In 2024–25, costs for claims involving brain injury at birth were £1,554 million, with the total cost of claims for paediatric failings...
Matched on
terms: clinical, harm, negligence
Committee recommendation
95match
#17 - Fourth Report - The safety of maternity services in England
It is clear to us that in its current form the clinical negligence process is failing to meet its objectives for both families and the healthcare system. Too often families are not provided with the appropriate, timely and compassionate support they deserve. For those delivering maternity care, the adversarial nature of litigation promotes a culture of blame instead...
Matched on
terms: clinical, learning, negligence
Committee recommendation
95match
#24 - Plans to limit lawyer fees for low-value clinical negligence claims are stalled.
The previous government announced plans to place limits on how much lawyers receive from lower damages clinical negligence claims of under £25,000 where 85% of cases fall within this category from April 2024, but 51 Q 50 52 C&AG’s Report, paras 2.12-2.13 53 Q 64 54 Q 67 55 C&AG’s Report, paras 3.12, 3.13 56 Q 64 57...
Matched on
terms: clinical, harm, negligence
Committee recommendation
95match
#8 - High-value maternity brain injury claims drive significant clinical negligence costs.
NHS Resolution told us that clinical negligence is putting pressure on NHS budgets and is a significant cost to the public purse. The Department told us the reasons for the rising costs were complex. NHS Resolution explained that the increasing costs of compensation for claims of £1 million in damages or more is a major contributing factor. Those...
Matched on
terms: clinical, harm, negligence
Committee recommendation
94match
#11 - 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% of their health expenditure each year, on which basis the costs in England could run to tens of...
Matched on
terms: clinical, harm, negligence
Committee recommendation
94match
#4 - Set out by summer 2024, key reasons and actions to reduce clinical patient harm.
We are concerned that the Department is spending £2.6 billion on clinical negligence payments without an effective plan to minimise future costs of the scheme. Incidences of clinical negligence continue to result in significant cost to the taxpayer, particularly in maternity settings. The Department has made provisions in its accounts worth over £21 billion to cover the potential...
Matched on
terms: clinical, harm, negligence
Committee recommendation
93match
#17 - Department fails to outline specific actions for reducing patient harm and improving safety.
The previous Committee were concerned that the Department was spending billions of pounds of taxpayers’ money without an effective plan to minimise future costs of the clinical negligence scheme.25 In April 2024, the Committee recommended that, by summer 2024, “the Department should set out the key reasons for patient harm and the actions it will take to address...
Matched on
terms: clinical, harm, negligence
Inquiry recommendation
93match
BRIS-37 - Urgently review compensation system for medical harm, replacing clinical negligence
There should be an urgent review of the system for providing compensation to those who suffer harm arising out of medical care. The review should be concerned with the introduction of an administrative system for responding promptly to patients’ needs in place of the current system of clinical negligence and should take account of other administrative systems for...
Matched on
terms: clinical, harm, negligence
Committee recommendation
92match
#20 - NHS clinical negligence costs significantly exceed international comparators, lacking litigation trend data.
The Department recognised that each incidence of clinical negligence is a tragedy for an individual and their families.31 They also come with a monetary cost to the taxpayer, in compensation payments for pain suffered and the impact on people’s everyday lives. The Department sets money aside in its accounts which it can use to fund compensation payments in...
Matched on
terms: clinical, negligence
Committee recommendation
91match
#20 - 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 use of instruments such as forceps.47 Similarly, evidence from Sands and Tommy’s Joint Policy Unit raised concerns that...
Matched on
terms: clinical, negligence
Inquiry recommendation
90match
IHRD-94 - Clinical Negligence Litigation Reform
The interests of patient safety must prevail over the interests engaged in clinical negligence litigation. Such litigation can become an obstacle to openness. A government committee should examine whether clinical negligence litigation as it presently operates might be abolished or reformed and/or whether appropriate alternatives can be recommended.
Matched on
terms: clinical, negligence
Committee recommendation
87match
#15 - Clinical negligence cases impose significant monetary costs on taxpayers, totalling £2.8 billion.
The Department recognised that each incidence of clinical negligence has a tragedy behind it involving a patient. It told us that while the optimal number of clinical negligence cases would be zero, this will never be a practical target. Clinical negligence also comes with a monetary cost to the taxpayer. The Department is required to make compensation payments...
Matched on
terms: clinical, negligence
Committee recommendation
87match
#25 - Presumption of private care in clinical negligence awards leads to double public payments.
The government may effectively be paying twice in some instances of clinical negligence, once through the compensation given to claimants and once again through providing NHS treatment and publicly funded social care. Section 2(4) of the Law Reform (Personal Injuries) Act 1948 provides that defendants who pay for the future healthcare and treatment of damaged patients must do...
Matched on
terms: clinical, negligence
Committee recommendation
86match
#30 - Clinical negligence framework focused on individual blame hinders early fault admission and settlement.
It is understandable that representatives of injured patients should wish to see fault admitted and cases settled early, but the statutory framework on which clinical negligence is based makes this very difficult. Clinical negligence is focused on individual blame, therefore, it is unsurprising that within this process individual clinicians will seek to defend their actions, protect their reputations...
Matched on
terms: clinical, negligence
Committee recommendation
86match
#4 - Establish an independent administrative body to investigate patient harm and determine compensation
The system for compensating injured patients in England is not fit for purpose. It is grossly expensive, adversarial, and promotes individual blame instead of collective learning. We recommend that when a patient is harmed, they or their family should be able to approach an independent administrative body which would investigate their case and determine whether the harm was...
Matched on
terms: harm, learning
Committee recommendation
83match
#18 - Significant proportion of clinical negligence compensation payments diverted to claimants' lawyers.
The Department told us that around 19% of the total compensation payments made in 2023–24 by NHS Resolution go to the claimants’ lawyers. This equates to £536 million of the total £2.8 billion paid to claimants in 2023–24 , which is over one–and–a–half times the amount spent by the Government Legal Department (the government’s principal legal advisers) in...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#16 - Department's clinical negligence liability reaches £58.2 billion, ranking second largest across government.
The Department recognises an amount for potential future compensation payments for incidents of clinical negligence in its financial statements as a liability. This is reported in the accounts of NHS Resolution and is consolidated into the Departmental Group accounts. The Department recognised a liability of £58.2 billion in its 2023–24 accounts to cover the expected potential future costs...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#23 - Legal costs for low-value clinical negligence claims are disproportionately high compared to damages.
Around three-quarters of clinical negligence claims settle for £25,000 or less, but the legal costs for these claims vastly exceed the damages payable to claimants. In 2024–25, there was a 3.7:1 ratio of claimant and NHS legal costs compared with damages payable for low-value claims.58 NHS Resolution agreed that legal costs were disproportionate for low-value cases.59
Matched on
terms: clinical, negligence
Committee recommendation
83match
#21 - Claimant legal fees for clinical negligence have significantly increased as a proportion of total.
Claimant legal fees have increased in real terms from £148 million in 2006–07 (in 2024–25 prices) to £538 million in 2024–25 and now represent 15% of all settled costs. During the same period, NHS’s legal costs increased in real terms from £76 million to £159 million, but fell as a share of total settled costs (from 7% to...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#7 - Clinical negligence costs have soared and are projected to rise further.
Clinical negligence is the second largest provision on the government balance sheet after nuclear decommissioning. Over the period 2006–07 to 2024–25, the total provision for clinical negligence increased by £45.6 billion in real terms, from £14.4 billion at 31 March 2007 to £60.0 billion at 31 March 2025. Since 2006–07, the annual cost of settling claims has increased...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#1 - Past committees consistently raised concerns about rising clinical negligence costs.
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), NHS England and NHS Resolution on the costs of clinical negligence.1 Our predecessor committees reported on clinical negligence in 2002 and 2017, and both this Committee and our immediate predecessor raised further concerns...
Matched on
terms: clinical, negligence
Committee recommendation
81match
#6 - Develop estimates and set out measures to prevent double payment for negligence care.
Clinical negligence claims are settled on the basis of costs of care in the private sector and yet there is nothing to stop the claimant using the NHS or publicly funded social care in the future, potentially inflating the costs of claims. It is not clear the extent to which the taxpayer is paying twice for clinical negligence...
Matched on
terms: clinical, harm, negligence
Inquiry recommendation
78match
IHRD-40 - SAI Learning Informing Clinical Audit
Learning and trends identified in SAI investigations should inform programmes of clinical audit.
Matched on
terms: clinical, learning
Committee recommendation
78match
#21 - Maternity and neonatal cases account for 65% of £69.3 billion clinical negligence liability.
NHS Resolution’s 2022–23 accounts include a liability of £69.3 billion to cover the potential costs of clinical negligence. Of this, £45 billion, some 65% of the £69.3 billion total, related to maternity and neonatal liabilities. The Department told us that this was not unusual across international comparators and reflected the severe and lifelong impact of such events on...
Matched on
terms: clinical, negligence
Committee recommendation
76match
#20 - Fourth Report - The safety of maternity services in England
We recommend that following that review, the Department brings forward proposals for litigation reforms that award compensation for maternity cases based on whether an incident was avoidable rather than a requirement to prove clinical negligence. That approach would allow families to access compensation without the need for the courts in the vast majority of cases and establish a...
Matched on
terms: clinical, negligence
Committee recommendation
76match
#9 - Administrative compensation system reduces adversarial process and lowers overall costs
The advantage of an administrative system is that criteria can be established to remove uncertainty and turn what otherwise would be an adversarial process into one concerned only with the facts of the case. Compensation should be based on agreement that correct procedures were not followed and the system failed to perform, rather than the higher threshold that...
Matched on
terms: clinical, negligence
Committee recommendation
72match
#5 - Develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex claims.
Legal costs in clinical negligence claims are disproportionate for medium and low volume claims. Legal costs in clinical negligence claims have risen sharply, with claimant legal fees increasing in real terms from £148 million in 2006–07 (in 2024–25 prices) to £538 million in 2024–25. At 19% of total settled claim costs it is unacceptable that so much taxpayers’...
Matched on
terms: clinical, negligence
Committee recommendation
72match
#18 - Reform investigatory system by establishing standardised, time-limited, independent investigations after medical errors.
Aside from the substantive reform of clinical negligence litigation that we have recommended, we also believe that the investigatory system should be reformed. After any tragedy involving medical error there should be a standardised process of investigation which focuses on the overriding priority to learn from mistakes and prevent tragedies being repeated. We recommend that, at a minimum,...
Matched on
terms: clinical, negligence
Committee recommendation
72match
#24 - Patients prefer simpler administrative compensation, which should be the mandatory first port of call.
Although our system would be no less generous in its awards than the courts, patients would still retain the option of pursuing clinical negligence cases and seeking redress via litigation. Evidence from abroad indicates, however, that when given the choice, patients and families prefer the simpler administrative process. We believe that the administrative system should be the mandatory...
Matched on
terms: clinical, negligence
PFD report
69match
Casey Garrett
Inappropriate midwifery care by a student and midwife, including insufficient fetal monitoring, misinterpretation of CTG, and failure to escalate, led to an infant's death and raised questions about the hospital's clinical learning environment.
Matched on
terms: clinical, learning
Committee recommendation
68match
#10 - Thirty-Seventh Report - Whole of Government Accounts 2018–19
Regarding the provision for clinical negligence, the WGA shows a levelling off of new cases and explains that in the second year of its new strategy to tackle clinical negligence laid out in April 2017, NHS Resolution mediated 380 cases, or 110% more than the previous year.20 We asked the Treasury what progress was being made to control...
Matched on
terms: clinical, negligence
Committee recommendation
68match
#27 - Transition to an administrative system to avoid intensive legal support and lottery of representation.
In the system we recommend, someone with a claim would not need intensive legal support as their claim would be evaluated inquisitorially without months or years of toil to demonstrate clinical negligence. It is also important to note that there is no guarantee that someone will find a solicitor equipped to provide them with the support and guidance...
Matched on
terms: clinical, negligence
PFD report
65match
Frances Bell
The investigation lacked a Root Cause Analysis and senior clinical input, coupled with unacceptable delays in patient transfer to theatre for critical treatment.
Matched on
terms: clinical
Committee recommendation
65match
#19 - 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 was taking to try to manage the cost of maternity claims. In response, NHS Resolution told us it...
Matched on
terms: clinical, negligence
Committee recommendation
64match
#21 - Second Report - NAO financial audit insights 2024–25
HMT acknowledged that clinical negligence had a significant impact on overall levels of compensation in terms of the high amounts paid each year, but noted there would inevitably always be clinical negligence in the health system.47 HMT informed us that clinical negligence will be reviewed by the Department of Health and Social Care as part of the upcoming...
Matched on
terms: clinical, negligence
Committee recommendation
64match
#19 - Fourth Report - The safety of maternity services in England
While the review of the negligence system is underway, we recommend the Department must implement the Rapid Redress and Resolution Scheme in full. We also recommend the Department provides the Committee with the scope and timetable for its review of clinical negligence by September 2021.
Matched on
terms: clinical, negligence
PFD report
61match
Margaret Theresa Corrigan
Ineffective communication, a missed fracture diagnosis in the Emergency Department, and inappropriate ward placement for medical issues contributed to patient harm. Procedural errors, such as issuing an outpatient appointment to an inpatient, were also noted.
Matched on
terms: harm
PFD report
61match
Wilfred Aspinwall
Healthcare provider at HMP Liverpool did not receive critical PPO and Clinical Review reports, hindering effective implementation of recommendations for prison fatalities.
Matched on
terms: clinical
PFD report
61match
Esther Jones
Significant delays in completing Serious Incident Reviews (SIRs) and disseminating lessons learned prevent timely improvements and risk further patient harm.
Matched on
terms: harm
PFD report
61match
Eileen Smith
The report detailed gross failings of nursing care for a patient with a learning disability and highlighted the risk of making assumptions about health based on external appearance, stressing the need for better communication with carers.
Matched on
terms: learning
LGO / SPSO decision
60match
PSOW-202005974 - Swansea Bay University Health Board
Mrs A complained about the Health Board’s management of her miscarriage (pregnancy loss) in January2020. Mrs A said that the Health Board failed to identify her miscarriage when she first presented with symptoms, to carryout an ultrasound scan to confirm that the miscarriage had fully completed, to advise her when to seek advice for complications, and to provide...
Matched on
terms: clinical, learning
Committee recommendation
60match
#31 - Ensure adequate hospital staff are trained in 'just culture' to reduce confrontation and breakdown.
NHS staff, injured patients and families need greater support in dealing with the fallout from clinical negligence cases. We recommend that every hospital should have adequate numbers of staff trained in “just culture” practices to reduce confrontation and relationship breakdown between injured patients, their relatives, and bereaved families.
Matched on
terms: clinical, negligence