Legal claims against NHS continue to rise

New report shows that legal claims against the NHS continue to rise – with the cost of clinical negligence reaching an ‘all-time high’ according to NHS Resolution

NHS Resolution has released its 2017/18 annual report and accounts; the results show that the organisation mediated more claims that year than in its entire history.

Legal claims against primary care practices and hospitals led to the NHS paying out over £1.63bn in damages – up from £1.08bn in 2016/17. £404m of that increase was simply due to a change in the personal injury discount rate. Legislation to address this is currently under parliamentary discussion.

While the latest costs were extremely high, they were at least accompanied by the first reduction in claimant legal costs in many years. This is due to changes made to NHS Resolution’s processes as part of its five-year strategy.

“The cost of clinical negligence is at all-time high,” says Helen Vernon, chief executive of NHS Resolution.

“The total provisions for all of our indemnity schemes continue to rise from £65bn last year to £77bn as of March 31, 2018, which brings a renewed urgency to efforts across government to tackle the drivers of that cost.”

Some of the other main points of the report are as follows:

  • The number of new clinical negligence claims reported in 2017/18 was 10,673, compared to 10,686 received in 2016/17 – a reduction of 13 claims (0.12%).
  • The total payments relating to NHS Resolution’s clinical schemes increased by £520.4m (30%), from £1,707.2bn to £2,227.5bn.
  • Damages paid to patients rose significantly from £1,083.0bn to £1,632.0bn – an increase of 50%.
  • The number of non-clinical claims fell to 3,570 from 4,082 (a 13% decrease).
  • The majority of claims received (69.6% up from 67.8% the previous year) were resolved without formal court proceedings and, in those early stages, more claims are resolved without payment of damages than with payment of damages.
  • Just under one-third of claims end up in litigation with less than one per cent going to a full trial (where most end in judgment in favour of the NHS).

While the majority of claims made are related to emergency medicine, orthopaedic surgery and A&E, the primary care sector receives a share of legal battles – Primary Care Appeals (formerly the Family Health Services Appeal Unit or FHSAU) offers an impartial tribunal service for the fair handling of primary care contracting disputes.

Dr Christine Tomkins, Medical Defence Union chief executive weighed in on the report.

“The cost of clinical negligence claims continues to spiral out of control.

“NHS Resolution chair Ian Dilks attributes much of the additional liabilities to the fall in the personal injury discount rate (PIDR) from March 2017. The MDU has seen the dramatic effect of the 3.25% PIDR decrease on GP claims too.

“These increases in claims payments are nothing to do with the quality of clinical care, which remains high. They are a result of a hostile legal climate. Awards of this size, paid from NHS funds, are damaging for everyone who uses the NHS and cannot be sustained if we want the NHS to survive.

“The government is listening. Following criticism from both the National Audit Office and the House of Commons Public Accounts Committee, the Department of Health and Social Care convened a working group to look at the how to manage the cost of clinical negligence to the NHS. But what we now need, in the interest of all users of the NHS, is urgent legal reform.

“It would be a fitting birthday present for the NHS if balance could be restored to a system which is so out of kilter, it is putting the NHS under unbearable strain.”

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