Select Committee · Public Accounts Committee

Costs of clinical negligence

Status: Open Opened: 10 Jul 2025 18 recommendations 9 conclusions 1 report

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’ …

Clear

Reports

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

Recommendations & Conclusions

10 items
2 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 and unresponsive complaints system. Neither the Department nor NHS England …

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 …
HM Treasury
10 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 duplication in the current patient safety landscape with relatively little …

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
11 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 …

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
12 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 the NHS’s initial response to harmful incidents could reduce the …

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
13 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 system and that managing those centrally is a huge task. …

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 …
HM Treasury
16 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 can mine its database to learn more about how claims …

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 …
HM Treasury
17 Recommendation 64th Report - Costs of clinical neglige… Accepted

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, and costs for paediatric claims were £325 million.36

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 …
HM Treasury
18 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 …

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 …
HM Treasury
19 Recommendation 64th Report - Costs of clinical neglige… Accepted

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 …

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 …
HM Treasury
20 Conclusion 64th Report - Costs of clinical neglige… Accepted

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 …

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 …
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
20 Nov 2025 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 View ↗

Correspondence

4 letters
DateDirectionTitle
21 May 2026 From cttee Letter to the Permanent Secretary at the Department for Health and Social Care …
12 Jan 2026 To cttee Letter from the Chief Financial Officer at NHS England relating to the Committe…
15 Dec 2025 To cttee Letter from the Permanent Secretary at the Department for Health and Social Car…
15 Dec 2025 To cttee Letter from the Permanent Secretary at the Department for Health and Social Car…