Select committee: Public Accounts Committee
Recommendation 2
64th Report - Costs of clinical negligence
Published 30 Jan 2026
Addressed to HM Treasury
Public Accounts Committee Costs of clinical negligence All items in this report Report on parliament.uk ↗ Inquiry on parliament.uk ↗
Recommendation (the committee's words)
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
From: Public Accounts Committee, 64th Report - Costs of clinical negligence (HC 1234), 30 January 2026
Government response
The government responded to the whole report on 7 April 2026 (deadline 30 March 2026).
Summary written by Accountability Index from the government's response. It is not the government's own words.The government agrees with the Committee's recommendation to set out an operational plan on clinical negligence, disagrees with others, and has some recommendations "under consideration".
- It agrees to write to the Committee "by this Autumn" with its workplan, key milestones and likely areas of focus for reform, but "disagrees" with publishing David Lock KC's review, saying it has "no current plans" to publish a separate report.
- It "disagrees" with estimating and tracking the costs of treating avoidable harm, stating it "would not be financially or logistically feasible", and "disagrees" with a new national data-sharing system, saying "there is already data sharing arrangements in place".
- On maternity, it agrees with the recommendation to learn lessons. Baroness Amos has confirmed the independent investigation will publish its final report in June 2026, and a National Maternity and Neonatal Taskforce will develop a national action plan.
- Alternative dispute mechanisms and fixed recoverable costs are "under consideration", and the government is "unable to commit" to the six-month timeframe for double recovery estimates. It will write to the Committee by Autumn 2026 on each.