Source · Select Committees · Public Accounts Committee
Recommendation 18
18
Accepted
Increasing clinical negligence compensation for children driven by legal precedents and long-term care needs.
Recommendation
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 increased due to new precedents set by the courts, for example around access to innovative or novel treatment options.38 NHS Resolution told us that these changing precedents have driven up costs over time.39 One participant in our roundtable questioned whether the current tort based legal system was fit for purpose and whether there should be changes. Others suggested possible lessons to be learned from the private sector and how commercial insurers go about assessing high value claims. It was also suggested that an amendment to the Pre-Action protocol to better reflect the complexities of clinical negligence claims by providing a more realistic framework than it currently does for the investigation of those claims.40 Secondly, adopting 36 C&AG’s Report, paras 8, 2.19-2.10 37 Q 35 38 C&AG’s Report, paras 1.11, 2.8 39 Q 35 40 Pre-Action Protocol for the Resolution of Clinical Disputes – Civil Procedure Rules – Justice UK, updated March 2024 14 a similar approach to rehabilitation, specifically the Rehabilitation code.41 Also, the cost of expert reports in clinical negligence average £3,100 and quite often two reports are needed. Significantly we heard about the case of Wiseman, currently before the Supreme Court relating to lost years.42 We await the outcome of this case to understand its implications.
Government Response Summary
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.
Government Response
Accepted
HM Government
Accepted
4. PAC conclusion: The Department's failure to address problems with maternity care in England has led to avoidable harm and unnecessary costs. 4a. PAC recommendation: The Department and the organisations it funds need to learn lessons from its failure to improve maternity care in England. Where problems arise the Department and the wider NHS should look for systemic failings in care and tackle these problems at their cause. 4.1 The government agrees with the Committee’s recommendation Target implementation date: Winter 2026-27 4.2 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. The Investigation will bring together the findings of past reviews into one clear national set of recommendations, including local investigations of maternity and neonatal services in selected trusts. 4.3 The National Maternity and Neonatal Taskforce, chaired by Secretary of State, will transform the Investigation’s recommendations into a new national action plan to drive real change. 4.4 DHSC is not waiting for the recommendations to improve services. NHS England’s Medium-Term Planning Framework sets out the requirement for all Integrated Care Boards and providers to take immediate steps to improve care, ensuring that progress is already underway ahead of the national action plan. 4.5 The introduction of best practice resources, including the maternal care bundle, new approaches to avoiding brain injury, a new maternity triage specification and roll out of the Perinatal Equity and Anti-Discrimination Programme, will help improve safety and consistency across services. NHSR’s Maternity Incentive Scheme continues to work with trusts to deliver safer maternity care and reduce cases of brain injuries or other harm. 4.6 The Maternity Outcomes Signal System, has been implemented across all trusts from November 2025, allowing near real time monitoring of key indicators and prompt timely safety reviews. 4.7 In January 2026 the Maternity and Neonatal Inequalities Data Dashboard was published, which will give leaders clearer insight into variation and emerging risks.