Source · Select Committees · Public Accounts Committee
Recommendation 22
22
Deferred
Alternative dispute resolution successfully increases claims resolved without litigation, saving significant legal costs.
Conclusion
Over the last 10 years, NHS Resolution has introduced several new approaches to help keep claims out of court. These alternative dispute resolution initiatives are typically less adversarial and more collaborative than conventional litigation and provide greater opportunities for claimants seeking non-monetary redress such as an explanation or apology. The proportion of claims resolved without litigation has also increased from 66% in 2016–17 to a record high of 83% in 2024–25.55 NHS Resolution told us keeping a case out of litigation saves on average £96,000 in claimant legal costs.56 The increased use of mediation and alternative dispute resolution has been praised and encouraged by legal stakeholders.57
Government Response Summary
DHSC, working with David Lock KC, is considering alternative dispute resolution mechanisms. The government will write to the Committee by Autumn 2026 to set out the case for change.
Government Response
Deferred
HM Government
Deferred
The Committee’s recommendation is under consideration by the government. Target implementation date: to be advised DHSC, working with David Lock KC, is considering alternative dispute resolution mechanisms and ways to reduce costs for less complex cases and speed up resolution. Disproportionate legal costs for low value claims is a key concern in this area of work. For the smallest/lowest value claims, payments to lawyers for processing claims can be over 10 times the compensation for the patient. For claims with a damages value under £50,000, a total of £184 million is spent on lawyers’ fees each year and only £70 million goes to patients as compensation. DHSC is also taking account of international examples to see what lessons can be learned about resolving claims outside litigation, but it remains important to note that other countries’ healthcare and legal systems are not directly analogous to the NHS in England and the English legal system. The government will write to the Committee by this Autumn 2026 to set out the case for change and provide additional information on the department’s intentions. However, specific policy proposals, like alternative dispute mechanisms, remain under consideration within government at this time.