Clinical negligence harms learning
Clinical negligence litigation hindering patient safety learning by focusing on blame rather than system-wide analysis.
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
100match
#4 - Develop a plan to reduce patient harm and manage escalating clinical negligence costs.
It is unacceptable that the Department is yet to develop a plan to deal with the cost of clinical negligence claims, and so much taxpayers’ money is being spent on legal fees. The Department has set aside an astounding £58.2 billion to cover the potential costs of clinical negligence events occurring prior to 1 April 2024, the second...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#18 - 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 life. Compensation awards for these claims have also...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#3 - Establish a national system for sharing and analysing clinical negligence data to improve patient safety.
We are concerned there is far too little data on the factors behind clinical negligence, given its huge impact on people’s lives and NHS finances. Behind every clinical negligence claim is a tragic incident of patient harm. We were disappointed that neither the Department nor NHS England could adequately explain how the NHS uses its extensive data on...
Matched on
terms: clinical, harm, negligence
Committee recommendation
100match
#17 - Clinical negligence litigation inhibits learning culture and thorough investigations into serious incidents.
It is not within the scope of clinical negligence litigation to encourage the culture, or support the mechanisms, to identify learning from serious incidents. Neither can the process of litigation disseminate learning and enhance patient safety. Moreover, the experience of those who gave evidence to our inquiry illustrated that investigations after serious incidents are often inadequate and the...
Matched on
terms: clinical, learning, negligence
Committee recommendation
100match
#16 - Clinical negligence litigation hinders patient safety learning, contrasting with no-blame investigations.
Clinical negligence litigation stands in stark contrast to best practice in terms of patient safety. Gains are made by careful system-wide analysis rather than the search for individual blame. The creation of the Health Services Safety Investigations Body as a statutory body which will undertake no-blame safe space investigations maps out the direction of travel for reducing harm...
Matched on
terms: clinical, harm, learning, negligence
Committee recommendation
100match
#2 - Clinical negligence system hinders patient safety learning and improvement
Clinical negligence cannot and does not inform or disseminate learning or systematically contribute to patient safety improvements. It is not its purpose and too much information is filtered out at an early stage to ever make this a realistic prospect. Demonstrating individual fault is fundamental if compensation is to be awarded, but this is not a process consistent...
Matched on
terms: clinical, learning, negligence
Committee recommendation
100match
#1 - Clinical negligence system requires shift from punitive approach to encourage cooperation and learning.
In 2005 the New Zealand Parliament made a conscious choice to alter the legislation underpinning their system of clinical negligence because they wanted to change from a punitive system to one that would encourage the co-operation of hospitals and medical professionals. This is the lesson we need to learn in England. If NHS Trusts, medical professionals, patients and...
Matched on
terms: clinical, learning, negligence
Inquiry recommendation
98match
BRIS-119 - Abolish clinical negligence system, establish expert group for alternative patient compensation.
In order to remove the disincentive to open reporting and the discussion of sentinel events represented by the clinical negligence system, this system should be abolished. It should be replaced by an alternative system for compensating those patients who suffer harm arising out of treatment from the NHS. An expert group should be established to advise on the...
Matched on
terms: clinical, harm, negligence
Committee recommendation
98match
#4 - Publish the Amos Review and outline concrete plans to reduce maternity care harm and costs.
The Department’s failure to address problems with maternity care in England has led to avoidable harm and unnecessary costs. Over the last 20 years the cost of settling claims involving infants and children has increased significantly. In 2024–25, costs for claims involving brain injury at birth were £1,554 million, with the total cost of claims for paediatric failings...
Matched on
terms: clinical, harm, negligence
Committee recommendation
95match
#17 - Fourth Report - The safety of maternity services in England
It is clear to us that in its current form the clinical negligence process is failing to meet its objectives for both families and the healthcare system. Too often families are not provided with the appropriate, timely and compassionate support they deserve. For those delivering maternity care, the adversarial nature of litigation promotes a culture of blame instead...
Matched on
terms: clinical, learning, negligence
Committee recommendation
95match
#24 - Plans to limit lawyer fees for low-value clinical negligence claims are stalled.
The previous government announced plans to place limits on how much lawyers receive from lower damages clinical negligence claims of under £25,000 where 85% of cases fall within this category from April 2024, but 51 Q 50 52 C&AG’s Report, paras 2.12-2.13 53 Q 64 54 Q 67 55 C&AG’s Report, paras 3.12, 3.13 56 Q 64 57...
Matched on
terms: clinical, harm, negligence
Committee recommendation
95match
#8 - High-value maternity brain injury claims drive significant clinical negligence costs.
NHS Resolution told us that clinical negligence is putting pressure on NHS budgets and is a significant cost to the public purse. The Department told us the reasons for the rising costs were complex. NHS Resolution explained that the increasing costs of compensation for claims of £1 million in damages or more is a major contributing factor. Those...
Matched on
terms: clinical, harm, negligence
Committee recommendation
94match
#11 - 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 costs in England could run to tens of...
Matched on
terms: clinical, harm, negligence
Committee recommendation
94match
#4 - Set out by summer 2024, key reasons and actions to reduce clinical patient harm.
We are concerned that the Department is spending £2.6 billion on clinical negligence payments without an effective plan to minimise future costs of the scheme. Incidences of clinical negligence continue to result in significant cost to the taxpayer, particularly in maternity settings. The Department has made provisions in its accounts worth over £21 billion to cover the potential...
Matched on
terms: clinical, harm, negligence
Committee recommendation
93match
#17 - Department fails to outline specific actions for reducing patient harm and improving safety.
The previous Committee were concerned that the Department was spending billions of pounds of taxpayers’ money without an effective plan to minimise future costs of the clinical negligence scheme.25 In April 2024, the Committee recommended that, by summer 2024, “the Department should set out the key reasons for patient harm and the actions it will take to address...
Matched on
terms: clinical, harm, negligence
Inquiry recommendation
93match
BRIS-37 - Urgently review compensation system for medical harm, replacing clinical negligence
There should be an urgent review of the system for providing compensation to those who suffer harm arising out of medical care. The review should be concerned with the introduction of an administrative system for responding promptly to patients’ needs in place of the current system of clinical negligence and should take account of other administrative systems for...
Matched on
terms: clinical, harm, negligence
Committee recommendation
92match
#20 - NHS clinical negligence costs significantly exceed international comparators, lacking litigation trend data.
The Department recognised that each incidence of clinical negligence is a tragedy for an individual and their families.31 They also come with a monetary cost to the taxpayer, in compensation payments for pain suffered and the impact on people’s everyday lives. The Department sets money aside in its accounts which it can use to fund compensation payments in...
Matched on
terms: clinical, negligence
Committee recommendation
91match
#20 - 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 and Tommy’s Joint Policy Unit raised concerns that...
Matched on
terms: clinical, negligence
Inquiry recommendation
90match
IHRD-94 - Clinical Negligence Litigation Reform
The interests of patient safety must prevail over the interests engaged in clinical negligence litigation. Such litigation can become an obstacle to openness. A government committee should examine whether clinical negligence litigation as it presently operates might be abolished or reformed and/or whether appropriate alternatives can be recommended.
Matched on
terms: clinical, negligence
GIRFT recommendation
89match
Respiratory Medicine
Reduce litigation costs by application of the GIRFT five-point plan. Share learning by ensuring claims, inquests and complaints are reviewed in regular M&M meetings. a) Assess benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT 'Litigation data pack'. b) Discuss with the legal...
Matched on
terms: clinical, learning, negligence
GIRFT recommendation
89match
Pathology
Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their litigation claims covered under Clinical Negligence Scheme for Trust (CNST) notified to the trust over the last five years. b Clinicians and trust management to discuss with the legal department or claims handler the claims submitted to NHS Resolution...
Matched on
terms: clinical, learning, negligence
GIRFT recommendation
89match
Mental Health – Adult Crisis and Acute Care
Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their litigation claims covered under Clinical Negligence Scheme for Trust (CNST) notified to the trust over the last five years. b Clinicians and trust management to discuss with the legal department or claims handler the claims submitted to NHS Resolution...
Matched on
terms: clinical, learning, negligence
Committee recommendation
87match
#15 - Clinical negligence cases impose significant monetary costs on taxpayers, totalling £2.8 billion.
The Department recognised that each incidence of clinical negligence has a tragedy behind it involving a patient. It told us that while the optimal number of clinical negligence cases would be zero, this will never be a practical target. Clinical negligence also comes with a monetary cost to the taxpayer. The Department is required to make compensation payments...
Matched on
terms: clinical, negligence
Committee recommendation
87match
#25 - Presumption of private care in clinical negligence awards leads to double public payments.
The government may effectively be paying twice in some instances of clinical negligence, once through the compensation given to claimants and once again through providing NHS treatment and publicly funded social care. Section 2(4) of the Law Reform (Personal Injuries) Act 1948 provides that defendants who pay for the future healthcare and treatment of damaged patients must do...
Matched on
terms: clinical, negligence
Committee recommendation
86match
#30 - Clinical negligence framework focused on individual blame hinders early fault admission and settlement.
It is understandable that representatives of injured patients should wish to see fault admitted and cases settled early, but the statutory framework on which clinical negligence is based makes this very difficult. Clinical negligence is focused on individual blame, therefore, it is unsurprising that within this process individual clinicians will seek to defend their actions, protect their reputations...
Matched on
terms: clinical, negligence
Committee recommendation
86match
#4 - Establish an independent administrative body to investigate patient harm and determine compensation
The system for compensating injured patients in England is not fit for purpose. It is grossly expensive, adversarial, and promotes individual blame instead of collective learning. We recommend that when a patient is harmed, they or their family should be able to approach an independent administrative body which would investigate their case and determine whether the harm was...
Matched on
terms: harm, learning
GIRFT recommendation
85match
Mental Health Rehabilitation
12. Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their litigation claims covered under Clinical Negligence Scheme for Trust (CNST) notified to the trust over the last five years. b Clinicians and trust management to discuss with the legal department or claims handler the claims submitted to NHS...
Matched on
terms: clinical, learning, negligence
GIRFT recommendation
85match
Children and Young People's Mental Health Services
Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their litigation claims covered under Clinical Negligence Scheme for Trust (CNST) notified to the trust over the last five years. b Clinicians and trust management to discuss with the legal department or claims handler the claims submitted to NHS Resolution...
Matched on
terms: clinical, learning, negligence
Committee recommendation
83match
#18 - Significant proportion of clinical negligence compensation payments diverted to claimants' lawyers.
The Department told us that around 19% of the total compensation payments made in 2023–24 by NHS Resolution go to the claimants’ lawyers. This equates to £536 million of the total £2.8 billion paid to claimants in 2023–24 , which is over one–and–a–half times the amount spent by the Government Legal Department (the government’s principal legal advisers) in...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#16 - Department's clinical negligence liability reaches £58.2 billion, ranking second largest across government.
The Department recognises an amount for potential future compensation payments for incidents of clinical negligence in its financial statements as a liability. This is reported in the accounts of NHS Resolution and is consolidated into the Departmental Group accounts. The Department recognised a liability of £58.2 billion in its 2023–24 accounts to cover the expected potential future costs...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#23 - Legal costs for low-value clinical negligence claims are disproportionately high compared to damages.
Around three-quarters of clinical negligence claims settle for £25,000 or less, but the legal costs for these claims vastly exceed the damages payable to claimants. In 2024–25, there was a 3.7:1 ratio of claimant and NHS legal costs compared with damages payable for low-value claims.58 NHS Resolution agreed that legal costs were disproportionate for low-value cases.59
Matched on
terms: clinical, negligence
Committee recommendation
83match
#21 - Claimant legal fees for clinical negligence have significantly increased as a proportion of total.
Claimant legal fees have increased in real terms from £148 million in 2006–07 (in 2024–25 prices) to £538 million in 2024–25 and now represent 15% of all settled costs. During the same period, NHS’s legal costs increased in real terms from £76 million to £159 million, but fell as a share of total settled costs (from 7% to...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#7 - Clinical negligence costs have soared and are projected to rise further.
Clinical negligence is the second largest provision on the government balance sheet after nuclear decommissioning. Over the period 2006–07 to 2024–25, the total provision for clinical negligence increased by £45.6 billion in real terms, from £14.4 billion at 31 March 2007 to £60.0 billion at 31 March 2025. Since 2006–07, the annual cost of settling claims has increased...
Matched on
terms: clinical, negligence
Committee recommendation
83match
#1 - Past committees consistently raised concerns about rising clinical negligence costs.
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), NHS England and NHS Resolution on the costs of clinical negligence.1 Our predecessor committees reported on clinical negligence in 2002 and 2017, and both this Committee and our immediate predecessor raised further concerns...
Matched on
terms: clinical, negligence
Committee recommendation
81match
#6 - Develop estimates and set out measures to prevent double payment for negligence care.
Clinical negligence claims are settled on the basis of costs of care in the private sector and yet there is nothing to stop the claimant using the NHS or publicly funded social care in the future, potentially inflating the costs of claims. It is not clear the extent to which the taxpayer is paying twice for clinical negligence...
Matched on
terms: clinical, harm, negligence
Inquiry recommendation
78match
IHRD-40 - SAI Learning Informing Clinical Audit
Learning and trends identified in SAI investigations should inform programmes of clinical audit.
Matched on
terms: clinical, learning
Committee recommendation
78match
#21 - Maternity and neonatal cases account for 65% of £69.3 billion clinical negligence liability.
NHS Resolution’s 2022–23 accounts include a liability of £69.3 billion to cover the potential costs of clinical negligence. Of this, £45 billion, some 65% of the £69.3 billion total, related to maternity and neonatal liabilities. The Department told us that this was not unusual across international comparators and reflected the severe and lifelong impact of such events on...
Matched on
terms: clinical, negligence
GIRFT recommendation
77match
Rheumatology
Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT 'Litigation data pack' b Clinicians and trust management to discuss with the legal department or...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Paediatric Trauma and Orthopaedic Surgery
Reduce litigation costs by application of the GIRFT Programme's five-point plan. a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT 'Litigation data pack.' b Clinicians and trust management to discuss with the legal department or...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Paediatric Critical Care
Reduce litigation costs through application of the GIRFT programme's five-point plan. a Clinicians and trust management to assess their benchmarked position compared with the national average when reviewing the estimated litigation cost per activity. Trusts should have received this information in the GIRFT 'Litigation data pack.' b Clinicians and trust management to discuss with the legal department or...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Orthopaedic Trauma
Trusts should reduce litigation costs using the GIRFT programme's five-point plan and by addressing common causes of litigation in orthopaedic trauma with respect to limb injuries, common interventions, such as plastering and splint application, and use of intraoperative tourniquets. GIRFT five-point Plan: a. Clinicians and trust management to assess their benchmarked position compared to the national average when...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Neurology
Reduce litigation costs through application of the GIRFT programme's five-point plan. Actions: a) Clinicians and trust management to assess their benchmarked position compared with the national average when reviewing the estimated litigation cost per activity. b) Clinicians and trust management to discuss with the legal department or claims handler the claims submitted to NHS Resolution included in the...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Hospital Dentistry
Reduce litigation costs by application of the GIRFT Programme's five-point plan - see actions 21a-e. a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT litigation data pack. b Clinicians and trust management to discuss with...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Gastroenterology
Reduce litigation costs by application of the GIRFT programme's five-point plan. a) Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT Litigation data pack. b) Clinicians and trust management to discuss with the legal department or...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Endocrinology
Reduce litigation costs by application of the GIRFT Programme's five-point plan. a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per unit of activity. b Clinicians and trust management to regularly discuss with the legal department or claims handler the claims submitted to NHS Resolution included...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Cardiology
Trusts should work to reduce litigation costs by adopting the GIRFT 5-point plan. a) Clinicians and trust management to assess their benchmarked position compared with the national average when reviewing estimated litigation cost per activity. Trusts would have received this information in the GIRFT Litigation data pack. b) Clinicians and trust management to discuss with the legal department...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Breast Surgery
Reduce litigation costs by application of the GIRFT programme's five-point plan. a) Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per breast surgery admission. (Trusts will receive this information in the GIRFT 'Litigation data pack'.) b) Clinicians and trust management to discuss with the legal department...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Anaesthesia and Perioperative Medicine
Reduce litigation costs by application of the GIRFT programme's five-point plan (this is the standard litigation guidance that applies to all GIRFT reports). a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts will have received this information in the GIRFT 'Litigation data pack'....
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Adult Critical Care
Reduce litigation costs by application of the GIRFT Programme's five-point plan. a Clinicians and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts have received this information in the GIRFT 'Litigation data pack'. b Clinicians and trust management to discuss with the legal department or claims...
Matched on
terms: clinical, learning
GIRFT recommendation
77match
Acute and General Medicine
Reduce litigation costs by application of the GIRFT programme's five-point plan. a Clinicians across the professions and trust management to assess their benchmarked position compared to the national average when reviewing the estimated litigation cost per activity. Trusts would have received this information in the GIRFT 'Litigation data pack' b Clinicians and trust management to discuss with the...
Matched on
terms: clinical, learning