Barely a week passes without patient safety in the NHS making headlines. The stories are usually shocking, and often upsetting – but that is why they are news. Between the horror stories there is a lot of joy, care, and healing from our NHS. But when it gets it wrong, lives can be shattered, and the financial cost of trying to put the harm right is often thrust into the spotlight.
The latest annual report from the NHS’s litigation arm, NHS Resolution (NHSR) has revealed that the total amount of money spent on settling clinical negligence claims has increased by 9.5 per cent since last year.
APIL’s research team has undertaken an initial analysis of the data in NHSR’s report and looked at where the money is being spent.
The number of claims which resulted in a compensation payment to an injured patient or bereaved family has risen by eight per cent since last year’s report. This increase will have had an obvious effect on the overall spend. It is worth noting at this point, however, that very few NHS patients who suffer harm go on to pursue a claim for redress. Latest available NHSR and NHS England data suggests that fewer than two per cent of patient safety incidents which cause harm result in a clinical negligence claim.
As well as the increase in claims, there has been rising inflation in the wider economy. Everything costs more than it did a year ago, including for the specialist things on which injured people must rely and for which the compensation pays, such as mobility aids, therapies, and care, which is where much of the compensation from the NHS goes. And these things are usually susceptible to much greater inflation than the things we usually measure inflation against, such as bread and teabags.
The money paid to claimant lawyers for representing injured patients in their claims has also increased, by 13.9 per cent. This should come as no surprise, since the increase in settled, successful claims means there is more work carried out. NHSR highlights that cases of a higher value (i.e. £250k-£4.8m) which are more complex have increased too. These cases, which will include life-changing injuries and negotiation of provision for long-term support, incur higher costs.
Other data not part of the NHSR annual report shed further light on the lawyers’ costs. The time taken for a claim to run, from notification to settlement, soared 51 per cent between 2013/14 and 2023/24. NHSR itself acknowledges that ‘the longer cases run for, the higher the costs’.
A good start in reducing those costs would be for the NHS to be open and honest from the moment it harms a patient. Injured patients often have unanswered questions and little information about what happened to them. It is their lawyers who must then investigate, which is not always straightforward when the NHS holds all the information about what happened.
A relatively small proportion of claims account for more than half of the NHS’s bill for damages.
The most devastating of claims are those caused by failures during births which can result in life-long catastrophic injuries to babies, if they survive. Claims for compensation are naturally the most expensive in these cases, as the injured children usually have complex care and support needs. Some will never walk or talk, let alone work. These cases account for 53 per cent of the NHS’s overall compensation bill, even though they represent just 11 per cent of claims. A quick look back over previous NHSR annual reports, shows this has been the case for years.
The spend on damages for these children is essential. There is no just way of cutting it. These children have catastrophic injuries and must be cared for.
APIL studies the NHSR annual report every year and it always comes back to the stories behind those headlines. The report may be a bunch of numbers, but each claim represents a person who has suffered when that suffering could and should have been avoided. As Stephen Walker, who retired in 2012 after 16 years as chief executive of the NHS Litigation Authority (NHSR’s former operating name) said: “If you stopped getting things wrong so consistently then you wouldn’t have to pay in the first place… I can guarantee you that I never paid a penny to a victim who wasn’t desperately in need of the funds.”