Tackling Clinical Negligence Costs in the NHS
The National Audit Office has recently published its report into the costs of clinical negligence within NHS Trusts.
The Status Quo
The report, 'Managing the costs of clinical negligence in Trusts', analysed both the number of claims and their associated current and expected costs:
- Over the last ten years, the number of clinical negligence claims being registered with the NHS per year doubled from 5,300 to 10,600.
- In addition, the report stated that the number of clinical negligence claims where damages were awarded also more than doubled over the same period.
- In 2016 - 17 NHS Resolution spent £1.6 billion on resolving clinical negligence claims. This amount is expected to increase to £3.2 billion by 2020-21.
Possible causes of these increases
The number of claims:
The increase in the number of claims being received by the NHS was explained by the NAO as being due to two key factors - an increase in activity undertaken by the NHS and the impact of legal reforms such as the introduction of 'no-win, no-fee' as a way of funding legal claims.
Interestingly, it does not specifically identify that, in addition to increasing levels of activity, there may also be an increasing level of negligence beyond that associated with increased activity. However, this is implied within the report through the recognition that there is insufficient learning from clinical negligence cases: 'to date, NHS Resolution has not had the required capacity to analyse its claims data systematically to draw out trends and clinical insights.'
The report also identified that 'there is no evidence yet that the rise in clinical negligence claims is related to poorer patient safety, but declining performance against waiting time standards is one factor which increases the risk of future claims from delayed diagnosis or treatment.'
Considering the rising level of costs, the report found that 'it has recently been taking longer to resolve cases, which is likely to increase the legal cost element of clinical negligence costs.'
The costs of claims:
The increasing costs of clinical negligence claims is associated within the report with increased life expectancy producing higher care needs, high-value birth injury claims and the impact of delays in the litigation process.
Solutions?
Of concern are two statements within the report which relate to how to resolve this costly situation:
- 'NHS Resolution and the Department (of Health)'s current actions are unlikely to stop the growth in the cost of clinical negligence claims.
- The government has not set out a coherent strategy on how it might stem the rise in clinical negligence costs, or a policy to support measures to tackle these costs.'
'Current Actions'
The current actions referred to relate to attempts to reduce both the number of clinical negligence incidents as well as the level of associated costs:
- The introduction of the 'Rapid Resolution & Redress' scheme aimed at quicker resolution of birth injury claims (which currently account for 33% of annual clinical negligence expenditure in the NHS)
- The introduction of the 'Better Births' programme to try to improve experiences in maternity care and reduce the number of associated claims
- The current proposal to introduce fixed recoverable costs in clinical negligence claims worth less than £25,000
NHS Resolution
In April of this year, the newly-named NHS Resolution published its five-year strategy, identifying its number one priority to 'resolve concerns and disputes fairly and effectively'.
Within this over-arching plan, their aims are:
- To reduce litigation and increase mediation
- To reduce unnecessary costs attached to claims
- To extend the reach of NCAS (the National Clinical Assessment Service) which works to resolve concerns about the practice of doctors, dentists and pharmacists.
Changing Attitudes
Those who represent claimants who have suffered from clinical negligence have been consistent in their approach to how the rising costs of these claims can be reduced:
- Ensure there is learning from mistakes which are made, thereby improving patient safety and reducing the number of future incidents
- Acknowledge mistakes promptly and settle claims early, thereby reducing the legal costs associated with these claims
Clinical Negligence
If you have been the victim of substandard care, contact Glynns Solicitors, specialists in medical negligence, to discuss your situation with an experienced solicitor.
You may be entitled to make a claim for compensation.
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