Is it time for a fundamental reform of NHS England’s clinical negligence claim system?

As the legal costs for NHS England’s clinical negligence claims spiral out of control, doctors represented by the Medical Defence Union, call for a reform of the current system.

This week the BBC reported on a huge bill of legal fees for NHS England to settle outstanding clinical negligence claims, totalling £4.3bn. With the reported cost of liabilities increasing by 8% to £83.4 billion before 31st March in 2019 (NHS Resolution’s annual report 2018/19), associations in the industry are calling for a reform of the system.

According to The Medical Defence Union, establishing an independent body to assess claims and the way compensation is calculated could help to reform the system. Dr Christine Tomkins, chief executive of the Medical Defence Union, reiterated her view from NHS England’s Resolution Report in August 2019, that compensation for clinical negligence claims for the NHS are “spiralling out of control”. She said, “This is money that should be going to healthcare, but instead is going to compensation claims – which is impairing all of our access to healthcare.

As the number of genuine claims in 2018/19 changed very little from 2017/18 (NHS Resolutions Report), and The Department of Health have reported seeing no decline in patient safety, the astronomical increase of fees and delays in claims being settled appears unjustified.

Peter Walsh, chief executive of Action Against Medical Accidents (AvMA), said the government had taken a “short-sighted and somewhat cynical approach” to clinical negligence.

“The NHS is not investigating incidents properly, recognising when it has harmed patients and seeking to compensate them fairly and promptly.”

This view has been highlighted in the press at recently scandal hit maternity care units including Kent, Morecambe Bay, and Shrewsbury & Telford where there have been repeated failures by the trust to improve the care received and address historic issues. This has consequently led to an increase of deaths and stillbirths at the hospitals.

Suzanne White, from the Association of Personal Injuries Lawyers (APIL), comments that although only 10% of claims relate to obstetrics, they take up 50% of compensation due to the injuries sustained often having a lifetime affect. More transparency is needed within the NHS as many people have no intention of suing, she said “What they want to do is find out what went wrong, why they have received these injuries… and to make sure it doesn’t happen to other patients.

Former Tory health secretary, Stephen Dorrell, warns that the NHS needs to admit mistakes more quickly to reduce the rising legal bill and learn from its mistakes and failings. As the cost for compensation continue to rise, clinical negligence reforms could soon be on the horizon.

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