Press Release - Handling Clinical Negligence Claims in
England
3 May 2001
The enormous human and financial costs of clinical negligence
are highlighted today in a National Audit Office report. The
estimated net present value of claims outstanding against the NHS
alleging clinical negligence has risen to £2.6 billion, plus an
estimated liability of a further £1.3 billion where negligent
episodes are likely to have occurred, but where claims have not yet
been received. On average claims take over five years to resolve
and there are 23,000 claims outstanding.
The report, presented to Parliament today by NAO head Sir John
Bourn, identifies a number of areas where the four bodies involved
(the Department of Health, the NHS Litigation Authority, the Lord
Chancellor’s Department and the Legal Services Commission) have
made improvements but could make further changes.
Key findings in the report are:
- The number and value of claims continues to
rise. At March 2000, there were 23,000 claims outstanding,
with a net present value of £2.6 billion. Claims expected to arise
from incidents that may have occurred but not been reported are
valued at a further £1.3 billion.
- On average, claims take a long time to settle.
For claims closed in 1999-2000 with settlement costs above £10,000
(excluding those for cerebral palsy and brain damage injuries), the
estimated average time taken to pay damages was five and a half
years after receipt of the claim. We estimate that in eight per
cent of such cases it took 10 years or more. Claims for cerebral
palsy and brain damage injuries take longer because of the time
required for the extent of any damage to become apparent.
- Nearly half of the claims settled in 1999-2000 cost
more in legal and other costs than the settlement itself.
For settlements up to £50,000, the costs of reaching the settlement
are greater than damages awarded in over 65 per cent of cases.
- There are indications that initiatives taken by the
Legal Services Commission and the NHS Litigation Authority to
improve the quality of solicitors advising on bringing and
defending clinical negligence claims are having a positive
impact. The success rate for claims with legal aid backing
pursued beyond the initial investigation rose between 1996-97 and
1999-2000; and the number of claims closed (settled or dropped) in
the main negligence scheme increased sharply between 1997-98 and
1999-2000.
The report identifies a number of areas where the four bodies
involved could build on the recent improvements:
- patients’ access to remedies: the Department
of Health, Lord Chancellor's Department and the Legal Services
Commission should further investigate alternative ways of
satisfactorily resolving small and medium sized claims, for example
through the offering of the wider range of non-financial remedies
that patients say they want, setting up regional panels and
offering mediation where appropriate.
The Department of Health, the Lord Chancellor’s Department and
the Legal Services Commission have accepted these
recommendations.
Sir John said today:
"The human and financial costs of clinical negligence
are enormous. At the end of March 2000, some 23,000 claims for
clinical negligence were outstanding. The net present value of
known and anticipated claims at that date was £3.9 billion. Many
claims have been outstanding for a long time, and the present
system is a slow and inefficient way of resolving small and many
medium size claims.
"The Litigation Authority and the Legal Services
Commission are making improvements to the way they handle claims.
Implementation of our recommendations should provide patients with
improved access to remedies, speed up settlements and cut legal
costs."
Notes for Editors
The figure of £3.9 billion is not an annual bill. It represents
an estimate of the discounted probable cost of settling claims
outstanding in respect of incidents that occurred before the end of
March 2000. This figure is discounted to net present value because
the claims will be settled over a number of years.
Press notices and reports are available from the date of
publication on the NAO website at http://www.nao.org.uk/ Hard
copies can be obtained from The Stationery Office on 0845 702
3474.
The Comptroller and Auditor General, Sir John Bourn, is the head
of the National Audit Office employing some 750 staff. He and the
NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 32/01
All enquiries to NAO Press Office:
Tel: + 44 (0) 20 7798 7400