Surge in NHS clinical negligence claims raises concerns over quality of care, Darzi Report finds

The increasing rate of clinical negligence claims is indicative of the poor state of the NHS in England, a damning government-commissioned review has concluded.

Today’s report by surgeon and Labour former minister Lord Darzi includes a section devoted to clinical negligence and the worrying rise in claims, particularly in obstetrics.

Darzi points out that, aside from pensions and nuclear decommissioning, NHS clinical negligence claims are now the largest liability on the government’s balance sheet.

‘The number of formal complaints raised about NHS services has changed over time as awareness of the complaints process has risen,’ Darzi said. ‘But it is still striking that complaints have nearly doubled in a little over a decade, according to data shared with the investigation by the parliamentary and health service ombudsman. As the highest level to which complaints about the NHS can be directed, they received 14,615 formal complaints in 2011-12, rising to 28,780 complaints by 2023/24.’

The report states that the NHS in England is an ‘outlier’ in clinical negligence payments, devoting double the share of total health spending as New Zealand, 10 times the level of Australia and 20 times as much as Canada.

Clinical negligence payments increase to £2.9bn or 1.7% of the entire NHS budget – amounting to more than the combined budget of every GP practice in the Midlands.

The report does not identify lawyers or legal costs as particular areas of concern, but instead places the emphasis on mistakes that are being made. The section on clinical negligence itself is placed under the chapter on quality of care.

‘In too many areas, we have been going in the wrong direction,’ Darzi concluded. ‘Complaints have doubled, and clinical negligence claims are at record levels. There is much work to be done if quality of care is to become the organising principle of the NHS once more.’

The report overall paints a dismal picture of the condition of the NHS in England. A&E is found to be in an ‘awful state’, waiting times for hospital procedures have ‘ballooned’ and cancer care still lags behind other countries. The key drivers of these problems are identified as austerity, lack of capital spending and the impact of the pandemic.

In maternity services, which contribute to the majority of clinical negligence costs, Darzi reported positive developments in reductions of stillbirths and a small decrease in neonatal mortality and serious brain injuries. But recent scandals in maternity units across England have highlighted a lack of progress in learning from mistakes, and the report recommends a ‘deeper conversation’ on skills, staffing mix, clinical models, leadership and culture in maternity services.

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