NHSR Annual Report: Clinical Negligence under the spotlight

Each year NHS Resolution, the body dealing with negligence claims against NHS bodies in England, produces a report which provides insights into what is happening with clinical negligence claims. This year the picture is very mixed. It shows that claims for clinical negligence are on the rise although more cases are being settled without the need for Court proceedings. Nonetheless, despite Government efforts, high levels of maternity cases and associated costs persist.
 

Keeping cases out of Court

A total of £3.1 billion was paid out in compensation and associated costs across all clinical schemes in 2024/25. NHSR states that a top priority has been to work in a collaborative way to deliver a fair and timely resolution of claims. It reveals that in 2024/25 a record 83 percent of cases were kept out of formal Court processes, compared to 66 percent in 2016/17. The report acknowledges the stress for claimants of going through a Court process and highlights that it is committed to using non-adversarial dispute resolution approaches wherever possible. This includes the use of mediators to assist with resolving claims.  This approach is extremely positive for claimants and bodes well for NHSR’s next three-year strategy – ‘Resolution through collaboration’. This is a positive trend and I am pleased that many of my clients won’t be retraumatised by the stress of litigation after the devastating consequences of a serious injury.

Top negligence cases

The top five case types with the most claims received (excluding GPI) were emergency medicine, orthopaedic surgery, obstetrics, gynaecology and general surgery. As a lawyer in this area, this accords with my own experience of current case trends.

Maternity claims

As a specialist in birth injury claims, and given government pledges to improve ailing maternity services, I was keen to find out in detail about the latest position with maternity cases.

Although secondary to the human impact, the report underlines what we already know – that errors in maternity care can result in huge financial cost to the NHS. Of the £3.1 billion total referred to above, £1.3 billion related to maternity claims. Looked at as a whole, obstetric claims accounted for 11 percent of all clinical claims received in 2024/25 (excluding GPI), but amounted to 53 percent by value. This compared to 57 percent in 2023/24.

The NHSR report further states that 84 percent of NHS hospital trusts delivering maternity care in England were ‘fully compliant with all elements of the Maternity Incentive Scheme (MIS) (four results pending)’. The scheme is stated to be a financial incentive program for ‘Trusts that can demonstrate they have implemented a set of core safety actions, ultimately aiming to improve the quality of care for women, families and newborns.’

However, the report recognises that ‘avoidable errors in maternity and neonatal services still occur all too often’. NHSR says that by working collaboratively with other partners it is supporting ‘the Government’s ambition to halve rates of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or shortly after birth, by 2025.’ This is referring to the National Maternity Safety Ambition launched in 2015.

It is noteworthy on this issue that a progress report from two baby loss charities, Sands and Tommy’s, estimates that the stillbirth and neonatal mortality rates are in fact not on track to meet the target. With regard to brain injuries at birth, I am also not aware of any evidence that suggests the ambition will be achieved within the timeframe. Brain injuries per 1,000 live births were 4.14 in 2010 and 4.07 in 2020, a 2 percent negative change. The ongoing level of medical negligence claims in this area certainly indicates that there is a lot more to be done in order to meet the Government target. I hope that the Avoiding Brain Injury in Childbirth programme (ABC), written about here by my colleague Kirsty Allen, will help to turn the tide.