Posts Tagged ‘Clinical Negligence’

Big negligence payouts do not make a bad hospital but trends need explaining

In 2012 on February 13, 2012 at 12:58 pm

BBC Radio Oxford was concerned last week about the scale of payments made by Oxford University Hospitals in relation to clinical negligence.  Although the figures came out last summer, attention was drawn to clinical negligence payments by a large amount in damages in a local case involving a GP. Jonathan Montgomery suggested to the Radio station that the amount paid out in damages was a poor guide to the quality of care in a hospital. Data from the NHS Litigation Authority (NHSLA) show that while the sums of money are large (£13m for the Oxford Radcliffe hospital in 2010-11) they relate to a relatively small number of claims (only 59 claims were received in that year).  About 40% of the payments related to obstetrics where a small mistake can have catastrophic effects.

One interesting way of considering the implications of the NHSLA data might be to compare the payments that are made into the Clinical Negligence Scheme for Trusts (CNST) with those paid out. The contributions in are based on an assessment of risk and therefore if payouts exceed the contributions, the damages paid are more than expected. If payouts are less, then hospital has been less prone to damages claims than its risk profile would predict. On this measure  the Oxford hospitals payouts in 2001/11 were only 1.5% higher than expected, a marginal figure. Southampton hospitals paid in £7.93m in that year and the CNST paid out only £3.46 million on its behalf, so they had a relatively cheap year for claims. Over the five-year period, 2006-11, payments in respect of Oxford have been 20.43% higher than their contributions. For Southampton, the difference is only 0.67%. This data can only generate questions and does not indicate poor services but perhaps there is something for Oxford to explain here.

Jonathan Montgomery

Clinical Negligence and the NHS

In 2011, NHS on November 15, 2011 at 1:45 pm

In June 2011 the Health Select Committee published a report on Complaints and Litigation in the NHS. It supported the continuation of fault-based compensation, concluding that that ‘the existing clinical negligence framework based on qualifying liability in tort offers patients the best opportunity possible for establishing the facts of their case, apportioning responsibility for errors, and being appropriately compensated’ (Para 157). However, it was very critical of claims management firms, which it thought pushed people into litigation rather than using complaints procedures and unduly contributed to the rising costs of clinical negligence (Para 172). The Government’s response to the report indicates that the Ministry of Justice is working closely with the NHS Litigation Authority (NHSLA) and the Association of Personal Injury Lawyers (APIL) to agree a scheme that will enable a speedier resolution of lower value clinical negligence cases and aims to reduce costs (Para 147). It also notes that the Jackson reforms of civil litigation, being implemented through the Legal Aid, Sentencing and Punishment of Offenders Bill, will have a significant effect in this area (Para 19). The Ministry of Justice is now consulting on the regulation of claims management firms.

The two volumes of evidence to the Select Committee contain a considerable amount of information on concerns about this area of law and practice. The previous parliamentary report by the Constitutional Affairs Select Committee on the (non)existence of a compensation culture is also relevant. The publication of the industry review of the NHSLA is still awaited, as is the implementation of the NHS Redress Act 2006 despite the initial policy announcements from the Department of Health. It does seem clear from the Annual Report of the NHSLA for 2011 that there is a significant increase in both the number of clinical negligence claims received by the NHS and also the money paid out in compensation and legal expenses.