Committee publication · Correspondence · 15 December 2025
Letter from the Permanent Secretary at the Department for Health and Social Care relating to the Committee’s evidence session on 20 November on Costs of clinical negligence, 04 December 2025
From: Public Accounts Committee
Inquiry: Costs of clinical negligence
Summary
Samantha Jones, Permanent Secretary at the Department for Health and Social Care, responds to the Public Accounts Committee's questions from its 20 November 2025 evidence session on clinical negligence costs. The letter addresses never-events and claims conversion, complaints response timelines, conditional fee agreements in inquests, General Practice indemnity scheme forecasts, and ongoing engagement with law firms on fee transparency.
Key findings
- Around 400 never-events are reported annually (a tiny fraction of 3 million patient safety incidents); NHSE's September 2025 consultation found 66% of respondents view the current never-events framework as unfit for purpose, prompting commitment to develop a revised framework.
- NHS Resolution discontinued its dedicated 'never event' flag in 2018 and now relies on primary cause codes as a proxy; historical data shows potential never-event claims but cannot definitively confirm which were recorded as never-events by NHSE.
- NHSE does not collect data on complaint response times, though regulations require acknowledgment within three working days and investigation completion within six months; Government committed to reforming complaints process through Ten Year Health Plan.
- No evidence currently suggests conditional fee agreements (no-win, no-fee) in inquests impact patient safety or adversarialism in coronial proceedings, though Ministry of Justice will monitor; Public Office (Accountability) Bill will expand legal aid for inquests.
- General Practice Indemnity scheme forecasts show CNSGP costs projected to rise as scheme matures while ELSGP costs fall; estimates incorporate actuarial input but are subject to incomplete data and unpredictable large settlements.
Tone
FactualTopics
Key actors
Samantha Jones, Geoffrey Clifton-Brown, Helen Vernon, NHS Resolution, NHS England, Healthcare Safety Investigation Branch, Care Quality Commission, Ministry of Justice
Notable line
“66% of respondents finding the current framework unfit for purpose. Acting on this …”
Key Quotes
“… this is a very concerning issue and it is right that we shine a light on it through both yours and the NAO's investigations.”
“Never events are patient safety incidents that are wholly preventable where guidance or safety recommendations that provide strong systemic protective barriers are available at a national level and have been implemented …”
“Both reports found that the idea that all the existing never event categories were 'wholly preventable' was flawed.”
“The revised framework will prioritise learning, focus on events of significant concern to patients and the NHS, align with Patient Safety Incident Response Framework principles, and support a just culture for reporting.”
“We currently have no evidence to suggest the use of CFAs has a detrimental effect on the inquisitorial nature of coronial proceedings, or impacts patient safety …”
Source · parliament.uk record ↗