Costs of clinical negligence

Status / emerging findings

• Settlement costs have tripled since 2006–07; Department of Health has shown little meaningful action despite repeated parliamentary scrutiny, while NHS Resolution has demonstrated concrete steps (more out-of-court settlements, better use of claims data).
• Department refused to commit to improvement activity until David Lock KC completes his ongoing review of clinical negligence policy—a delay the committee found unacceptable.
• Maternity care failures drive recent cost increases; a small number of high-value maternity cases are behind disproportionate damages awards.
• Legal costs are flagged as a key sustainability problem but not yet systematically addressed.
• NHS England restructuring (18,000 redundancies by March 2028) is happening in parallel, raising questions about capacity to tackle negligence causes amid organisational upheaval.

Why it matters

A £60 billion liability and £4 billion annual spend on negligence settlements is money not spent on patient care; without action, NHS budget cuts will be hollowed out further by rising claims costs.

Tone arc

Started procedural, examining cost trends and departmental response; became sharply critical after evidence revealed the Department's passivity and refusal to commit to action pending external review, contrasted with NHS Resolution's proactive measures.

Key witnesses

Samantha Jones, Helen Vernon, Elizabeth O'Mahony, Professor Aidan Fowler, NHS Resolution (scheme administrator), Department of Health and Social Care (unnamed departmental witnesses)