Fast track scheme for medical negligence starts

BMJ 1996; 313 doi: (Published 27 July 1996) Cite this as: BMJ 1996;313:187

A fast track scheme for handling medical negligence claims under £10 000 ($15 000) quickly, efficiently, and cheaply is to be piloted at Birmingham county court from 1 October.

The scheme, the first of its kind in Britain, is backed by local NHS trusts and health authorities and could provide a blueprint for dealing with such cases nationwide.

A local initiative by solicitors, judges, and an NHS risk manager, it has the support of the Lord Chancellor's department and will be monitored by a researcher at Nottingham Law School. The results of the pilot scheme will be compared with data from another court where cases are dealt with in the traditional way. One law firm, the Lewington Partnership, which acts for more than 90 trusts and health authorities, estimates that the scheme will cover more than 50% of its caseload.

Moves to speed up and simplify medical litigation are expected to follow the publication next week of Lord Woolf's final proposals for reforming the civil justice system. Fast tracking of claims under £10 000 is one of the key planks of his recommendations for reducing costs, delays, and uncertainty in the litigation process.

Like Lord Woolf's proposals, the Birmingham scheme obliges lawyers to adhere to a strict timetable for each stage of litigation. Instead of costs at an hourly rate, the losing side will have to pay only a fixed amount towards the other side's costs, depending on the stage at which the case is resolved.

This will enable NHS trusts to know exactly what it will cost them to settle a case at a particular stage or fight it through to a trial. If a trust settles at the earliest stage after examining the evidence provided by the patient's lawyers, costs will be £2000, plus £350 for each expert's report after the first.

Fixed costs will also mean more certainty for patients and more chance of pursuing a claim on a “no win, no fee” basis with insurance against the risk of loss. Under the rules, the trust's lawyers will provide the patient's medical notes in answer to a completed request form from the patient's solicitors. Before issuing proceedings, the patient will supply the trust with a “mini-trial” bundle, a package of documents including a chronology of events and the core evidence relied on—information provided usually only much later in the proceedings. Within two months the trust will notify the patient's lawyers whether it is willing to admit any part of the claim.

Cases that are not settled will go to trial around 12 months after proceedings are started, compared with a typical 24 months under the standard procedure. Costs recoverable from the losing side if the case goes to trial will be limited to a maximum of £3250 plus value added tax.—CLARE DYER, legal correspondent, BMJ

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