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Feature Clinical Negligence

New settlement procedures: changing the way the NHS resolves negligence claims

BMJ 2017; 358 doi: (Published 07 September 2017) Cite this as: BMJ 2017;358:j4134
  1. Clare Dyer, legal correspondent, The BMJ
  1. claredyer4{at}

Superseding the Litigation Authority, NHS Resolution promises to act faster, helping valuable lessons to be learnt and reducing spiralling legal costs when something goes seriously wrong. Clare Dyer reports

A 5 year old boy with cerebral palsy won an £11.5m (€12.5bn; $15bn) settlement from the NHS in December 2015. His brain had been deprived of oxygen in the womb after midwives failed to notice his mother’s prolapsed cord. Had he been delivered 11 minutes earlier, the legal claim alleged, he would have escaped the devastating injuries that will leave him entirely dependent on other people for the rest of his life.

Last March, an 11 year old girl who was left with permanent brain damage when her blood sugar concentration fell dangerously low after her birth received a £17m settlement. Mother and baby were discharged from hospital when they should not have been; the baby’s blood sugar levels continued to fall, and she sustained brain damage so severe that she will need 24 hour care for the rest of her life.

£2bn of claims

These stories are heart wrenching yet depressingly familiar. Parents made 232 legal claims against NHS trusts in England for severe birth injuries in 2016-17, up 23% from the 188 filed the previous year. These claims are among the most expensive faced by trusts: the total value of those filed in 2016-17 hit nearly £2bn (fig 1). Obstetrics accounts for only 10% of the claims made against trusts, but 50% of the overall value of claims.1

Fig 1 Clinical negligence claims by specialty, 2016-171

And disasters during birth are set to get more costly for the NHS. In February, the government reduced the discount rate, the …

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