By John Tingle
Adding to the enormity of the challenges facing the NHS in developing a patient safety-focused culture, NHS Resolution and the Care Quality Commission (CQC) have recently produced important reports on NHS litigation and poor care. The analysis of these reports will help to reveal the full nature and extent of the NHS’s patient safety problems.
This organization occupies a unique position in the NHS, as one of its several functions includes managing litigation claims brought against the NHS organizations. This position gives it a unique overview of NHS clinical negligence complaints and patient safety trends, challenges, and opportunities.
NHS Resolution 2019/2020 Annual Report
NHS Resolution provides in its annual report a financial estimate of liabilities for current and future expected legal claims. The latest figure given is £84.1 billion.
Facts and figures
- In 2019/20 NHS Resolution received 11,682 new clinical negligence claims and reported incidents, compared to 10,684 in 2018/19, an increase of 998 (9.3%).
- As to settled claims, the report states that in 2019/20, 15,550 claims were settled, with 71.5% settled without proceedings, 27.9% with proceedings, and 0.6% at trial.
- The top three categories of clinical claims received in 2019/20 by value and number are Obstetrics, Emergency Medicine and Orthopedic Surgery.
- Maternity claims once again stand out as the highest claims value specialty: “Obstetrics claims remain the largest proportion, 50% of the total estimated value, while only representing 9% of the volume of claims received,” the report states. A case discussed by JMW solicitors also highlights the high claims value of obstetric negligence. In this case, which the firm handled, failures by maternity staff resulted in brain damage to a baby. The £26 million compensation awarded by the court will have to cover lifetime specialist care and provide financial security .
The CQC have just published two new reports, which make for uncomfortable reading. It is hard to understand why the failings that have been identified occurred in a modern-day, post-Mid Staffordshire care crisis NHS, and why poor care issues have not been properly dealt with.
Extracts from the report show the dire nature of the issues reported by the CQC:
“Staff did not keep detailed records of patients’ care and treatment. Records were not always clear or up-to-date. This meant that care staff could not easily identify care to be given to individual patients. This had not improved since the last inspection. However, records were stored securely and easily available to all staff providing care.”
The report states that staff did not always report incidents, and the service did not always manage patient safety incidents well.
Mid and South Essex NHS Foundation Trust: Basildon University Hospital
The recent, unannounced CQC inspection on maternity services at Basildon University hospital was carried out to follow up concerns raised by a whistleblower. Some examples of good practice were found, but there were several serious failings identified:
“CQC found several concerns, including; high risk women giving birth in the low risk area, insufficient numbers of staff with the relevant skills and experience to keep women safe and provide the right care and treatment, and dysfunctional multidisciplinary team working which had impacted on the increased number of safety incidents reported.”
Taken together, these reports starkly reveal the seemingly insurmountable nature of the problems and challenges that the NHS must face in order to develop a sustainable, ingrained patient safety culture which puts the patient first.