New NHS guidance encourages focus on learning from litigation claims

18 May 2021

Getting it Right First Time (GIRFT) and NHS Resolution have published ‘Learning from Litigation Claims: The Getting It Right First Time (GIRFT) and NHS Resolution best practice guide for clinicians and managers’. It aims to help NHS trusts to learn from litigation claims in order to improve patient safety, reduce claims and curb costs.

NHS Resolution has reported that clinical negligence claims from incidents in 2019/2020 will cost the NHS around £8.3bn. Learning from Litigation Claims says ‘It is important that trusts recognise the direct link between clinical incidents, claims for compensation and their financial contribution to the Clinical Negligence Scheme for Trusts (CNST). Nowhere is the business case for investment in safety improvement clearer. With some trusts paying over £40m in yearly contributions and the annual cost representing around 2% of the NHS budget, it is clear that board-level attention on claims is essential and should be part of the effective governance of any organisation’.

The guide highlights that clinicians and managers are often unaware of claims against the trust unless they are directly involved. This means that key learning opportunities are often missed because, whilst there are established processes for learning from clinical incidents, there is less focus on learning from claims. Trusts are encouraged to ‘make use of the value added services from NHS panel legal firms in seeking feedback from claims, as well as making the most of other educational offerings’. Senior clinicians are encouraged to contact their trust’s panel law firm to explore learning opportunities that can then be shared in their teams. Clinicians are also encouraged to use patient feedback and learning resources available from claimant legal firms and patient-led charities such as Action against Medical Accidents (AvMA).

The main recommendations in the guide are:

1. Appointing dedicated clinical staff to help trust legal teams, with time built into job plans

2. Regular discussion of claims with clinicians in governance or multidisciplinary meetings

3. Making clinicians more aware of the claims process, and making legal teams more visible

4. Ensuring clinical staff are aware of any claims and are fully supported through the process

5. Working in partnership with patients, families and carers to involve them in investigations, to ensure openness

The guide highlights a number of areas where a focus on learning from clinical negligence claims has already influenced and improved clinical practice. At Guys and St Thomas’ NHS Foundation Trust, a focus on informed consent has seen the development of the practice of consenting patients in the outpatient clinic two weeks prior to surgery for open spinal procedures, and repeating the process if the patient does not have surgery six weeks after signing the consent form. At East Lancashire Hospital NHS Trust, patients attend a ‘hip and knee school’ with senior nurses, physiotherapists and occupational therapists before they undergo hip and knee arthroplasty surgery which ensures that they understand the operation and recovery pathway.

Kenneth Lees, specialist Clinical Negligence Solicitor at Curtis Law said of the introduction of the guide:

‘We welcome the introduction of Learning from Litigation Claims. Taking steps to improve involvement and engagement ensures that patients are fully engaged with the treatment that they receive. When the outcome of the treatment results in harm to the patient, they expect candour from the treating clinician, an apology, a promise that the medical accident will be investigated and, crucially, reassurance that the same events will not happen again. Victims of medical negligence seek legal assistance because they want to know what has happened to them, they want an apology for the harm that they have suffered, and they want support with their needs, both in terms of the immediate health needs and the longer term financial ramifications. The steps recommended in the guide should help NHS trusts to learn from incidents and improve the patient experience.’

If you wish to discuss a potential clinical negligence claim with our specialist solicitors you can contact us through our online enquiry form, free phone on 0800 008 7450, call our mobile friendly number 0333 2400340 or text "CURTIS" to 82727.