Claims lodged against the NHS have risen exponentially in recent years. Official figures from the NHS Litigation Authority (NHS LA) show that litigation has grown by 80 per cent since 2009 and £1.2 billion of the NHS’s annual budget has been set aside for clinical negligence expenditure in 2013/2014.
Opinions are currently divided on the impact the litigation is having on the NHS. While some believe that negligence claims are inciting change in the health service, others feel that the litigation is draining funds and preventing the service from improving patient care.
With two very conflicting arguments existing surrounding the effect that clinical negligence claims are having on the NHS, we have taken a look into both sides to determine whether claims are having a positive effect or are just taking money out of the health care system?
The argument that clinical negligence claims drain NHS funds
The NHS Litigation Authority (NHS LA) amongst others believe that a growing litigation culture and large compensation awards are diverting funds away from patient care.
It is their opinion that strong legal marketing campaigns and a heightened public awareness of clinical negligence – through incidents such as the Mid Staffordshire scandal – have contributed to the current compensation culture, where people ‘have a go’ at claiming. Many also believe that no win, no fee arrangements have led to more spurious or inflated claims being made over the years.
While the Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) was introduced in April 2013 to reform no win, no fee arrangements, the NHS LA found that in 2013/2014, they “met the challenge of a large rise in claims following changes to ‘no win no fee’ funding arrangements”. Many claims being handled are still under the old form arrangements, as they were started before the changes took effect and those are often very costly for the health service.
Commenting on the compensation culture in 2010, Lord Young found that “the health service paid out £8bn in five years – only one third went to the claimants, and two thirds went to all those other parties.” With old style no win, no fee arrangements still impacting upon the NHS, it can be seen that the health service is continuing to be affected by the legal costs that accompany these claims.
High compensation costs for long-term care and loss of earnings have also been cited as significant drains on the NHS. Many have called for a cap to be placed on awards to allow the NHS to better manage its funding.
People are concerned about the impact large compensation costs and legal fees alongside the increasing compensation claims are having on patient care. As practitioners concentrate on following procedures to protect themselves from costly claims, it has been said that this is stopping them from doing what is best for patients.
With NHS funds already under pressure, people believe that the majority of funding should be going towards improving standards to reduce medical negligence actually taking place in the NHS every year.
The argument that clinical negligence claims help to improve NHS services
Risk Management Director at the NHS Litigation Authority (NHS LA) Anne Bartholomew has said: “A key role of the NHS Litigation Authority is to work with NHS partners to improve the safety of NHS patients.”
The NHS LA handles all claims brought against NHS Trusts in England, with the aim of instilling a safety culture within the health service through the work they carry out.
Knowledge gained from claims is fed back to relevant Trusts to reduce harm and improve patient and staff safety. This is done through Safety and Learning services, providing members with access to a library of best practice guidelines, local network events, targeted workshops and webinars.
Therefore, many believe that claims have the incidental effect of improving health care standards. For any case that provides the NHS LA with fresh insight into the performance of Trusts and how they can be improved, that information is absorbed and reacted upon, leading to positive advantages with practices.
Some people also feel that negligence claims shouldn’t be seen as the cause of the strained healthcare budget and any subsequent decline in standards, but that instead focus should be on the slowdown in government spending and the increasing financial pressure that this has been placed on the NHS.
The Mid Staffordshire report conducted by Robert Francis QC showed an “inevitable tension between finance and quality” and that focus needed to shift from balancing books to improving patient care. One year after the Francis Report, the Care Quality Commission (CQC) discovered a greater number of major or moderate impacting problems since the previous year, while around 10% of all hospitals still provided poor care.
Claimant lawyers would also suggest that earlier admissions of liability and sensible offers of settlement by the Trust or their representatives following episodes of negligence, would also cause the legal costs to the NHS to fall.
Many believe that the increase in claims indicates that people are no longer willing to tolerate this type of substandard care however caused, particularly as awareness of medical negligence cases such as the Mid Staffordshire scandal has grown within the public.
Opinion
Despite the two conflicting opinions on clinical negligence claims and their impact on the NHS, one thing is agreed upon – funding needs to be improved in some way. The health care system requires access to the right level of funding in order to provide a consistently high standard of medical care and focus on what is most important – looking after the best interests of their patients.
Author Bio: Lauren Knowles is a digital content writer for Lees solicitors. Established in 1989, the leading law firm has a team of over one hundred specialists who are dedicated to providing expert legal support and guidance to clients dealing with a wide range of different issues, from divorce and moving house to wills and clinical negligence.
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