Medical Negligence News

 

Clinical negligence claims against the National Health Service have increased by almost a third over the past year, with an extra £100million paid out to victims of medical blunders. 

 

Nearly 9,000 patients claimed for damages after allegedly suffering at the hands of doctors or nurses, figures from the NHS Litigation Authority show.

 

It paid out £863m to victims of accidents in hospitals and clinics, up from £787m the year before, after settling 5,398 cases.

 

But a quarter of this was spent on legal costs, with £200m going to claimants’ lawyers under the system whereby so-called “ambulance chasers” can charge up to £900 an hour to pursue claims.

 

The litigation authority’s annual report is scathing about the current regime, which it claims is driving the “rapid growth in claims numbers” rather than any increase in mistakes by NHS staff.

 

Under the “no-win, no-fee” system set up by Labour so poorer people could have access to justice, known as Conditional Fee Arrangements, claimants do not have to pay for lawyers upfront. But if they win cases, the lawyers can claim big “success fees” from the defendant.

 

Steve Walker, chief executive of the NHS Litigation Authority , said: “We believe very strongly that a regime which allows success fees and the recoverability of After the Event (ATE) insurance premiums makes litigation so profitable that solicitors and so-called ‘claims farmers’ are drawn into the market thereby fuelling the rise in claims volumes we have experienced.”

 

However he added that the body is “delighted” that the Ministry of Justice is acting on the Jackson review of civil litigation costs, which recommended that success fees and ATE premiums should not be recoverable in no-win, no-fee cases.

 

At the same time the Government hopes to save millions every year by scrapping Legal Aid in cases of alleged malpractice.

 

The litigation authority’s report shows that in total it recorded 12,142 claims against NHS trusts in 2010-11 but expects only 4 per cent to go to court, as most will either be settled beforehand or dropped.

 

Of these, 8,655 were clinical claims, up from 6,652 the previous year, and 4,346 were non-clinical, up from 4,074.

 

A further 22,364 claims were still open at the end of the financial year. 

 

The authority – funded partly by trusts and partly by the Department of Health directly – paid out £729m under its main clinical scheme and a further £134m under claims relating to incidents that took place before 1995.

 

This was an increase on £651m under the current scheme and £136m under the old schemes recorded in 2009-10.

 

A further £47.9m was paid out in non-clinical cases. 

 

However these figures do not only include compensation paid to patients, staff and members of the public but legal costs as well.

 

“The costs claimed by claimant lawyers continue to be significantly higher than those incurred on our behalf by our panel defence solicitors. This continues to be a major concern.

 

“The availability of Conditional Fee Agreements (CFAs) and the continued increase in their use by claimants in clinical negligence claims has also meant that claimants’ costs are almost invariably disproportionate, often significantly, to the amount of damages paid, particularly in low-value claims.

 

“In the 5,398 clinical negligence claims closed by us with a damages payment in 2010/11, we paid over £257m in total legal costs, of which almost £200m (76 per cent of the total costs expenditure) was paid to claimant lawyers.”

 

 

 

 

(As reported in the Guardian

 

Payouts to patients or their families hit unprecedented levels according to Medical Defence Union

 

Negligence claims against GPs are soaring and payouts to patients or their families have hit unprecedented levels, according to the organisations that indemnify most of the country's family doctors.

 

The Medical Defence Union has told the Guardian that claims against GPs rose by 20% between 2009 and 2010, mostly (60%) over wrong or missed diagnoses. An unprecedented 13 of the claims cost more than £1m to settle.

 

The alarming rise in claims comes as the government prepares for a confrontation with family doctors over plans to publish data on the performance of GP practices. Patients will then be able to access a new website, where they can compare local GP services.

 

The Medical Protection Society has also revealed that a significant increase in the number and cost of clinical negligence claims brought against GPs has caused costs to soar. The society has seen a 50% increase in three years and the largest claims have hit new heights – with payouts of £6m in cases involving lifetime care after catastrophic injury. A few years ago, these would not have reached more than £4m.

 

Longstanding concerns about variability in GP practices around the country have reached new heights in the wake of government plans to put £80bn of the NHS budget in their hands. It has been argued that, before GPs begin to commission care from other doctors, they should be able to demonstrate their own competence.

 

More complaints are made to the General Medical Council about GPs than any other doctors: although they make up 25% of all doctors, they feature in 45% of the complaints received.

 

The NHS medical director, Sir Bruce Keogh – a heart surgeon who pioneered the publication of data on mortality rates in cardiac surgery – has told GPs that patients should be able to get information about the performance of their own doctors.

 

"The NHS is owned by the people of this country, who are its shareholders, and at times its reluctant or distressed customers," he said. "People are now their own bankers, their own travel agents and their own checkout cashiers. They expect to have data immediately available to make choices. The website will show variation, but it will also demonstrate how good the NHS is."

 

There would be opposition from doctors, Keogh admitted, but he added that "there are no arguments I haven't heard", in reference to his previous work on heart surgeons' mortality rates.

 

Useful information for patients could include how many cancer patients are being referred to see a specialist within two weeks or how many medication errors a surgery makes.

 

Critics will argue about the data's methodology, confidentiality and accuracy, to which Keogh said: "If you publish raw data, people go and look and it gives them a chance to advertise how good they are or defend themselves." He said he was urging GPs to think of what patients wanted rather than what suited doctors.

 

GP leaders say they are not opposed in principle to the publication of data on their performance, but argue that it must be adjusted to take account of the general health and deprivation of the neighbourhood.

 

Dr Laurence Buckman, chair of the British Medical Association's GPs committee, pointed out that his treatment of chronic bronchitis would look exemplary from raw data – but he practises in Hampstead Garden Suburb, where his patients have taken care of themselves, do not smoke and have private medical insurance. Inevitably, he said, journalists would draw up misleading league tables, which would wrongly make some GPs' performances look poor.

 

The government is talking to both the BMA and the Royal College of GPs about its plans, and Keogh is asking the college to draw up a list of indicators of good GP performance for the website. However, the college refused to comment on the initiative.

 

Professor Steve Field, former chairman of the college, said Keogh's plan was necessary to improve standards of patient care and should go ahead even if some doctors' leaders opposed it.

 

"While the vast majority of care provided in general practice is good, we must sort out the unacceptable variation in the quality of GPs across the UK because it costs lives. We know that at the moment some people get very poor care and that needs to be urgently addressed. A minority of care provided by GPs isn't good enough."

 

The only national GP performance data in the public domain are the QOF performance statistics, a range of targets – such as ensuring babies get routine vaccinations – that attract extra payments for GPs.

 

While primary care in the UK generally has a good reputation, some experts think that it hides both inadequate doctors at the bottom and average practice in the middle. Publication of results would enable GPs to compare themselves with the best and drive up standards.

 

The first study to try to identify poorly performing GPs, published last month, looked at those with the worst QOF scores. The team from King's College London found that they were most likely to be single-handed or from small practices, male, UK-qualified and aged over 65.