New guide helps NHS trusts improve patient safety by learning from clinical negligence claims

A new best practice guide helping trusts learn more from NHS negligence claims has been issued in the drive for better patient safety.

With the cost of harm for clinical negligence claims from incidents in 2019/20 expected to cost the NHS £8.3 billion, the Getting It Right First Time (GIRFT) programme and NHS Resolution have worked together to produce Learning from Litigation Claims, offering trust clinicians, managers and legal teams a practical and structured approach to claims learning, and sharing examples of best practice from across England.

The aim is to maximise what can be learned from litigation, for the benefit of patients and to curb escalating costs.

GIRFT’s ongoing review meetings with providers across England have highlighted that clinicians and managers are often unaware of the claims against their department. There is the potential for greater learning and improvement if clinicians can work alongside legal teams in the claims management process. The new guidance provides a framework to deliver this, suggesting measures such as:

• Appointing dedicated clinical staff to assist trust legal teams, with sessions incorporated into job plans;
• Enabling regular discussion of claims with clinicians in forums such as clinical governance or multidisciplinary meetings;
• Making clinicians more aware of the claims process and ensuring legal teams are more visible to clinical staff at all times;
• Ensuring clinical staff are aware when a claim has been initiated and are fully supported through the process;
• Working in partnership with patients, families and carers, and involving them in investigations, to ensure openness.

The guide also offers practical steps to help improve claims management, such as suggested datasets for reporting claims, and advice on reducing the risk of litigation by ensuring robust processes are in place for surgical consent, documentation and patient education.

The GIRFT litigation workstream has previously collaborated with NHS Resolution to share claims data with trusts in bespoke data packs, to help trusts identify high performance and targets for improvement. The 2021 litigation data packs are now being issued to trusts and legal teams asked to complete GIRFT’s five-point action plan with the support of clinicians and panel law firms.

John Machin, who co-leads GIRFT’s litigation workstream with Professor Tim Briggs, said: “Historically, claims learning has not had the attention it needs to maximise the potential improvements for patient care. It is vital that claims learning is given the same importance as learning from clinical incidents, as it is such a rich resource to help improve patient safety.

“The triangulation of learning from claims, complaints, incidents and inquests must become a corner stone of our clinical governance and future clinical improvements.”

Professor Tim Briggs, Chair of GIRFT and National Director of Clinical Improvement for the NHS, said: “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. With the additional financial pressures on the NHS from COVID-19, getting our approach to claims right, and learning from them, has never been more important.”

Helen Vernon, chief executive of NHS Resolution, added: “Claims for clinical negligence are a valuable source of learning and an opportunity for improvement which should not be lost.

“This guidance sets out some practical steps to help trusts to give learning from claims the attention it deserves so that these devastating events can be avoided and NHS funds preserved for caring for patients.”

Learning from Litigation Claims is endorsed by Sir Robert Francis QC, who specialises in medical law and clinical negligence and has chaired several high profile health inquiries.

Sir Robert, who is also Chair of the independent patient organisation Healthwatch, said: “I look forward to a day when all patients who have suffered unexpected and unwanted harmful outcomes will have the chance to be part of the learning from incidents.

“I believe this approach offers the best chance of maintaining the patient’s confidence in the service, promoting the best remediation for any injury, avoiding a fruitless hunt for unfortunate staff to blame and punish, and improving safety through learning. Not least it is likely to reduce the inexcusable cost of negligence claims.

“This welcome guidance is a promising advance towards that goal.”

Learning from Litigation Claims is available on the GIRFT website here.