Claim trends by NHS Resolution from 2018 to 2022 show how the NHS deals with negligence claims and how much they cost the NHS annually.

When compared with previous years, it is possible to see how NHS Resolution settles claims from 2018 to 2022 and where projections indicate for coming years.

Patients access NHS Resolution to bring claims against the NHS and win damages for any negligence. NHS Resolution exists to avoid legal conflict and resolve claims in a fair and equitable manner.

The NHS Resolution Report 2022 highlights areas with the most cause for claims as well as costs, number of claims and overall spending on successful claims by NHS Resolution.

Claim trends by NHS Resolution

What areas have seen the most claims against the NHS since 2018?

Obstetrics has seen the most claims against the NHS again, according to the 2022 report.

Most claims against the NHS by speciality in 2022:

  • Obstetrics – 1243
  • Emergency medicine – 1229
  • Orthopaedic surgery – 1203
  • Gynaecology – 751

The growth in obstetrics claims has been steady since 2018. In 2018 / 19, claims were at 1076 and grew to 1157 in 2020/ 21 and up to 1243 in 2022

Gynaecology claims have also seen an upward trend since 2018. Claims in gynaecology jumped from 569 in 2018 to 761 in 2019/ 20 and again grew to 980 in 2020 / 21.

areas that have seen the most claims against the NHS since 2018

Emergency medicine claims were steady at 1409 and 1400 in 2018/ 19 and 2019/20, respectively. Claims in Emergency medicine grew again in 2021 / 22 to 1229 after a drop to 1151 in 2020/ 21. 

Orthopaedic surgery has seen little change, with 1262 claims in 2018/ 19, growing to 1361 in 2019 / 20 and with normal rates at 1248 in 2020 / 21 and 1203 in 2022.

Obstetrics claims have increased by 16% during the four years from 2018 to 2022, while Gynaecology claims grew by 24% over the period from 2018 to 2022 period.

The top four categories of clinical claims received each year from 2018/19 to 2021/22 by number

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How many NHS claims go to trial?

Very few NHS claims go to trial and a clear majority of claims settle before proceedings are issued. Only 23% of settled claims had proceedings issued in 2022, from a high of 32% of claims in 2018—a drop of nine percentage points over the years from 2018 to 2022.

The period from 2018 to 2022 saw a year-on-year increase in claims settled without proceedings being issued. 77% of settled claims against the NHS did so without court proceedings in 2022. The figure was 74% in 2021 and 71% in 2020. A figure of 69% in 2019 was slightly better than the 68% of 2018.

According to figures in the NHS report, only 0.12% needed to go to a full trial before settling in 2020, 2021 and 2022. The figure is down from the 0.24% of 2019 and 0.30% of 2018.

The increase in settled claims figures from 68% in 2018 to 77% in 2022 shows how NHS Resolution prefers to engage with solicitors and patients to settle cases without a need to go to court.

The figures indicate a trend in NHS Resolution settling claims without the need for court and in listening to families, which will continue into the future.

Litigation rate for clinical claims (2017/18 to 2021/22)

What does NHS Resolution spend on claim payments?

NHS Resolution spent £2.459 billion on claim payments in 2021 / 22. The figure is an increase of £199 million or 8.8% from 2020/2021. (p55)

The cost of settling claims in 2020/21 was £2.26 billion, which was actually down £120 million from the £2.38 billion of 2019/20, reflecting less activity due to Covid restrictions. 

2018 / 19 settled claims were at £2.35 billion, up £132 million from 2017/ 18 and following the trend of increased NHS Resolution settlements over previous years.

The spend by NHS Resolution in 2021 / 22 shows claim settlement figures are at pre-Covid levels again and increasing at an annual rate of more than 8%.

The NHS Resolution claim provision fund increases each year

The NHS Resolution claim provision fund increased by £43.4 billion to £128.6 billion in 2022. An increase of 50.8% over the 2020 / 21 claim provision fund amount. 

The claim provision fund is to finance future claims against the NHS, and the fund is added to each year. 

In 2018 /19 the fund was at £83 billion. The increase of 50.8%, or £43.4 billion to £128.6 billion in 2021 /22, shows how much NHS Resolution is preparing for settling claims in the future.

The current fund of £128.6 billion indicates how much NHS Resolution expects to spend settling claims over the coming years.

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Which clinical area accounts for the most claim payments?

Maternity claims payments account for 38% of the overall costs by NHS Resolution when settling claims during 2022.

NHS Resolution’s Early Notification scheme aims to settle Maternity negligence claims promptly to avoid distress to families. It can take an average of 5.2 years to settle maternity claims, and the Early Notification scheme aims to reduce the stress on families.

Maternity-related claims make up 62% of all reported claims by value in 2021 / 22. The figure for 2020 /21 was the same at 62% for the cost of reported claims.

The 62% was up on the 53% of 2019 / 20, showing how claim procedure changes by NHS are making the process for families easier to follow.

The Early Notification scheme is reflected in 70% of the money put into clinical negligence claim provision being for maternity negligence, out of a total figure of £128.6 billion in 2022.

Some maternity statistics as of 28 March 2022

Is there an increase in claims against the NHS from 2018 to 2022?

Yes, there is an increase in claims against the NHS in the period from 2018 to 2022, as shown by the 2021 / 22 report. 

NHS Resolution received 15,078 clinical claims in the 2021 /22 period. The figure is an increase of 13%, 1727 claims, on the 2020/21 total of 13,351 claims.

The number of new clinical and non-clinical claims and incidents reported in each financial year from 2012/13 to 2021/22

The reported number of clinical claims in 2018 / 19 was 10,678, which rose to 11,677 in 2019 /20. 

In the years from 2018 to 2022, the clinical claims against the NHS have increased from 10,678 to 15,078, nearly an increase of 1,000 new claims year on year.

NHS Resolution sees a growing trend in reported claims and expects it to keep rising over the coming years and has a fund of over £128.6 billion for settling future claims.

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Are NHS Resolution claims successful?

Yes, NHS Resolution claims are successful. Payments are up to £2.4 billion, and 16,684 claims were won in 2021 / 22, an increase on the 15,712 in the previous period of 2020 /21.

In 2019 / 20, the number of closed claims was 16,378, and the figure was 16,393 in 2018 / 19.

The drop to 15,712 in 2020 / 21 reflects the effect of Covid, but the overall trend in settled claims stays steady and growing slightly at just over 16,600 per year.

Administration costs as a percentage of total claim settlements have increased to 1.5% in 2021/ 22. In 2018 / 19, the figure was 0.72%, and in 2019 / 20, it was 0.98%.

The percentage rose to 1.28% in 2020 / 21 and has doubled over the four years, reflecting the investment in NHS Resolution to settle claims in a timely manner. 

NHS Resolution exists to reduce times in settling claims and to avoid the need for going to court, a traumatic experience for families.

16,484 clinical and non-clinical claims were settled in 2021/22 compared with 15,712 in 2020/21 with an increasing percentage settled without proceedings

Administration spend as a percentage of annual total claims settlement costs

Where are the areas of negligence in the NHS?

All areas of clinical activity see claims for negligence in the NHS.

Every NHS speciality experiences medical negligence, and new claims by patients increase yearly, with 10,284 in 2022.

Obstetrics, Emergency Medicine and Orthopaedic Surgery account for the highest percentage of claims, with 12% each in 2021 / 22. 

Orthopaedic surgery is at 12% of claims in 2020 / 21, while Emergency medicine and Obstetrics is at 11% in 2020 / 21. 

Of the total of 11,281 claims in 2019 / 20, Emergency medicine and Orthopaedic surgery are 12% of received claims, and Obstetrics is at 11%.

In 2018 / 19, 10,678 claims were received, and Emergency medicine, at 13% of the total, led the way. Orthopaedic surgery, at 12% and Obstetrics, at 11%, were the other big areas of claims in 2018 / 19.

General Surgery is steady at 8% of claims over the four years from 2018 to 2022. Gynaecology grows from 5% to 9% from 2018 to 2021 and steadies at 7% in the 2022 NHS Resolution Report. 

Radiology is at 4% of total claims from 2018 / 19 to 2021 / 22, while Urology, Psychiatry and Gastroenterology make up 3% each over the same reporting period.

Obstetrics jumps to 62% when it comes to the financial cost of claims in 2022. The figure is up from 59% in 2020 / 21 and was still highest at 50% in both 2018 / 19 and 2019 / 20, reflecting the high price of settling claims involving maternity negligence.

Current trends indicate a similar path for NHS Resolution in the coming years.

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What is of growing concern to the NHS?

Maternity negligence is of growing concern to the NHS, and 2022 figures reflect NHS Resolution’s aim of reducing claim times and learning from the negligence.

The Early Notification scheme allows NHS Resolution to investigate sooner and make more early admissions in cases of cerebral palsy and brain damage.

Cerebral Palsy and Maternity brain damage concern NHS Resolution, as children suffer when there are delays in treatment. 

The value of cerebral palsy claims received in 2018 /19 was at £1500 million, and this grew to over £2500 million in 2020 / 21 and was at just under £2000 million in 2021 / 22.

The 70% of clinical negligence provision going to maternity negligence for future claims shows how NHS Resolution prepares for settling cases such as Cerebral Palsy and maternity brain damage claims.

Some maternity statistics as of 28 March 2022

Is NHS Resolution effective?

NHS Resolution is effective in resolving and settling claims without the need to go to court. Court proceedings are stressful for families and are avoided where possible. 

The fact that only 0.34% of all claims go all to way to trial is an excellent indicator of how NHS Resolution works. The figure for settled claims grows each year from 2018 to 2022, with a slight drop due to Covid in the 2020 / 21 period.

16,484 clinical and non-clinical claims were settled in 2021/22 compared with 15,712 in 2020/21
with an increasing percentage settled without proceedings

Litigation rate for clinical claims (2017/18 to 2021/22)

77% of cases with NHS Resolution now settle without proceedings being issued.

The number of settled claims without court proceedings grew from 69% in 2018 / 19, showing a move by NHS Resolution to agree claims quicker than in the past. 

NHS Resolution says in 2022 a fund for future claims amounts to £128 billion up by 50.8% from 2020/21. The fund is set aside to meet future claims.

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