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The Public Accounts Committee calls for action on clinical negligence


Following a damning report by the National Audit Office (see CSJ’s Feb edition), the Public Accounts Committee (PAC) has also released a report warning that the government has failed to tackle the issue of clinical negligence – despite repeated warnings for over two decades. PAC points out that the government’s liability for clinical negligence has quadrupled over 20 years (£60bn in 2024-2025). The report states that the DHSC is unable to show any meaningful action taken to address this and the NHS has not done enough to tackle the underlying causes of patient harm. The report paints a picture of a system


overwhelmed by safety recommendations that it cannot action. Despite the NHS in England keeping a plethora of data on patient harm, its fragmented nature does not amount to good information, which could identify and address clinical negligence’s underlying causes. PAC further highlights the problem of


disproportionate legal costs in clinical negligence claims. Claimant legal fees more than tripled to £538m in 2024-25, while claims with damages of £25k or less cost far more in fees than victims receive, with a cost-to-damages ratio of 3.7 to 1. Government’s previous plans to limit the amount


paid to lawyers in lower-value cases were not implemented as planned two years ago, and the DHSC should develop an alternative mechanism to speed up decisions and reduce costs for these cases. Recent increases in settlement costs (tripling to £3.6bn in ’24-’25) are likely to rise significantly to over £4bn/year by the end of the decade, with these costs representing many tragic incidences of patient harm. However, despite warnings from the PAC dating


back to 2002, the DHSC would not commit to acting to make improvements to the fundamental issues of clinical negligence until the completion of a review announced last year, for which it did not have an expected date. The PAC is seeking, within two months of this report:


l An operational plan from government to tackle clinical negligence;


l A national framework for improving patient safety with clear annual improvement targets, and


l A national system for sharing data between NHS Trusts.


The report calls, in particular, for the DHSC to learn lessons from its failure to improve maternity care in England, and set out how it plans to reduce the incidence of harm and the costs of claims in this area. The report shows settled claims involving infants and children increasing significantly, reaching £325m in claims for paediatric failings in 2024-25. The inquiry heard that 120-130 brain injury cases involving children are settled every year, but it can take an average of 11-12 years to resolve each claim, at a high cost both for the victim’s experience and financially. Evidence to the PAC’s inquiry from the Royal College of Obstetricians and Gynaecologists suggested that the maternity workforce is struggling under the pressure of delivering increasingly complex care, with more than half


of births involving medical intervention, such as a Caesarean section, or the use of instruments such as forceps. Further evidence raised concerns that inadequate training, poor workforce planning and failure to adhere to staffing requirements have created the conditions for clinical negligence claims to occur. PAC asks that DHSC and NHS find and fix systemic failings in care, and for the publication of the Amos review into maternity and neonatal care in England within two months alongside its response to the report. Sir Geoffrey Clifton-Brown, Chair of the Public Accounts Committee, said: “The rising costs of such claims are diverting resources away from frontline care badly in need of them. That is why it feels impossible to accept that, despite two decades’ worth of warnings, we still appear to be worlds away from government or the NHS engaging with the underlying causes of this issue.” Responding to the report, Dr. Pallavi Bradshaw, Medical Director at Medical Protection Society, said: “The Public Accounts Committee is right to highlight the eye-watering cost of NHS clinical negligence claims, the staggering amount of public money being spent on legal fees, and the inaction of successive governments on this issue. “At a time when NHS finances are under strain,


and there is much to be done to transform patient care and services, the Government simply cannot afford to do nothing. A comprehensive strategy - which balances fair compensation for patients and affordability for the NHS - is urgently needed, following David Lock KC’s review. “This strategy must iron out the many inequities


and flaws in the system - not least disproportionate legal fees in lower-value claims, and the 80-year- old legislation which sets out that claims are settled based on how much a patient’s care would cost in the private sector, rather than in the NHS.” View the report at: https://publications. parliament.uk/pa/cm5901/cmselect/ cmpubacc/1234/report.html


Paperclip-sized sensor will help monitor heart conditions at home


A wireless sensor the size of a paperclip could transform care for people living with chronic heart failure, enabling them to monitor their condition daily from home and catch warning signs before they become emergencies, NICE has said. The CardioMEMS HF System, developed by healthcare company Abbott, and recommended in final guidance, is implanted in an artery between the heart and lung during a minimally invasive


procedure. Once in place, patients take daily pressure readings by lying on a special pillow and pressing a button. The readings are sent wirelessly to their healthcare team, who can spot early warning signs and adjust medication before symptoms become serious, potentially avoiding emergency hospital visits. Evidence from three RCTs showed that CardioMEMS was associated with a 34% reduction in heart failure hospitalisations


compared with usual care. “This technology offers a real opportunity to


improve care for people living with chronic heart failure. By enabling early detection of problems and timely medication adjustments, it has the potential to reduce emergency hospital admissions and help people manage their condition more effectively from the comfort of their own home,” said NICE HealthTech Programme Director, Dr. Chalkidou.


March 2026 I www.clinicalservicesjournal.com 9


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