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Why NHS delays could lead to a rise in clinical negligence claims

View profile for Malcolm Underhill
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This winter has seen the National Health Service under perhaps the heaviest pressure ever, with NHS bosses ordering hospitals to cancel tens of thousands of operations and outpatient appointments in an effort to free up capacity to cope with demand on emergency services.

Waiting times in A&E departments across England have soared, with new NHS figures show the percentage of patients admitted to hospital A&E units who receive treatment within four hours fell to 77.3% in December 2017 – the worst level ever and far below the government’s target of 95%.

NHS providers have warned ministers that it will now be impossible for them to deliver on their pledge for all hospitals to hit the 95% target by March. President of the Royal College of Emergency Medicine, Dr Taj Hassan, said: “Our emergency departments are not just under pressure, but in a state of emergency.”

While the NHS took steps to prepare for winter demand, including launching a drive to free up 2,000-3,000 beds by 1 September 2017, hospitals saw a record 520,163 emergency admissions in December 2017 – a 4.5% rise compared to December 2016. 

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As a result, average bed occupancy hit 95%, which Dr Hassan called “a danger to patient safety, with around 7,000 fewer beds open than in the same period last year”. Expert advice accepted by the NHS suggests a maximum bed occupancy rate of 85% is required to provide acceptable levels of patient care and prevent the spread of hospital-acquired infections such as MRSA or Clostridium difficile.

Doctors running 68 A&E departments across England have written to the Prime Minister, warning these issues are leading to patient deaths because staff do not have the capacity to treat them.

The doctors suggest 3 important steps the government should take to help fix the underlying causes behind the current crisis:

  1. “A significant increase in Social Care Funding to allow patients who are fit to be discharged from acute beds to be cared for in the community.
  2. A review of the number of hospital beds that are available for acute care. A number of independent organisation have confirmed that the UK has an inadequate bed base to meet the needs of its population.
  3. Prioritisation to implement the workforce strategy that has been agreed between the Royal College and the relevant arms length bodies.

If implemented, these measures could help to prevent similar problems in future, but will not help patients receiving inadequate care right now, nor those who have already suffered due to delayed treatment for serious illnesses. 

One likely consequence of these failings in patient care is a rise in clinical negligence claims against NHS trusts responsible for individual A&E units. This is because a large percentage of such claims are based on patients’ diagnosis and treatment having been delayed, leading to a worse outcome than if they had been given effective treatment more quickly. Where doctors and other medicals staff are stressed and overworked, they are also more likely to make mistakes, such as misdiagnosis and surgical errors, which also commonly lead to medical negligence claims.

Concerns have also been raised following a leaked email from the chemotherapy department at Churchill hospital in Oxford, which suggests patients may have to wait to undergo chemotherapy or receive fewer treatments due to a shortage of nurses.

The email, sent by chemotherapy lead Dr Andrew Weaver to other cancer specialists at the hospital, discusses difficulties faced by the hospital’s day treatment unit (DTU), which is suffering from a lack of specialist cancer nurses to administer chemotherapy.

In the email, Dr Weaver wrote: “Currently we are down approximately 40% on the establishment of nurses on DTU and as a consequence we are having to delay chemotherapy patients’ starting times to four weeks.”

To deal with the nursing shortage, Dr Weaver suggested lengthening the time between cancer treatments or reducing the overall number for some types of patients. He also admitted: “Sadly we cannot see the staffing levels on DTU improving for at least 18-24 months.”

The Oxford University hospitals NHS trust, which runs the Churchill hospital, said it has not yet decided to implement Dr Weaver’s suggestion, but has also not ruled it out. With delayed diagnosis of cancer being a cause of medical negligence claims, if such measures do end up being taken this may lead to an increase in cancer misdiagnosis claims

If you or a loved one have experienced poor quality hospital care due to the NHS winter crisis, or for any other reason, we recommend speaking to one of our experienced medical negligence claims solicitors as soon as possible to find out if you might have grounds for a claim. We can advise you on the strength of your claim, how much you might be able to win as a settlement and how the claims process works. Our aim is to help you get the compensation you deserve so you can get the care and support you need and start rebuilding your life.

Contact our NHS and medical negligence claims experts today

If you are the victim of medical negligence, call us today on 0333 123 9099 to begin your claim or write to us at

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