Westminster Health Forum

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Clinical negligence in the NHS - patient safety, the impact of COVID-19, legal cost reform and next steps for policy

February 2021

Price: £95 PLUS VAT

***Full-scale policy conference taking place online***
This conference is focussing on key issues for clinical negligence in the NHS and priorities for NHS resolution.

The discussion is bringing together stakeholders with a range of key policy officials who are due to attend from DHSC; the Government Legal Department; HM Treasury; the MOJ and the NAO.

The discussion at a glance:

  • a patient safety culture - assessing progress and next steps in its development in the context of the NHS Patient Safety Strategy and the publication of the first Annual progress report
  • COVID-19 - the impact on clinical negligence risk and increased clinical negligence claims
  • the workforce - priorities for support through a period of unprecedented pressure
  • legal costs - options for mitigation and policy

The agenda:

  • Assessing the rising costs of clinical negligence in the NHS, and priorities for NHS Resolution
  • The impact of investigations on improving patient safety
  • Understanding the key issues for patient complaints within the NHS, and the impact of COVID-19
  • Improving support for BAME staff - reducing bias in reporting, and tackling isolation and systemic issues
  • Patient safety and protecting the NHS workforce through the pandemic and beyond - tackling unwarranted variation, preventing safety failures, and learning from the new challenges posed by the COVID-19 emergency
  • Challenges and opportunities for keeping cases out of litigation - mediation, regulation, next steps for legal cost reform and adapting practices during COVID-19
  • Next steps for improving patient safety

Developments that are relevant to the discussion:

  • pandemic-related litigation:
    • calls from the MDU and MPS, alongside leaders in the profession, for exemptions and a proportionate approach to possible litigation arising from clinical decisions made by medical staff about prioritising and treating patients during the second wave of the pandemic
    • the Health Secretary stating that, following advice, change in  legislation was not necessary at this point but would be kept under review
    • COVID-19 specific guidance published for doctor complaints - from the GMC
    • chief medical officers asking doctors to be flexible during the second wave as they may have to work on clinical areas outside their specialty, and reassuring them that the COVID-19 context will be taken into consideration in complaints procedures
  • vaccinations - the NHS Resolution and BMA announcement that administering COVID-19 inoculations will be covered by the clinical negligence scheme for general practice
  • the Annual progress report for the NHS Patient Safety Strategy: year one - looking at systems development, culture and workforce links, learning from litigation with NHS Resolution and GIRFT, and adapting to heightened patient safety issues in relation to COVID-19
  • First Do No Harm - the Independent Medicines and Medical Devices Safety Review report, with recommendations including appointment of an independent Patient Safety Commissioner
  • the Health Service Safety Investigations (HSSIB) Bill - which would establish the Health Service Safety Investigations Body to examine patient safety incidents and make recommendations
  • NICE’s Patient safety update - with proposals for the evolution of patient safety and considering how the integration of new technology can help to detect patient safety signals more quickly
  • National Learning Report: Support for staff following patient safety incidents - the HSIB highlighting the need for workforce psychological support after patient safety concerns, in the interests of patient safety performance for the future
  • clinical negligence legal fees:
    • NHS Resolution’s Annual Report and Accounts - showing a cost of claims although their number is remaining steady - and with substantial legal bills expected for the NHS
    • Managing the costs of clinical negligence in hospital trusts - the Public Accounts Committee calling for a joint strategy to address the rising cost of clinical negligence in the NHS

The discussion in detail:


  • impact - on clinical practice, the health workforce, patients and negligence claims, as NHS Resolution outline a Clinical Negligence Scheme for Coronavirus aimed at meeting liabilities arising from the special healthcare arrangements being put in place in response to the coronavirus outbreak
  • patient safety - identification and management of at risk patients and ensuring a patient safety culture remains at the heart of the NHS response to COVID-19
  • COVID-19 alert now at level 5 - assessing the impact on clinical negligence and patient safety
  • support - what more is needed for the workforce through the pandemic, and into the future
  • remote healthcare - ensuring the safety of telemedicine, with increased challenges for information sharing and supporting patient understanding
  • delayed treatment - including the impact of emerging claims from patients affected by rescheduled operations, screenings, diagnosis and treatment
  • continued care - for patients that have received procedures such as a tracheostomy, as well as in maternity care
  • processing claims - with the Parliamentary and Health Service Ombudsman accepting new health-related claims following a pause to enable the NHS to focus on its work during the pandemic
  • vaccinations - assessing concerns around administering two different vaccines for COVID-19, the extended window for the second dose of vaccine and the impact on GP workload
  • litigation:
    • key issues for protecting clinicians during COVID-19 when they have to make life and death decisions due to supply, balanced with not protecting against intentional harm or misconduct, following a reported jump in complaints to the CQC over the use of inappropriate blanket DNAR decisions in the first wave
    • government’s emergency indemnity funding during the pandemic - its effectiveness and scale, as well as duration with the potential for COVID-19 related claims to be raised into the future
  • learning for the future - examining opportunities and measures taken to adapt regulation and processes around litigation, including long-term options that are fair for both doctors and patients

Ethnic minority staff and patients

  • referrals - addressing disparities in the context of Fair to Refer? commissioned by the GMC, which found that a lack of employer support and isolation contributed to more referrals for BAME doctors
  • health outcomes - next steps for the drive to tackle the poorer outcomes experienced by ethnic minority patients with developments outlined in the Annual progress report and the refresh of the strategy which will focus on promoting equality expected at the end of 2020
  • COVID-19 - how clinicians from ethnic minority backgrounds can be protected from increases in legal claims and referrals to the regulator, as well as from increased risk from the virus, including being given priority vaccinations

Reducing avoidable harm

  • improvement for the future - what more could be done to mitigate harm when failures occur, and address the rising cost of clinical negligence in the NHS, assessing proposals from the Independent Medicines and Medical Devices Safety Review report
  • learning from litigation - aims in the Annual progress report through NHS Resolution and GIRFT, including for maternity incidents and publication of GIRFT best practice guidance
  • GIRFT - progress in reducing unwarranted variation in patient safety
  • Early notification scheme - its role in improving maternity safety and supporting families
  • Clinical Negligence Scheme for General Practice - its impact, including on collating data from claims to learn from errors
  • priorities for the Patient Safety Commissioner (PSC) for England - recommended in the Independent Medicines and Medical Devices Safety Review report, including for their role in promoting patient views in decisions on medicines and medical devices
  • whistleblowers and investigations - their role in improving patient safety, changing organisational cultures, and avoiding future claims
  • Support for staff following patient safety incident - the HSIB report, with discussion expected on how support and advice be improved

Policy officials attending:

Our forums are known for attracting strong interest from policymakers and stakeholders. Places have been reserved by parliamentary pass-holders from the House of Commons, and officials from the DHSC; the Government Legal Department; HM Treasury; the Ministry of Justice and the National Audit Office. Also due to attend are representatives from Acumension; Allianz Insurance; ARAG; Association of Personal Injury Lawyers; Berkshire Healthcare NHS Foundation Trust; Bevan Brittan; BPP; BrisDoc Healthcare Services; Browne Jacobson Solicitors; Capsticks Solicitors; Centre for the Adavancement of Interprofessional Education (CAIPE); City Law School; Clyde & Co; DAC Beachcroft; FOIL; Four Elms MEdical Centre Cardiff; General Medical Council; Government Actuary's Department; Hailsham Chambers; Hampshire Hospitals NHS Foundation Trust; Hempsons; Hilary Meredith Solicitors; Hill Dickinson; HSJ Training; JMP Solicitors; Kennedys Law; Kent Community Health NHS Foundation Trust; London School of Economics; Lyons Davidson Solicitors; Medical Protection Society; Moorfields Eye Hospital NHS Foundation trust; NHSEI – GIRFT; NHS Resolution; NHS Patient Safety; NHS Wales Shared Services Partnership; North Tees And Hartlepool Foundation Trust; Novum Law; Nursing and Midwifery Council; Paul Crowley & Co; Premex Services; Primary Care 24; Ropewalk Chambers; The Medical Protection Society; The Silverlining Brain Injury Charity; St John's Chambers; Trust Mediation; United Kingdom Thalassaemia Society; University of Nottingham; Virgin Care and Ward Hadaway.

Press passes have been reserved by representatives from HSJ Training; Pulse and The Irish Times.

This is a full-scale conference taking place online***

  • full, four-hour programme including comfort breaks - you’ll also get a full recording and transcript to refer back to
  • information-rich discussion involving key policymakers and stakeholders
  • conference materials provided in advance, including speaker biographies
  • speakers presenting via webcam, accompanied by slides if they wish, using the Cisco WebEx professional online conference platform (easy for delegates - we’ll provide full details)
  • opportunities for live delegate questions and comments with all speakers
  • a recording of the addresses, all slides cleared by speakers, and further materials, is made available to all delegates afterwards as a permanent record of the proceedings
  • delegates are able to add their own written comments and articles following the conference, to be distributed to all attendees and more widely
  • networking too - there will be opportunities for delegates to e-meet and interact - we’ll tell you how!

Full information and guidance on how to take part will be sent to delegates before the conference

This pack includes

  • Dropbox video recording of the conference
  • PDF transcript of the discussion, including all speaker remarks and Q&A
  • PDFs of speakers' slide material (subject to permission)
  • PDFs of the delegate pack, including speaker biographies and attendee list
  • PDFs of delegate articles