NHS Compensation Claims 2026: How Clinical Negligence Works, What You Can Claim & The Process

NHS compensation claims are handled by NHS Resolution (formerly the NHS Litigation Authority) — the body that manages clinical negligence claims against NHS organisations in England. Claims must demonstrate four elements: 1. **Duty of care** — The NHS owed you a duty of care (this is usually straightforward — established when you were a patient) 2. **Breach** — The care provided fell below the standard expected of a reasonably competent practitioner (the Bolam test, as refined by Bolitho) 3. **Causation** — The breach of duty caused or materially contributed to the harm you suffered 4. **Loss** — You suffered quantifiable loss (physical injury, financial loss, psychological harm, reduced quality of life) All four elements must be proven on the "balance of probabilities" (more likely than not — i.e., greater than 50% likelihood). If any element fails, the claim fails.

**1. Initial enquiry (free):** Contact a clinical negligence solicitor for a free initial assessment. They will review your case and advise on prospects. **2. Investigation and medical records:** Your solicitor obtains your medical records (the NHS must provide these within 40 days under GDPR). Expert medical opinion is obtained to assess whether care fell below standard. **3. Letter of Claim:** A formal letter is sent to the NHS Trust/GP practice outlining the allegations, the harm suffered, and the legal basis. **4. NHS Resolution investigation (up to 4 months):** NHS Resolution investigates the claim on behalf of the Trust. They obtain their own expert evidence. **5. Letter of Response:** Liability is admitted (full or partial), denied, or the Trust makes a Part 36 offer to settle. **6. Negotiation (quantum):** If liability is established, both sides negotiate the compensation amount. This can take months to years for complex cases. **7. Settlement or Trial:** Most claims settle out of court (approximately 98%). Only 1–2% proceed to trial. Settlement avoids the uncertainty of a judge's decision.

Strict time limits apply to clinical negligence claims: • **Adults**: 3 years from the date of injury, OR 3 years from the "date of knowledge" (when you first realised the harm was caused by negligence) • **Children**: No time limit until the child turns 18, then 3 years from their 18th birthday (i.e., until age 21) • **Patients lacking mental capacity**: No time limit while they lack capacity • **Fatal claims**: 3 years from the date of death (or date of knowledge of the personal representative) These limits are strictly enforced. If you think you may have a claim, seek legal advice promptly — even if you're unsure.

Compensation (called "damages") covers two main categories: **General damages (pain, suffering, and loss of amenity):** • Compensation for the injury itself and its impact on your life • Assessed using judicial guidelines and case precedent • Examples: minor scarring £5,000–£15,000; loss of a limb £100,000–£300,000; severe brain injury £300,000+ **Special damages (financial losses):** • Past and future loss of earnings • Care costs (professional carers, family members providing care) • Medical treatment costs (private treatment, rehabilitation, equipment) • Travel costs to medical appointments • Accommodation adaptations (wheelchair access, wet rooms) • Court of Protection costs (for brain-injured patients) In catastrophic injury cases (severe brain injury, spinal cord injury), the care and accommodation costs often dwarf the general damages, producing multi-million pound settlements.

NHS Resolution's annual report provides insight into the scale of clinical negligence: • **New claims received**: ~15,000 per year • **Total damages paid**: ~£2.7 billion per year • **Average resolution time**: 3.4 years • **Costs split**: ~65% goes to claimants, ~35% to legal costs (both sides) • **Total outstanding liabilities**: £128.5 billion (the estimated cost of all current and future claims) The largest single area of cost is maternity/birth injury claims — approximately 60% of all compensation paid despite representing only about 12% of claim numbers. A single severe birth injury claim can exceed £20 million.

Not every grievance requires litigation: • **NHS Complaints Procedure**: Formal complaint to the Trust, then to the Parliamentary and Health Service Ombudsman (PHSO). Can result in apology, explanation, and service changes — but NOT financial compensation. • **Mediation**: Available through NHS Resolution's Early Notification Scheme. Can resolve disputes faster and with less stress. • **HSIB investigations**: For patient safety incidents — focused on learning rather than blame. • **Coroner's inquest**: For deaths where the cause is uncertain. Can lead to Prevention of Future Deaths reports. Many patients want an explanation and apology more than money. The NHS has improved its approach to openness and duty of candour, but the "litigation culture" remains a concern for many clinicians.

Clinical negligence claims are complex and almost always require specialist legal representation: • Most solicitors offer a free initial consultation • **AvMA** (Action against Medical Accidents): Free independent advice on 0345 123 2352 • **The Law Society**: "Find a Solicitor" tool locates specialists by area • **Citizens Advice**: Can provide general guidance and referrals • **Legal Aid**: Available for birth injury claims (clinical negligence is otherwise excluded from legal aid) Choose a solicitor who specialises in clinical negligence — general practice solicitors may not have the expertise for complex medical cases. Check for accreditation (AvMA panel membership, Law Society Clinical Negligence Accreditation).