The clinical negligence deaprtment at Leigh Day & Co is often asked to comment on the cost of clinical negligence litigation against the NHS - usually in the context of a so-called "compensation culture". The cost of compensation and legal costs to the NHSLA in 2006 - 2007 was nearly £580 million.
Of course it is easy to count the financial cost of medical negligence in pounds. It is far harder to express the suffering and stress on injured patients and, often ignored, their families. The most devastating of injures in terms of its extent and victim is a cerebral palsy claim on behalf of an injured child due to a mismanaged delivery. A typical case will settle for between two and three million pounds lump sum with annual care costs on top which can be as high as £200,000 for life.
When commenting on such cases we often will say that it would be far wiser for the NHS to invest in better training and staffing so as to minimise the incidence of medical error. Prevention being better that cure. It is good to hear that a NHS trust in Bristol has succeeded in proving that it is possible to dramatically reduce serious medical injury by changes in management.
Following national concern about the quality of interpretation of electronic fetal monitoring it was reported recently in the BMJ that the use of multi-disciplinary training in Southmead Hospital’s maternity unit caused a fall by about half in the number of babies born needing resuscitation and suffering from brain injury. Lessons learnt were to "make the right way the easiest way" and that in-house training encouraged staff to become "in house experts". The cost of each training package was less than £20.
Importantly, a system was designed to monitor the quality of care so that when a dip in the condition of the newborn was noted, more training on fetal electronic monitoring was given. There was then a prompt improvement in the condition of the newborn, proving the link between training and outcome.
In the USA it has been reported that such programmes have led to the reduction of litigation and lower insurance costs. It is encouraging to see that it is possible to improve patient safety by the implementation of well thought out management systems.
Henry Dyson, a partner in the clinical negligence department, said:
"It is good to see evidence that appropriate training can reduce brain injuries in maternity units. We have come across cases in some hospitals where mistakes have been repeated despite internal reports recommending extra training and the use of new guidelines. We hope that other NHS trusts learn from this experience."
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