Learning from Litigation Claims – GIRFT and NHS Resolution’s new guide for NHS trust managers and staff

Getting it Right First Time (GIRFT), the national programme working to improve NHS medical care, has collaborated with the NHS defence organisation, NHS Resolution, to publish new guidance to help NHS trust managers and staff learn the lessons from medical negligence claims within their organisations.

The stated aims of the new guide, “Learning from Litigation Claims: The Getting It Right First Time (GIRFT) and NHS Resolution best practice guide for clinicians and managers”, is to maximise what can be learned from claims, to improve patient safety and reduce escalating costs.

Background to GIRFT’s ‘Learning from Litigation Claims’ guide

According to NHS Resolution, the annual cost of avoidable harm to patients from NHS mistakes amounted to £8.3billion in 2019 to 2020. As patient claims specialists, we know this shocking figure only tells part of the story, as it relates to the financial compensation (now and in the future) and legal costs paid in claims. The true cost of harm to injured patients and their families (including those whose injuries are not compensated) remains unknown. The impact of severe avoidable injury cannot be measured financially.

We have reported before on GIRFT’s valuable work to improve standards of care across various areas of medicine, such as diabetes and different types of surgery.

GIRFT’s ‘deep dive’ investigations into litigation in high priority areas of healthcare have revealed that ways in which NHS trusts can get better at preventing claims, and managing those that occur better, to learn from them and improve patient safety. 

GIRFT learned that even though some NHS Trusts’ claims insurance contributions exceed over £40 million per year, hospital staff and managers are often unaware of claims against their department. More needs to be done within NHS trusts to recognise the direct link between patient safety incidents, claims for compensation and the cost of their insurance contribution, and to improve patient safety and reduce the number and cost of claims by learning from when things go wrong.

In order to help NHS trusts properly manage and learn from medical negligence claims, GIRFT and NHS Resolution published their Learning from Litigation guide.

What does the new ‘Learning from Litigation’ guidance say?

The guide provides a structure for learning from medical negligence claims. The recommended steps should be led by NHS trust legal departments and supported by the trust’s clinicians and managers. Learning from claims should be seen to be as important as learning from patient safety incidents.

Recommendations include:

• involving clinical staff in learning from negligence claims by:
  • appointing dedicated clinical staff, with time allocated within their job schedule, to assist the trust’s legal team;
  • formally discussing and reviewing a clinical department’s claims, at least quarterly, in departmental meetings led by senior clinicians and attended by clinical staff with support from trust legal teams;
  • annual reviews of claims at regional level.
• targeting high value learning areas in discussions with clinicians, such as:
  • using case summaries provided by the trust legal team from closed cases where liability (fault) was admitted;
  • having updates from NHS defence panel law firms and expert witnesses about high cost cases which are ongoing;
  • benchmarking the trust’s litigation activity using resources from GIRFT and NHS Resolution;
  • attending clinically relevant legal talks with invited speakers from defence panel law firms.
• making clinical staff aware when a patient has started a claim and supporting them through the process.
• removing the stigma around discussing medical negligence claims to improve patient care by:
  • making clinicians more aware of the claims process;
  • ensuring that the trust’s legal team is more visible to clinical staff at all times;
  • ensuring that legal teams are supported by senior clinicians to increase staff engagement and effective communication with clinical teams. 
  • Keeping the emphasis of discussions on analysing the cause and making improvement instead of blame.
• working in partnership with patients, their families and carers by:
  • Involving them with safety investigations;
  • being open with them and demonstrating candour (honesty);
  • signposting them to support;
  • committing to them that learning will be shared from what has happened.

The guide refers NHS trusts and their staff to further resources provided by NHS Resolution on how to be open, honest and apologise and support patients and their families when incidents occur.

The guide emphasises the importance of making sure that all concerns of the patient and their family are fully and frankly addressed and that everything possible is done to maintain their trust. It says that this may include offering material support, including treatment, advice, equipment and early resolution of appropriate claims where the patient is entitled to compensation.

Other recommendations in the guide include minimum reporting requirements, including using NHS Resolution’s learning resources, standards required of medical experts and other sources of advice about best practice in claims litigation.

GIRFT highlighted some key areas of clinical practice which commonly emerge in medical negligence claims, which NHS trusts should consider targeting for improvement. These included:

• the steps needed to obtain the patient’s informed consent; 
• the importance of managing the patient’s expectations before they have treatment or undergo any procedure;
• the importance of properly completing clinical records;
• ensuring that patients have timely access to investigations, such as MRI scans for suspected cauda equina;
• the proper use of safety checklists.

Boyes Turner continue to help injured patients claim compensation after negligent care

We recognise the efforts and valuable work carried out by GIRFT specialists and teams across the country to help NHS trusts, managers and clinicians learn from their mistakes and standards of good practice to bring about improvements in patient care. Despite this support, however, the NHS has yet to demonstrate that it can learn. Whilst the financial cost of claims all too frequently hits the headlines, we remain committed to helping injured patients recover their entitlement to compensation after they are left with lifelong disability as a result of negligence and avoidable harm.

If you have been injured as a result of medical negligence, and would like to find out more about making a claim, contact us by email at mednegclaims@boyesturner.com.