Expert Witness Secrets

Will the NHS implode under its mountain of litigation claims?

October 06, 2021 Dr Sandeep Senghera BDS, University certified expert witness Season 2 Episode 13
Expert Witness Secrets
Will the NHS implode under its mountain of litigation claims?
Show Notes

Working in the NHS is very tough. We all have first hand experience of the impact of litigation on being able to deliver excellent care however the future liability could erode the essence of the service. 

 

Facts

  • The NHS paid £2.4 billion in clinical negligence claims in 2018/2019, according to NHS resolution formerly the NHS litigation authority *
  • The NHS resolution has accounted for £83.4 billion worth of future claims.
  • The annual budget for the NHS in 2018/2019 was around £129 billion 
  • This amount set aside is amongst the most substantial public sector financial liability faced by the UK government.

 

Underlying Issues

A small number of high valued claims mostly related to maternity care contribute to the majority of the clinical negligence claims. It is clear that this is a direct result of the constraints of the NHS system. In my view patients typically turn to litigation when some or combination of the following affect their care.

 

Firstly, service level experienced by the patient and, secondly, quite often patients are waiting for significant periods before commencing care within the NHS. The providers of health in NHS healthcare are usually under considerable pressure to deliver a high volume of work in very tight time frames. This inevitably prevents the protection of time required to interview, examine, and treat patients, let alone address preventative measures that could address the core issues. I’ve been personally affected by this when targets were increasingly imposed upon me and the system within which I worked. The tendency to simply run faster to treat more patients. This is clearly not the solution. The lack of investment in prevention based medicine in the last few decades is clearly taking its toll on a system designed to treat symptoms rather than prevent the disease. Naturally an aging population with more complex treatment needs along with finite resources is naturally squeezing time doctors and nurses have to manage their patients health needs..

 

Future Impact

The funding required for handling litigation by the NHS being essentially taken from the same pot as the delivery of care. A significant proportion of funding is essentially being redirected from the delivery of care and directed towards limiting financial exposure ( Over £4bn last year). This vicious cycle will perpetuate and compound the issue of limiting resources as more funding is directed away from the delivery of care and directed towards funding litigation. This worsening  position places doctors under growing amounts of time pressure, stress which naturally impacts on their chronic physical and mental health. Figures from the Office for National Statistics, covering England, showed that between 2011 and 2015, 430 health professionals took their own lives.

Whilst successive government talk about investing more in the NHS, very little evidence of disease prevention is noticeable, in my view. Whilst no healthcare system around the world is perfect, ultimately to maintain a finite resource politicians must take a long term view on investing in disease prevention and screening rather than spending more treating lifestyle related disease. 

 

Summary

I do not envisage that politicians are able to take the long term view in light of the limited time they have in power along with the huge political foothold that the NHS has become. It is clear that the quality of patient care is suffering through no fault of the doctors that provide it. In my experience the less time doctors can spend with each patient the more litigation rises. 

This is having a major impact on the health of doctors and dentists.