1117 The NHS in Crisis; Assessment of the Impact of Litigation Trends Over 20 Years in General Surgery

Abstract

Abstract Introduction A rising proportion of the National Health Service (NHS) annual budget is being spent on medico-legal costs, with over 1.6% of total UK healthcare spending on litigation in the year 2018/19. This is a risk to both patient care and public opinion of the NHS and as per business definitions the system is in crisis. This paper aims to assess the scale of the litigation crisis to fuel further work into mitigating it to improve value for patients and staff alike. Method Data was obtained from NHS resolution for claims relating to General Surgery between January 2000 and December 2020 to include the following: number of claims, cost of settled claims with and without damages paid, age/sex of patients, and primary injuries/causes. Results Between 2000 and 2020, 17,542 claims were made against General Surgical units in England with an increase in claims per year. Successfully closed claims cost the NHS £1.3 billion. The three most common causes for claims were intra-operative problems, failure/delay of treatment and failure/delay of diagnosis. Conclusions The NHS is threatened by a litigation crisis, with case volume and cost rising out of proportion to surgical workload and inflation. The most common causes for claims are known complications discussed as part of a standard consenting process, indicating that current practice may fail to achieve adequate patient understanding of surgical risk. More research is required to improve the current consenting process and identify demographics that may increase an individual’s propensity to make a claim.