Abstract
Aims and methodWe analysed all 1213 negligence claims made against contributing psychiatric services since the inception of the National Health Service Litigation Authority (NHSLA) in 1995 and until 1 June 2009. More than half (55%) were settled, at a cost of £47.2 million, 26% were closed without penalty and 19% were still in progress at the time of review. Five individual claims exceeded £1 million.ResultsBy allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%).Clinical implicationsAt the individual level it is difficult to see patterns of errors, whereas increased volumes reveal systemic trends. This analysis presents a new perspective from which to improve patient safety.
Highlights
ResultsBy allocating 43 National Health Service Litigation Authority (NHSLA)-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%)
Following a request to the National Health Service Litigation Authority (NHSLA) under the Freedom of Information Act 2003, a Microsoft Excel spreadsheet containing litigation data directed at NHS psychiatric services between 1995 and 2009 was received
Causes of litigation/injury had been grouped by the NHSLA into 43 domains which we rationalised to 39 by re-assigning 4 domains that related to outcomes based on their vignette detail
Summary
By allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%). The National Health Service Litigation Authority (NHSLA), established in 1995 to handle compensation claims against the NHS, reports that £769 million was paid in connection with clinical negligence claims during 2008/2009, up from £633 million in 2007/2008.1 Against a total annual budget for the NHS of approximately £75 billion (excluding the capital budget), litigation costs represent approximately 1%. In these straitened times when the NHS is expected to make savings of over £20 billion during the 4 years, a clinical governance input to service delivery is an important area of focus. The effects of the error have been extracted and categorised to provide a meaningful classification of the impact on the patient
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