25 September 2024

Abby Wallace, Trainee Solicitor in the Clinical Negligence Department considers the outcome of the independent investigation of the NHS which was released on 12^th September 2024.

What was the Independent Investigation?

In July 2024, the Secretary of State for Health and Social Care requested that Lord Dazi, a Consultant Surgeon and Independent Member of the House of Lords, conduct an independent investigation of the NHS to understand its current performance, in particular patient access to healthcare and the quality of the healthcare provided.

What was the outcome of the investigation?

The investigation concluded that the NHS is currently in a critical condition, due to the continuing struggle with the aftershocks of the Covid-19 pandemic and managerial capacities and capabilities being degraded. The trust and goodwill of frontline staff has been lost and there has been a lack of capital investment which is less than other comparable countries by some tens of billions of pounds.

In contrast, the demand on the NHS has increased as the health of the nation, including mental health, has deteriorated. There are more people living with long term conditions, but the NHS has not been able to keep up with the demand on its services.

It was highlighted that in almost all NHS services, performance on access to care has declined and long waiting times have become normalised. In June 2024 more than 300,000 patients waited over a year for treatment and 1.75 million waited between 6-12 months. Unsurprisingly, public satisfaction has declined as a result and is currently at its lowest.

It was however felt that significant improvement could be made over time in order to restore the NHS, with an aim to focus on re-engaging staff, re-empowering patients, addressing care closer to home, making care more accessible, increasing hospital productivity and generally reforming the service to make it deliver.

Complaints and Clinical Negligence

It was revealed that the number of complaints regarding NHS care has almost doubled in just over a decade with 14,615 formal complaints in 2011-2012 compared to 28,780 in 2023-2024, with clinical negligence payments of £2.9 billion being made in 2023-24 accounting for 1.7% of the entire NHS budget.

Other key points

Some other key points noted within the report were:

• The patient’s voice was felt to ‘not be loud enough’

• There is a cover-up culture within the NHS which includes concealing problems, taking retaliatory actions against clinicians who raise concerns, the altering of care plans, disappearance of crucial documents after patients have died and robust denial in the face of evidence.

• The NHS still appears to struggle with the duty of candour (to act in an open and transparent way with people receiving care or treatment from them).

Conclusion

This investigation has highlighted the pressure that the NHS is currently under and that as a result, availability, timings and quality of care are being affected. With such pressure comes the potential for more mistakes and further substandard care, which in turn is likely to result in further clinical negligence claims.

It is important to bear in mind that in clinical negligence claims, this pressure to some extent will be considered in determining whether care has been negligent and, in some cases, although the care is not the standard that would be expected, it may not fall below a standard deemed to be negligent and will simply be regarded as poor care.