Vernon: Ongoing challenges across the system
NHS spending on claimant legal costs was static last year, even though the costs of low-value cases continue to rise sharply.
The annual report of NHS Resolution (NHSR) showed that a record 84% of clinical negligence claims were resolved without the need for proceedings, which it said demonstrated the impact of the first year of its ‘Resolution Through Collaboration’ strategy.
The strategy focuses on delivering “fairer resolution”, using data to drive learning, and strengthening NHS Resolution’s contribution to improving patient safety, particularly in maternity and neonatal care.
NHSR received a record 15,236 new clinical negligence claims in the year to 31 March, 6% more than in 2024-25, and resolved 11,841, 11% fewer due to the transition to its new claims management system, “which had a short-term impact in relation to the day-to-day management of claims”.
Nonetheless, NHSR still paid out £3.24bn in 2025-26 (up 4.8%), made up of £2.43bn in damages (up 6.2%, £622m in claimant legal costs (up 0.2%) and £188m in NHS legal costs (up 3.9%).
The figure for claimant costs payouts is striking given that it rose significantly in each of the last two years, by 14% and 11% respectively.
However, for claims valued up to £25,000, the average claimant legal costs paid per claim jumped 11% to £30,264 – this has been steadily increasing and it was only in 2023-24 that the average costs exceeded damages for the first time.
For claims valued between £25,001 and £100,000, the average claimant legal costs paid per claim actually fell marginally to £55,615.
NHSR acknowledged that the increase in the proportion of claims resolved without litigation “cannot continue indefinitely” – in 2017-18 it was 68% – but “we will always continue to promote dispute resolution over litigation”.
Only 16 clinical claims went to trial; damages were awarded in six of them.
“In 2025/26, we continued to develop and expand our use of resolution meetings, stock take meetings, mediation, and early neutral evaluation,” NHSR said.
Two new claimant firms were introduced to resolution meetings – where the parties discuss their positions openly – “which delivered excellent outcomes”.
The report said: “This has further enhanced constructive engagement and early dialogue between the parties, reducing protracted litigation and reinforcing the value of resolution meetings as an effective dispute resolution tool.
“Interest in participating in resolution meetings continues to grow, with a number of additional claimant firms expressing a desire to engage in this way.”
Some 143 claims went to mediation, with 71% settling on the day or within 28 days – the number of mediations has not been largely static over the 10 years the scheme has been operating.
NHSR said a pilot with two claimant law firms to assess early neutral evaluation “yielded positive results by providing a pathway for cases unresolved through other dispute resolution methods and facilitating closure for claimants”.
The report went on: “It fostered collaborative working, openness, and transparency, effectively mitigating the need for litigation. Additionally, the pilot influenced wider case management approaches, leading to increased mutual exchange of expert evidence and the adoption of stock take meetings.
“Of the 47 claims processed through the early neutral evaluation pilot, 70% were successfully resolved.”
As we reported last year, there has been a competitive procurement exercise to award four-year contracts for the provision of neutral evaluation services, with the Centre for Effective Dispute Resolution and Trust Mediation successful, but the launch date for the new service has yet to be confirmed.
NHSR chief executive Helen Vernon said: “We recognise the ongoing challenges across the system and we will continue to work closely with government and partners to address these issues, while remaining focused on resolving claims fairly, sharing learning, and supporting safer care across the NHS.”
One-time justice minister David Lock KC is advising the government on the rising legal costs of clinical negligence and how to improve patients’ experiences when making claims, while earlier this year MPs said it was “unacceptable” that so much public money was spent on legal fees for clinical negligence claims.
Leave a Comment