In this report, clinical / social care negligence is defined as:
‘A breach of duty of care by members of the health and social care
professions employed by HSC organisations or by others consequent on
decisions or judgments made by members of those professions acting in
the course of their employment, and which are admitted as negligent by
the employer or determined as such through the legal process.’
The information presented in this publication is sourced from two
Departmental returns:
CN1a - aggregate information on cases including the
amount paid out each quarter.
CN1 - annual patient level return including the
amount paid on each case since it opened.
During 2022/23, £41.7 million was paid on clinical / social care
negligence cases in Northern Ireland, with almost three quarters (74.6%,
£31.1 m) paid in damages, £6.9 million (16.6%) in plaintiff costs and
£3.6 million (8.7%) in defence costs (Figure 1).
During the last five years, the amount paid in clinical / social care
negligence cases increased by £12.5 million (42.9%), from £29.2 million
in 2018/19 to £41.7 million in 2022/23 (Figure 1).
Figure 1: Amount paid out in each year (2018/19 -
2022/23)
Source:
Hospital Information Branch - CN1a Information Return
Between 2018/19 and 2022/23, the number of cases opened increased by
69 (1.7%), from 3,995 to 4,064 (Figures 2 & 3).
Figure 2: Cases open at any stage (2018/19 -
2022/23)
Cases open at any stage in
2022/23:
Belfast: 1,874
Northern:
462
South Eastern: 515
Southern: 519
Western:
551
Legacy HSS Boards: 110
NIAS / NIBTS:
33
Source:
Hospital Information Branch - CN1 Information Return
Outcome of cases at 31 March 2023
Of the 4,064 cases open at any stage in 2022/23, over three quarters
(75.9%, 3,084) remained open at 31 March 2023, 350 (8.6%) were settled
and 630 (15.5%) were closed. Of the 4,064 cases, 457 were newly opened
during 2022/23 (Figures 3 - 6).
Open cases
Across HSC Trusts, the number of cases open ranged from 118 in the
Legacy HSS Boards, NIAS & NIBTS to 1,411 in Belfast HSC Trust
(Figure 3).
Figure 3: Open cases at 31 March (2019 - 2023)
Source:
Hospital Information Branch - CN1 Information Return
Settled cases
Between 31 March 2019 and 2023 the Belfast HSC Trust reported the
largest increase (58%, 49) in settled cases, from 84 to 133 at 31 March
2023 (Figure 4).
Figure 4: Settled cases at 31 March (2019 -
2023)
Source:
Hospital Information Branch - CN1 Information Return
Closed cases
Since 2018/19, the number of cases closed in the Belfast HSC Trust
increased, from 319 to 330 in 2022/23 (Figure 5).
Figure 5: Closed cases (2018/19 - 2022/23)
Source:
Hospital Information Branch - CN1 Information Return
New cases
Since 2018/19, the Northern HSC Trust reported the largest percentage
decrease in the number of new cases opened during the year (-43, -48%),
from 89 to 46 in 2022/23 (Figure 6).
Figure 6: New cases (2018/19 - 2022/23)
Source:
Hospital Information Branch - CN1 Information Return
Age of case
Age of case:
The
average length of time a case had been open in 2022/23 was 3.7
years.
On average, 2.7 years pass between the alleged incident taking place
and a case being opened.
Of the 3,084 cases that remained open at 31 March 2023, 1,296 (42.0%)
had been open for less than three years, whilst 146 (4.7%) had been open
for 10 years or more (Figure 7).
Cases open at any stage in 2022/23, had been open on average for 3.7
years.
Figure 7: Cases open at any stage during the year, by age of
case
Source:
Hospital Information Branch - CN1 Information Return
57 cases accounted for four fifths (£146.9m)
of damages paid
At 31 March 2023, £227.3 million had been paid on the 4,064 clinical
/ social care negligence cases that were open at any stage in 2022/23.
Of this, £179.6 million (79%) had been awarded in damages, £31.1million
(13.7%) in plaintiff costs and £16.7 million (7.3%) in defence costs
(Figure 8).
The plot below details the amount of money paid on cases from the
open date to 31 March 2023 on the x-axis, and the amount of this paid in
2022/23 on the y-axis. Information on damages, defence costs and
plaintiff costs are included for each HSC Trust / Legacy HSS Board, with
larger circles indicating larger payments.
Figure 8: Paid from open date to 31 March 2023 vs paid in
2022/23 only
Source:
Hospital Information Branch - CN1 Information Return
The Belfast HSC Trust paid the largest amount in damages and legal
costs (£65.2m) on cases which were open in 2022/23, 28.7% of all monies
paid (Figure 8).
Over four fifths (81.8%, £146.9m) of the total amount paid in damages
related to 57 (1.4%) of the 4,064 open during 2022/23.
Payments by specialty and nature of incident
Almost three fifths (60%, £136.1m) of the amount paid out on cases
open at any stage in 2022/23 related to the ‘Obstetrics’ specialty
(Figure 9).
The ‘Pregnancy/Childbirth’ nature of incident group accounted for
over two fifths (44.4%, £101m) of the total amount paid to date, on
clinical / social care negligence cases open at any stage during 2022/23
(Figure 9).
The plot below details the amount of money paid by specialty and
nature of incident from the open date to 31 March 2023 on the y-axis,
and the number of cases on the x-axis, with larger circles indicating
larger payments.
Figure 9: Amount paid on cases by specialty and nature of
incident (2022/23)
Source:
Hospital Information Branch - CN1 Information Return
The plot below details the average (median) amount paid by specialty
and case outcome from the open date to 31 March 2023. Each circle
represents the average payment for a particular specialty.
The largest average payouts by specialty related to closed cardiac
surgery cases, with a median payment of £0.5 million (Figure 10).
Figure 10: Average amount paid on cases by specialty
(2022/23)*
*To avoid disclosure of personal data only specialties with more
than one payment are included.
Source:
Hospital Information Branch - CN1 Information Return
The plot below details the average (median) amount paid by nature of
incident and case outcome from the open date to 31 March 2023. Each
circle represents the average payment for a particular nature of
incident.
The largest average payouts by nature of incident related to settled
pregnancy/childbirth cases, with a median payment of £0.9 million
(Figure 11).
Figure 11: Average amount paid on cases by nature of incident
(2022/23)*
*To avoid disclosure of personal data only specialties with more
than one payment are included.
Source:
Hospital Information Branch - CN1 Information Return
PPO cases:
43
PPOs accounted for 55% of all monies paid
Periodic payment orders
Of the £227.3 million paid up to 31 March 2023, over half (55%,
£125.9m) had been paid on 43 PPO cases.
Of the £125.9 million paid in cases with PPOs, £104.7 million (83%)
was paid in damages, £14.8 million (12%) in plaintiff costs and £6.5
million (5.2%) in defence costs.
Figure 12: Amount paid on PPO cases (2018/19 -
2022/23)
Source:
Hospital Information Branch - CN1 Information Return
Payments by outcome
Median payments by
outcome:
Open cases: £2,650
Settled cases:
£70,440
Closed cases: £29,106
Of the £227.3 million that had been paid on cases up to 31 March
2023, 84% (£190.5m) was paid on settled cases, £25.3 million (11%) on
closed cases and £11.4 million (5.0%) on open cases.
During 2022/23, 630 (16%) cases were closed, 68% (431) closed without
payment.
The plot below details the amount paid by nature of incident and case
outcome from the open date to 31 March 2023. Each circle represents the
average payment for a particular nature of incident.
The plot below details the amount paid on each case, by the case
outcome, from the open date to 31 March 2023. Each circle represents a
payment on a particular case. The dashed vertical grey line indicates
the average (median) payment for all cases, whilst the three larger
circles indicate the median payment by outcome at 31 March.
Figure 13: Amount paid by case outcome at 31 March
2023*
*To avoid disclosure of personal data only cases with £500 or more
paid are included.
Source:
Hospital Information Branch - CN1 Information Return
Cases closed with legal costs exceeding
damages
Legal costs exceeding the amount awarded in damages in 112 (17.8%) of
cases closed in 2022/23. Overall, (£2.1m) was paid in legal costs
compared with damages (£1.2m), with the Belfast Trust recording the
largest difference (£0.4m).
Payments on cases closed with no damages
46 (7.3%) cases closed in 2022/23 had no damages awarded but had
legal fees amounting to £0.2 million. This accounted for 0.7% of all
monies paid out on cases closed during 2022/23.
This statistical release summarises information collected from Health
& Social Care (HSC) Trusts, Agencies and Legacy Health and Social
Services (HSS) Boards on clinical / social care negligence cases in
Northern Ireland open during the year ending 31 March 2023. Information
includes all cases currently open and settled, including those withdrawn
or closed with details of any monies paid.
Authors
Jenni Donnelly
Kieran Taggart
Siobhan Morgan
Issued by
Hospital Information Branch
Information & Analysis Directorate
Department of Health
Stormont Estate
Belfast
BT4 3SQ
Information detailed in this release has been quality assured with
HSC Trusts and other Agencies prior to release.
Target audience
DoH, Chief Executives of HSC Trusts in Northern Ireland, health care
professionals, academics, Health & Social Care stakeholders, media
and general public.
