Queries over clinical negligence figures used in the House of Lords

Following our factcheck on the cost of clinical negligence claims against the NHS, Full Fact were contacted about the number of instances of clinical negligence versus those which give rise to a court case. In particular, in the House of Lords Lord Beecham claimed that:

"The noble Lord, Lord Wigley, referred to the rather alarming statistic that 10 per cent of National Health Service patients in any year suffer from clinical negligence."

Full Fact could not locate Lord Wigley's exact reference to this statistic. However, Lord Wigley does make the claim that "there are about one million adverse accidents in the NHS every year", arguing that there was a much smaller number of instances resulting in a clinical negligence claim and subsequently there was little evidence of a compensation culture, so we assume this is what Lord Beecham refers to.

The claim that 10 per cent of patients suffer from clinical negligence can be traced back to evidence given to the Health Select Committee by Professor Richard Thomson in 2008.

Professor Thomson states that "around 10% of admissions to hospital suffer some form of harm but more associated with medical management than with the underlying disease processes. That figure is seen internationally in other developed healthcare systems".

Professor Thomson cites a study in 2001 by Professor Charles Vincent into the number of patients experiencing 'adverse events', reviewing medical notes for 1014 patients. 110 patients experienced an adverse event, giving a rate of 10.8 per cent.

An adverse event is defined as "unintended injuries caused by medical management rather than the disease process" - a much broader definition than that used by the courts for clinical negligence.

Furthermore, the NHS Litigation Authority outlines a two-part test for clinical negligence, whereby negligence has occurred if:

1. The doctor (or medical professional) must have acted in a way that fell short of acceptable professional standards
2. Their actions must be shown on the balance of probabilities to be directly linked to the harm suffered

In particular, the first requirement that the actions of the party responsible must have fallen below acceptable professional standards is not taken into account when defining 'adverse events'. It is also possible it will not be present in some of the cases found in the NHS's favour, although cases without this element are unlikely to be brought before the courts.

The Whole Government Accounts give figures for the amount paid out for clinical negligence claims, and therefore are not subject to the same distinction.

Nevertheless, members of the House of Lords appear to be using the terms interchangeably, potentially undermining their arguments about 'no win, no fee' arrangements. This is apt to cause a certain amount of confusion about what the figures actually mean.