NHS Resolution: Learning from Emergency Medicine compensation claims (28 March 2022)

Summary

NHS Resolution has published a set of three reports which explore clinical issues that contribute to compensation claims within Emergency Departments.

Content

In total, 220 cases were examined, where the incidents occurred between 2014 and 2018 and a legal liability had been established.

The first report looks at high-value and fatality-related claims over £1m; the second report assesses missed fractures; and the third report evaluates hospital-acquired pressure ulcers and falls in ED. Each report also contains clear recommendations to help prevent further incidents. One of the main findings across all the reports is that ED clinical services should provide timely identification of diagnoses and treatment plans for patients. This should include what to look out for and actions that should be taken if the patient deteriorates. Good record-keeping and communication to support handover and ‘safety netting’ for patients – where they are followed up in a timely and appropriate manner – underpins the delivery of timely diagnoses and the delivery of effective treatment plans.

The other key clinical issues the reports highlight are:

• access to senior staff review, with appropriate use of multidisciplinary teams working between specialties;
• systems in place for prompt clinical imaging;
• infrastructure for appropriate escalation and handover of clinical details to senior clinical staff and specialist clinicians respectively;
• identification and proportionate clinical strategy regarding patients who regularly attend ED; and
• the benefits of digital solutions to support timely and appropriate clinical decisions for patients.