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Group B Streptococcus (GBS) is the leading cause of serious bacterial infection in the first few weeks of life and is a major global cause of neonatal meningitis, sepsis and pneumonia. This report examines clinical negligence claims related to early onset GBS disease in neonates. The analysis reviewed 19 closed claims notified between January 2016 and March 2023, of which 11 were settled with damages paid. The total cost of these closed claims was £1,430,894, including claimant legal costs, NHS legal costs and damages. The report makes practical recommendations for maternity and neonatal services, including improved triage systems, robust processes for tracking and communicating test results, and enhanced staff training in recognising signs of sepsis. Did you know? Most babies in this group were symptomatic within the first 24 hours of life. Most babies in this cohort presented as being unwell at the time of birth or with early jaundice or poor feeding. 79% of infants required a prolonged inpatient admission, with the mean stay being 6.6 days and the maximum being 21 days. Across all these claims, this included days on neonatal units (NICUs), paediatric intensive care units (PICUs), postnatal wards and paediatric wards. Only 25% of babies in this group received antibiotics within the nationally recognised 1-hour target. In this group of babies with early onset GBS disease, the proportion of mothers known to be colonised during pregnancy, found to be colonised during or after the delivery, and not known to be carrying GBS at all were almost equal (i.e. around a third in each of these categories). Further reading on the hub Top picks: 7 resources about Group B Strep

Patients, service users, their loved ones and carers have the right to raise concerns about the care they receive under the NHS in Wales. This can be done through the Listening to People NHS Wales Complaints, Incidents, and Redress process. Raising a concern can be difficult and distressing. People often come forward because something has had a real impact on them or their loved ones. This guidance explains what support you can expect and what will happen when you raise a concern. A concern can include a complaint, patient-safety incident or any other issue relating to an organisation’s health services. Responsible bodies, which are organisations that are legally responsible for your care, have a duty to listen to, act on, investigate and respond to concerns, and to learn from them to improve care and reduce the risk of harm re-occurring in the future. Responsible bodies can be an NHS organisation, a GP practice, dental practice or an Independent Provider delivering NHS funded care. Raising a concern often follows upsetting or traumatic experiences and NHS organisations in Wales aim to respond in ways that are compassionate, respectful and sensitive to the impact on you and your loved ones.  Further reading on the hub: How to make a complaint

In this report the Public Accounts Committee states that, although the as UK government’s liability for clinical negligence quadrupled over 20 years, the Department of Health and Social Care (DHSC) is unable to show any meaningful action taken to address this. They also argue that the NHS has not done enough to tackle the underlying causes of patient harm. This report was published as part of an inquiry by the Public Accounts Committee looking specifically at the costs of clinical negligence claims. The Committee examines the value for money of UK Government projects, programmes and service delivery. Key conclusions and recommendations in the report are as follows: DHSC has failed to tackle the rising costs of clinical negligence despite repeated warnings. The report notes that the government’s liability for clinical negligence has quadrupled in real terms since 2006–07, reaching £60 billion in 2024–25. Annual settlement costs have tripled to £3.6 billion in 2024–25 with forecasts suggesting the cost of clinical negligence will continue to rise significantly in coming years. It recommends that: Alongside its Treasury Minute response to this report DHSC should write to the Committee explain its operational plan to tackle clinical negligence, including key milestones for achieving reductions in claim costs and volumes. DHSC should also publish David Lock KC’s review of clinical negligence within six months of it being completed. This should include all supporting analysis and the Department’s response to any recommendations made by the review. The NHS has not done enough to tackle the underlying causes of harm to patients. The report states that DHSC and NHS England’s (NHSE) approach to patient safety lacks coordination and that patients often pursue legal action to get answers and accountability due to a confusing and unresponsive complaints system. It recommends that: DHSC must set a national framework for improving patient safety with clear targets for annual improvement. DHSC must review the NHS complaints system and improve the number of cases that are resolved without recourse to litigation. DHSC should estimate and track the costs to the NHS of treating avoidable harm. DHSC should write to the Committee to set out progress in implementing the Dash Review and its assessment of the impact of abolishing the Health Services Safety Investigations Body (HSSIB) on patient safety. DHSC and NHSE should have a clear system of accountability for patient safety, learning from mistakes and sharing what works, implementing best practice across the NHS streamlining patient safety alerts and recommendations from national bodies. We are concerned there is far too little data on the factors behind clinical negligence, given its huge impact on people’s lives and NHS finances. The report states they are disappointed that neither the Department nor NHS England could adequately explain how the NHS uses its extensive data on patient harm to identify and address the underlying causes of clinical negligence. It recommends that: DHSC should establish a national system for sharing data between trusts and analysing trends. If there are barriers to sharing protected data, it should develop analysis on an anonymised basis to pull out lessons and provide early warning alerts to trusts DHSC, NHSE and NHS Resolution should explore the use of artificial intelligence to analyse live data, detect discrepancies and outliers quickly, and improve the speed of early warning systems. The Department’s failure to address problems with maternity care in England has led to avoidable harm and unnecessary costs. It recommends that: DHSC and the organisations it funds need to learn lessons from its failure to improve maternity care in England. Where problems arise the Department and the wider NHS should look for systemic failings in care and tackle these problems at their cause. DHSC should publish the Amos Review within two months alongside its response and set out how it plans to reduce the incidence of harm and the costs of claims in maternity care. Legal costs in clinical negligence claims are disproportionate for medium and low volume claims. It recommends that: DHSC should develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex cases. As part of this, the Department should look at international examples (such as in New Zealand and Sweden) of non-adversarial and ombudsman models and assess how our ombudsman system could be improved. DHSC should clarify its position on a fixed recoverable costs scheme for lower-value clinical negligence cases at the earliest opportunity. Clinical negligence claims are settled on the basis of costs of care in the private sector and yet there is nothing to stop the claimant using the NHS or publicly funded social care in the future, potentially inflating the costs of claims. It recommends that: DHSC should develop, within six months, proper estimates of the impact of assuming health and social care for clinical negligence victims will be provided exclusively by the private sector. It should by the same deadline set out additional measures—including any requiring changes to legislation—which it judges would effectively guard against the risk of paying twice for the care of those it has harmed and an indicative timeline for their potential implementation.

In this letter, Samantha Jones OBE Permanent Secretary Department of Health and Social Care writes in response to the questions at the Public Accounts Committee hearing on 20th November 2025 into the costs of clinical negligence. The letter responds to the following unanswered questions on the topic of clinical negligence only: 1) Never events: How often do they result in clinical negligence claims?   2) Complaints: How quickly are complaints responded to, and is that data  published?   3) Inquests: Will the use of conditional fee agreements in inquests impact  patient safety?  Also included are sections where she shares insights on: 4) General Practice Indemnity (GPI) schemes five-year financial forecasts.  5) Detail on work ongoing to engage firms on the transparency of conditional.  fee agreements between claimants and their solicitors. 

This report, produced by NHS Resolution in collaboration with the Royal College of Obstetricians and Gynaecologists, analyses Obstetric Anal Sphincter Injuries (OASI) claims made by claimants between 2011/12 and 2021/22. It highlights common themes in OASI claims and provides guidance to help healthcare professionals prevent OASI where possible. It also identifies key areas of care that can be improved, ensuring better support for women affected by OASI. This report identifies the following areas for improvement in the prevention, diagnosis, and management of OASI: Safer assisted vaginal births – Ensure all obstetricians are trained on the basic principles of assisted instrumental delivery, including avoidance of excessive force so that gentle traction is applied with a uterine contraction and appropriate use of ventouse and forceps with episiotomy when required. This should also include how to assess for OASIs. Supervision of trainee clinicians – Provide adequate support and supervision of both midwives and non-consultant grade doctors when performing complex deliveries such as assisted births, particularly rotational deliveries. Promote and encourage perineal protection, especially during difficult deliveries. Diagnosis of OASI – Focus on appropriate clinical training to ensure clinicians can perform a systematic bimanual vaginal and rectal examination to identify an OASI. This should include using the pill rolling technique to identify OASI at the time of birth so that the injury can be repaired, as this gives the best outcomes. Education – Educate clinicians on the symptoms that can affect women who sustain OASIs, as well as the social, psychological, and economic impact of these injuries. This includes supporting clinical teams to consider underlying risk factors during pregnancy, follow the appropriate pathway of assessment, and escalate concerns about potential OASIs, supported by greater awareness of the significant impact these injuries can have on women. We must also ensure that clinicians are appropriately trained and supervised to repair OASIs. Awareness of rectovaginal fistula (an undetected or repaired fourth degree tear) – This remains a rare complication of OASIs but has a devastating impact on women. Clinicians should be aware of this potential complication, its presenting symptoms, and how to assess for this in a multidisciplinary context. Pathway for management of women with missed OASIs – Management remains very variable across units, depending on local facilities and expertise available, and further guidance is urgently needed to improve consistency and long-term outcomes. NHS Resolution have also produced a one page poster that summarises the key messages at a glance which clinicians are encouraged to print and display this poster on notice boards within clinical areas. You can find this here.

Judy Walker, specialist After Action Review facilitator and training provider, joined Joanna Lloyd for a discussion on how PSIRF is impacting on clinical negligence claims, the inquest process, and how different learning responses are received by families. The presentation slides can be found in Bevan Britain's On Demand library, via the link below. The presentation slides are also available to download and share. 

In this blog John Tingle, Associate Professor at Birmingham Law School (University of Birmingham), discusses the concept of blame in relation to patient safety. He considers how this relates to the current NHS patient safety policy framework and clinical negligence litigation , outlining tensons between the two.

There's a call to compensate women caught up in the scandal of faulty breast implants manufactured by a French company. The PIP scandal happened in 2012 when it emerged that the implants were filled with industrial silicone instead of medical grade silicone. The implants are far more likely to rupture than others. MPs on the Women’s and Equalities Committee have been hearing calls for compensation during their inquiry into the health impacts of breast implants and other cosmetic procedures. Jan Spivey from PIP Action Campaign and Professor Carl Heneghan from The Centre for Evidence Based Medicine join Women's Hour to discuss this.

NHS Resolution has announced the implementation of a new Clinical Negligence Claims Agreement for 2024. This agreement has been developed in collaboration with key stakeholders, including Action against Medical Accidents (AvMA) and the Society of Clinical Injury Lawyers (SCIL). Key features of the new agreement include: Extended limitation periods for certain cases, providing flexibility for claimants and their representatives. Emphasis on early disclosure of relevant documentation to help narrow issues and reduce investigation costs. Improved communication protocols, including ongoing acceptance of electronic correspondence and service of documents. Encouragement of pre-action discussions and dispute resolution to avoid unnecessary litigation. "The agreement encourages apologies where appropriate and reflects that harmed individuals and their families often want to ensure that similar errors are avoided in the future. Defendant organisations are encouraged to provide apologies and identify where lessons have been learned and what steps have been taken to prevent further harm." Sharon Allison, Chair of SCIL (Society of Clinical Injury Lawyers

On 13 September, our Safety and Learning team, in collaboration with Health Services Safety Investigations Body and NHS England, hosted a virtual forum on the benefits of implementing safety science in primary care, responding to patient safety incidents and the support available to staff working in primary care. The recording of the forum is now available.