England and Wales introduce new system for medical negligence claims

Clare Dyer, legal correspondent , BMJ

The biggest changes this century to the way medical negligence claims in England and Wales are dealt with came into effect this week. In cases of serious adverse outcomes, patients will be entitled for the first time to an explanation of what happened. New procedures to encourage openness, the early release of medical notes, and early settlement should revolutionise a system which up until now has been plagued by high costs, delays, and mistrust.
Medical negligence claims cost the NHS £300m ($480m) in 1998-9, much of the money going on legal costs. The average medical negligence claim takes five years to resolve, and some drag on for a decade or more. The new "pre-action" protocol for the resolution of clinical disputes lays down the steps both sides will have to take from the moment a patient first raises concerns about treatment. Part of a shake up of the whole civil justice system, which came into operation on Monday (26 April), the measure is designed to encourage greater openness, minimise the atmosphere of mistrust which often surrounds a medical negligence claim, and lead to speedier resolution of cases, without litigation if possible.

BMJ 1999;318:1165 ( 1 May )