The NHS is a cornerstone of healthcare provision in the UK, providing vital medical treatment to millions of people each year. However, despite the dedication of NHS healthcare professionals, mistakes can sometimes happen. When substandard medical care leads to injuries or harm, patients may be entitled to pursue an NHS compensation claim. This process gives those affected by negligence the financial support they need to move forward, whether this is to cover ongoing medical expenses, loss of earnings, or compensation for pain and suffering.

At JMW, we understand how distressing it can be when medical negligence occurs, particularly in a setting where patients place their trust in medical professionals. Our expert team of medical negligence solicitors has years of experience helping individuals navigate the claims process and securing the compensation they deserve.

In our NHS compensation payouts guide, we will explain everything you need to know about the NHS compensation claims process, exploring eligibility criteria, how claims are calculated, and the process of pursuing your case. Whether you have experienced hospital negligence, substandard medical care, or another form of clinical negligence, this guide aims to provide clear advice about your options.

What Are NHS Compensation Payouts Available For?

NHS compensation payouts are designed to provide financial support to individuals who have suffered harm due to substandard medical care within the NHS. These payouts address a wide range of situations where medical negligence occurred, ensuring that individuals receive fair compensation for the injuries sustained, the impact on their quality of life, and any associated financial losses.

Below are some examples of the most common scenarios where patients may be entitled to claim clinical negligence compensation:

• Misdiagnosis or delayed diagnosis: A misdiagnosis, or a delay in diagnosing a condition, can have devastating consequences. When the right treatment is not provided promptly, it can result in the worsening of a patient’s condition or lead to avoidable complications. For example, a delayed diagnosis of cancer may reduce treatment options or even affect the chances of recovery. In these cases, patients may seek compensation for the harm they have endured.
• Surgical errors: Surgical procedures carry inherent risks, but when mistakes occur due to negligence, the consequences can be life-altering. Examples include performing surgery on the wrong part of the body, leaving surgical instruments inside a patient, or causing unintended injuries during a procedure. Such incidents can lead to further medical treatment, prolonged recovery times, and significant emotional distress, all of which can be accounted for in a compensation claim.
• Birth injuries: Birth injuries can have a profound impact on both the baby and the mother. Cases of clinical negligence in obstetric care may include a failure to monitor the baby’s heart rate, delays in performing a necessary caesarean section, or improper use of instruments like forceps. These incidents can lead to conditions such as cerebral palsy, brachial plexus injuries, or physical trauma. Families affected by such errors may be entitled to medical negligence payouts to help with ongoing care and support.
• Medication errors: Mistakes involving prescription drugs, such as providing the wrong medication, delivering or recommending incorrect dosages, or failing to consider potential drug allergies, can have serious consequences for patients. Whether the error occurred in a hospital setting or during routine GP care, those affected may be able to claim compensation for the harm caused by these preventable errors.
• Negligent aftercare: Post-surgery treatment and aftercare are crucial parts of a patient’s recovery process. Failing to provide proper aftercare, such as monitoring patients for complications, can lead to unnecessary suffering or further harm. For example, failing to detect an infection after surgery could result in the need for additional treatment or prolonged hospital stays. Patients experiencing substandard medical care such as this may be eligible to pursue a clinical negligence claim.

The goal of compensation is not only to acknowledge the harm caused by hospital negligence or medical accidents, but also to help those affected to rebuild their lives. For many individuals, the financial support provided by a successful claim can make a significant difference in accessing the care and resources they need for a full recovery.

When Am I Eligible to Make an NHS Compensation Claim?

You may be eligible to make an NHS compensation claim if you have suffered harm due to substandard medical care provided by a healthcare professional or within a hospital setting. To pursue a claim, there are two key legal criteria that must be satisfied: a breach of duty of care and causation.

• Duty of care: Healthcare professionals, including doctors, nurses, and other healthcare professionals, are required to provide a standard of care that is considered reasonable and competent. If the treatment you received fell below this standard and amounted to medical negligence, this constitutes a breach of their duty of care. For example, a breach may occur if a medical professional fails to diagnose a serious condition based on clear symptoms or administers the wrong treatment.
• Causation: It is not enough to prove that a breach of duty of care occurred - you must also demonstrate that this negligence caused you to suffer harm. This can include physical injuries, emotional distress, or financial losses as a direct result of the substandard medical care. Establishing causation is crucial in any clinical negligence claim and often involves obtaining expert medical evidence to support your case.

Here are some scenarios where individuals may be eligible to claim clinical negligence compensation from the NHS:

• A surgeon operates on the wrong area of the body, leading to further surgery or permanent disability.
• A misdiagnosis results in delayed treatment, causing a condition to worsen.
• An avoidable birth injury, such as cerebral palsy, occurs due to a failure to monitor the baby or perform a timely caesarean section.
• A patient is prescribed medication they are allergic to, resulting in severe side effects.
• A doctor fails to recognise life-threatening symptoms in an emergency setting, leading to preventable harm.

Who Pays for NHS Compensation Claims?

If you pursue an NHS compensation claim, it is common to have concerns about who ultimately pays the compensation you receive. Many people are reluctant to take away funds that should be used for frontline care.

In reality, medical negligence compensation claims against the NHS are never funded directly through frontline NHS budgets, and will have no financial impact on the individual doctors, nurses, or other medical professionals involved in your care. Instead, payouts for clinical negligence claims are managed centrally by an organisation called NHS Resolution.

NHS Resolution oversees the Clinical Negligence Scheme for Trusts (CNST), which is a fund specifically designed to cover compensation claims brought against NHS trusts in England. This fund ensures that patients who have suffered harm due to substandard medical care can access the financial compensation they deserve without negatively impacting the treatment provided to other patients by healthcare professionals or hospitals.

In addition to managing claims, NHS Resolution works to learn from medical negligence cases and implement improvements in healthcare standards, to reduce the likelihood of similar errors occurring in the future.

As such, it’s important to remember that medical negligence claims are ultimately intended to help those who have suffered harm to cover essential costs such as rehabilitation, ongoing medical care, or loss of earnings. By seeking compensation, you are also helping to highlight areas where care can be improved, potentially preventing future negligence.

What Is the Process for Making an NHS Compensation Claim?

Making an NHS compensation claim may seem overwhelming, but with the right guidance, the process can be straightforward. At JMW Solicitors, we specialise in helping clients through every stage of their claim. Below is a brief outline of the key steps:

1. Seek legal advice: Speak to a specialist medical negligence solicitor who will assess your case and advise whether you have a valid claim.
2. Gather evidence: Collect key evidence, including medical records, witness statements, and expert reports, to prove negligence and causation.
3. Letter of claim: Your solicitor will draft a detailed letter outlining the negligence and harm caused, which is sent to NHS Resolution. The organisation typically responds within four months.
4. Negotiate a settlement: If liability is admitted, your solicitor will negotiate a compensation award that reflects your injuries and financial losses.
5. Court proceedings: If NHS Resolution disputes the claim, court proceedings may be started. This does mean that you have to appear in court and is a way of ensuring the defendant in your case adheres to strict court deadlines in terms of dealing with your claim. Only in a small minority of cases does this process fail to ensure a fair resolution, meaning that the case has to be heard in court before a judge (trial). Your solicitor will fully support you throughout this process.

Most claims are resolved without the need for court, and your legal team will work to deliver the compensation you deserve as quickly as possible.

For a more detailed guide, visit our Medical Negligence Claims Process page.

How Are NHS Compensation Payouts Calculated?

The average payout you may receive for an NHS negligence claim depends on several factors, including the severity of the harm suffered, the financial impact of the negligence, and any ongoing or future care needs. Compensation is calculated to ensure that victims of medical negligence are fairly compensated for the physical, emotional, and financial impact of their experience.

Compensation is generally divided into two categories: general damages and special damages.

• General damages: This part of the compensation covers the pain, suffering, and loss of enjoyment of life caused by the negligence. The amount awarded depends on the severity of the injury or condition, as well as its impact on your daily life. For example, a life-altering injury, such as a brain injury or a condition requiring long-term care, will result in higher compensation than a less serious injury with minimal long-term effects. Solicitors use guidelines set by the Judicial College to calculate general damages and maintain consistency across similar cases.
• Special damages: Special damages compensate for financial losses and expenses directly related to the medical negligence. These may include:
• Medical expenses: Costs for private treatment, therapy, or rehabilitation.
• Loss of earnings: Compensation for wages lost due to an inability to work, including future loss of earnings if your ability to work is permanently affected.
• Care costs: Expenses for professional care or care provided by a family member.
• Travel expenses: Costs incurred for attending medical appointments.
• Adaptations: Costs for making adjustments to your home or vehicle if required due to your injury or condition.

Calculating precisely how much compensation you may be owed requires a detailed understanding of both legal principles and medical complexities. Solicitors often work with medical experts to assess the severity of your injuries and determine the costs of ongoing care and treatment. This ensures that the final compensation award reflects the full extent of your needs, both now and in the future.

How to Make a Successful NHS Compensation Claim

Making a successful NHS compensation claim requires careful preparation and a clear understanding of the claims process. Working with an experienced medical negligence solicitor is vital, as they will guide you through each stage of the process to make your claim as strong as possible. Here are the key steps and considerations to maximise your chances of success:

• Act quickly: Timing is critical in a medical negligence claim. In most cases, you have three years from the date the negligence occurred or from when you became aware of it (known as the "date of knowledge") to start your claim. Acting promptly gives your solicitor sufficient time to gather evidence, prepare your case, and comply with all legal deadlines. Exceptions to the time limit may apply in cases involving children or individuals lacking mental capacity.
• Collect evidence: A successful claim relies on strong evidence to prove both the breach of duty of care and the harm caused. You can strengthen your case by:
• Obtaining medical records: These provide crucial details about the treatment you received and any decisions made by healthcare professionals.
• Keeping a diary: Record how the negligence has affected your daily life, including pain, suffering, and the practical impact on your work and family life.
• Retaining receipts: Keep evidence of any expenses incurred as a result of the negligence, such as travel costs, medical treatments, or specialist care.
• Seek expert opinions: Your solicitor will often consult independent medical experts to assess whether the care you received fell below acceptable standards and to evaluate the severity of the harm caused. These expert opinions play a crucial role in strengthening your case and determining the appropriate compensation amount.
• Be thorough and transparent: Provide all details relevant to your case to your solicitor. Transparency and honesty are essential to build a strong claim. Failing to disclose key information or underestimating the harm caused may weaken your case or affect the compensation you receive.
• Work with a specialist solicitor: Choosing the right legal representation is one of the most important factors in achieving a successful claim. An experienced medical negligence solicitor will have the expertise to handle complex clinical negligence cases, gather the necessary evidence, and negotiate effectively with NHS Resolution. At JMW Solicitors, our team has a proven track record of success in securing compensation payouts for clients who have suffered harm due to NHS negligence.

By working closely with your solicitor, you will give yourself the best chance of making a successful NHS medical negligence claim.