Following the release of the NHSR annual report earlier this week, it has been widely reported that the cost of NHS medical negligence claims is increasing.
The implication is that claimants and claimant solicitors are wrong to be taking money from the NHS, that such claims are preventing the NHS from improving patient safety and modernising services and that affordability for the NHS, as opposed to fair compensation to an injured claimant, should be the driving factor. Matthew Lee, chief executive of the Medical Defence Union is quoted in the attached article as saying that we require reform to “bring claimant legal fees under control”.
But are claimants and claimant solicitors really to blame for increasing litigation costs? I would argue that we are not.
The bottom line is that NHSR simply do not pay damages or costs when they do not believe they are at fault. A claim will only be settled where liability is admitted or NHSR recognise the risk that they will be found to have been negligent. The report highlights that claims have increased by 5.6% in 2025/26. To my mind, this indicates that more patients are being harmed as a result of substandard care in the NHS. The focus should be on reducing the harm suffered and not putting barriers in the way to holding the NHS accountable for these events.
In my experience the key drivers of increasing litigation costs are:
- Expert fees – expert fees have increased significantly in recent years. In cases involving significant injury multiple experts will be required to advise in relation to a claim and this increases costs significantly.
- Inefficiencies in the court system – significant delays, lost documents and an inability to speak directly to the court to clarify issues also leads to additional costs.
- The conduct of NHSR/the Defendant solicitor – in my experience, this is the biggest driver in high litigation costs. In cases where the Defendant undertakes thorough investigations at the outset and is open and honest in the litigation process, claims can proceed without significant costs being incurred. However, all too often, liability will be robustly denied in a Letter of Response/Defence only for a Defendant to later make substantial admissions or to settle the claim (without significant reduction in litigation risk). These cases could and should have been settled at an earlier stage and, had they done so, this would have inevitably reduced the costs incurred by both parties and the burden of litigation for the claimant.
Restricting a claimant’s entitlement to recover legal costs will lead to less thorough investigations being undertaken and ultimately restrict access to justice for people who suffer injury at the hands of the NHS.
The cost of NHS medical negligence claims rose to £3.24bn in 2025/26, according to NHS Resolution (NHSR).
https://www.healthcare-management.uk/medical-negligence-claim-costs-rise-staggering-324bn