Ten Years of Clinical Negligence Claims in Otolaryngology: Trends, Costs, and Preventable Harm in the UK National Health Service
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Introduction
With greater pressures on the British National Health Service (NHS), litigation is increasing across surgical specialties. The national litigation trends in otolaryngology have not been adequately explored in the recent years, particularly in the aftermath of the COVID-19 pandemic.
Objectives
The primary objective was to analyse NHS litigation data in otolaryngology over the last decade, exploring the impact of the pandemic on claim volumes and costs. The secondary objective was to identify common areas of concern in patient care.
Methods
National-level anonymised negligence claims data for the financial years 2013/14 to 2023/24 were obtained from NHS Resolution via a Freedom of Information request. The data included claim status, claimant’s age group, incident and notification dates, primary cause and injury codes, and the associated costs.
Results
A total of 1,450 claims were received and 1,594 cases were closed. Number of received claims declined from 2020/21 onwards, whereas, total costs followed the closed claim numbers, both gradually increasing with spikes in 2018/19 and 2022/23. The total costs were also driven up by a sharp increase in damages and steadier increase in claimant legal costs. Of the closed cases, 58% resulted in damages payment. The most frequent claim cause was delay in treatment or diagnosis, whilst inadequate intra-operative monitoring led to the highest mean payout. The most frequent injury code was unnecessary pain, whilst brain damage, although rare, was the costliest. We identified six Never Event categories, with foreign body left in situ being the most common.
Conclusion
Whilst received claims are declining since the pandemic, litigation costs in otolaryngology continue to rise. The results highlight areas of care for targeted improvement, including earlier diagnosis and treatment, robust monitoring, and better communication to reduce preventable harm.
