NHS in England not paying out £8 billion a year in maternity negligence compensation

A comment piece in The Times claimed that the NHS in England pays £8.2 billion in annual clinical negligence compensation for maternity care.

Columnist Janice Turner on Friday 8 September said: “It is mind-blowing that the NHS in England now pays £8.2 billion in annual clinical negligence compensation for maternity care, more than double the total £3.2 billion maternity and neonatal budget.”

But the most recent annual accounts for NHS Resolution, which deals with compensation claims on behalf of the NHS in England, show that the clinical negligence payments in 2022/23 were £2.6 billion. 

This is up from just over £2.4 billion the previous financial year.

NHS Resolution also says that 41% of the £2.6 billion of clinical negligence payments in 2022/23 related to maternity, which would equate to around £1.1 billion. 

This is much lower than the £3 billion a year a recent NHS England board paper said is spent on maternity and neonatal services. 

Full Fact has contacted The Times to ask about this figure but has so far not received a response. However, the article has now been amended to say: “It is mind-blowing that the NHS in England now reckons the annual bill for clinical negligence in maternity care is £8.2 billion.”

It is the responsibility of the newspaper to ensure the Editors' Code of Practice is upheld by external contributors, as well as editorial staff. In line with this, the press must take care not to publish inaccurate or misleading information and a significant inaccuracy must be corrected promptly.

Where does the £8.2 billion figure come from?

While we do not know exactly how Ms Turner calculated the £8.2 billion “annual bill” figure, a report in The Times from April mentioned the same number.

The article said: “The total cost of harm from clinical negligence was £13.6 billion in the 2021-22 reporting year, according to an annual report from NHS Resolution, the arm of the Department of Health and Social Care that handles litigation. 

“Sixty per cent of the cost of harm was for maternity claims, amounting to £8.2 billion for the year.”

So this could be where Ms Turner’s figure comes from.

But the cost of harm is not the same as the amount paid in clinical negligence compensation. An NHS Resolution definition of the cost of harm says that “the cost of harm is the present value of the estimated cost of claims that we expect to receive, or have already received, from incidents that occurred” and that due to “delays in clinical claims being notified to NHS Resolution, the majority relates to claims that have not yet been received and is therefore based on an actuarial assessment of claims’ volumes and values”. 

NHS Resolution’s annual report for 2021/22 does state that “60% of the total clinical negligence cost of harm (£13.6 billion)” relates to maternity services, which would be £8.2 billion. While these were the most recent figures available when the April Times article was published, figures for the latest year were released in July.

The latest accounts from NHS Resolution say the cost of harm in 2022/23 was £6.6 billion, with 63% of this relating to maternity (£4.2 billion).

NHS Resolution’s accounts say that the £7 billion drop year-to-year was mainly due to a change in Treasury discount rates, which “has had the effect of significantly reducing the value of claims”.

The accounts also say: “These rates are used to convert future payments into a present value.”

So the annual cost of harm is not the same as the amount actually paid out in compensation. It is the value of the claims that have been reported, along with an actuarial estimate of claims NHS Resolution expects to receive in the future arising from incidents in that financial year. 

Image courtesy of Christian Bowen.