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Otolaryngology litigation in England: 727 clinical negligence cases against the NHS
  • +3
  • Annakan Navaratnam,
  • Ahmad Hariri,
  • Cherrie Ho,
  • John Machin,
  • Andrew Marshall,
  • Tim Briggs
Annakan Navaratnam
NHS England & NHS Improvment
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Ahmad Hariri
University College London Hospitals NHS Foundation Trust
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Cherrie Ho
NHS England & NHS Improvement
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John Machin
NHS England & NHS Improvement
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Andrew Marshall
Queen's Medical Centre
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Tim Briggs
NHS England & NHS Improvement
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Abstract

Introduction: Litigation against the National Health Service (NHS) in England is rising, costing £2.4 billion in 2018/19. The aim of this study was to determine the incidence and characteristics of otolaryngology clinical negligence claims in England. Methods: A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to otolaryngology between April 2013 and April 2018. Analysis was performed using information for cause, patient injury and claim cost. Where claim information was adequately detailed, the authors categorised claims by subspecialty, diagnosis and operation. Results: A total of 727 claims were identified with an estimated potential cost of £108 million. From these, 463 were closed claims. Including open claim reserves, the mean cost of a claim was £148,923. Head and neck surgery was the subspecialty with the highest number of claims (n=313, 43%) and highest cost (£51.5 million) followed by otology (n=171, £24.5 million) and rhinology (n=171, £13.6 million). Over half of claims were associated with an operation (n=429, 59%) where mastoid surgery (n=46) and endoscopic sinus surgery (n=46) were equally associated with the greatest number of claims. The most frequent reasons for litigation included failure or delay to diagnose (n=178, 25%) failure or delay to treat (n=136, 19%), intra-operative complications (n=130, 18%) and failure of the consent process (n=107, 15%). Discussion: Clinical negligence claims in otolaryngology are related to several different components of patient management and is not limited to post-operative complications. This study highlights the importance of robust pathways in outpatient diagnostics and the consenting process, especially in the high-risk speciality of head and neck surgery, in order to deliver better patient care and reduce the impact of litigation.

Peer review status:ACCEPTED

18 Jun 2020Submitted to Clinical Otolaryngology
19 Jun 2020Submission Checks Completed
19 Jun 2020Assigned to Editor
22 Jun 2020Reviewer(s) Assigned
30 Jun 2020Review(s) Completed, Editorial Evaluation Pending
10 Jul 2020Editorial Decision: Revise Major
21 Jul 20201st Revision Received
24 Jul 2020Assigned to Editor
24 Jul 2020Submission Checks Completed
02 Aug 2020Reviewer(s) Assigned
06 Aug 2020Review(s) Completed, Editorial Evaluation Pending
08 Aug 2020Editorial Decision: Revise Minor
10 Aug 20202nd Revision Received
12 Aug 2020Submission Checks Completed
12 Aug 2020Assigned to Editor
16 Aug 2020Reviewer(s) Assigned
19 Aug 2020Review(s) Completed, Editorial Evaluation Pending
23 Aug 2020Editorial Decision: Accept