Written by The NHS’s legal defence spending has become a sprawling industry, with over £158.8 million allocated to legal defence costs in 2022/23 and a staggering £2.6 billion spent on clinical negligence claims overall. Behind these figures lies a network of law firms operating under lucrative contracts, collectively managing NHS Resolution’s extensive litigation portfolio. However, the true scale of this spending remains opaque, with inconsistencies in reporting obscuring the full picture.
Clarifying the Figures: £2.6 Billion vs £772 Million
At first glance, the £2.6 billion spent on clinical negligence claims appears to contradict the NHS’s £772 million legal defence framework for 2022–2025. However, these figures refer to different components of the NHS’s litigation spending:
- The £2.6 Billion Total Clinical Negligence Cost includes:
- Compensation Payments: The largest component, awarded to claimants for harm suffered.
- Claimant Legal Costs: Legal fees paid to the claimant’s solicitors, totalling £490.9 million in 2022/23.
- Defence Costs: Legal fees incurred by the NHS to defend claims, which amounted to £158.8 million in 2022/23.
- The £772 Million Framework represents the total value of contracts awarded to panel law firms over three years (2022–2025) for:
- Clinical Negligence and Liability Claims: The majority of the framework’s value.
- Non-Clinical Claims: Focused on employment tribunals and other disputes, worth approximately £8 million annually.
The £772 million framework specifically covers the cost of legal services provided by the NHS Resolution panel law firms, not the full financial burden of resolving claims, which is driven primarily by compensation payments.
The NHS Legal Defence Panel: A £772 Million Framework
The NHS’s legal defence panel, managed by NHS Resolution, comprises 11 pre-approved law firms responsible for defending clinical negligence and liability claims as well as handling non-clinical matters like employment tribunals. These firms operate under a framework contract valued at £772 million for the 2022–2025 period. The allocation of work to these firms is not evenly distributed, with a few key players dominating the landscape.
The Key Firms on the Panel
The following firms constitute the NHS Resolution panel, sharing the substantial volume of claims across the UK:
- DAC Beachcroft
- A dominant force in NHS litigation, DAC Beachcroft handles some of the most high-value and complex cases, particularly catastrophic injury claims.
- Known for their influence in setting the tone of NHS defence strategies, they often lead in regions with heavy caseloads, including London and the Midlands.
- Bevan Brittan
- Frequently involved in non-clinical claims such as employment tribunals and governance disputes.
- Their strong advisory practice complements their litigation role, providing NHS Trusts with strategic legal guidance.
- Capsticks
- Specialises in defending employment disputes and whistleblowing claims.
- Criticised for aggressive tactics in cases involving whistleblowers, Capsticks often takes the lead in high-profile employment matters.
- Hempsons
- Handles a significant share of high-value clinical negligence cases, particularly those involving birth injuries and catastrophic outcomes.
- Hempsons’ expertise in regulatory matters and complex liability claims makes them a key partner for NHS Resolution.
- Browne Jacobson
- Primarily focused on healthcare governance and liability claims.
- Active in supporting Trusts with regional case management, particularly in the Midlands.
- Hill Dickinson
- Well-regarded for their work in healthcare litigation, Hill Dickinson manages a diverse caseload across clinical negligence and non-clinical disputes.
- Kennedys
- Known for their expertise in defending high-value claims, particularly those requiring intricate medical and legal analysis.
- Often involved in multi-party litigation.
- Weightmans
- Regional specialists in liability claims, with a strong presence in the North and North-West.
- Also active in non-clinical claims, including disciplinary and employment disputes.
- Ward Hadaway
- A northern powerhouse, Ward Hadaway primarily handles claims in the North of England.
- Their work often involves regional Trusts with moderate caseloads.
- Clyde & Co
- Focuses on professional indemnity claims and complex liability disputes.
- Less prominent in employment cases but remains a key player in clinical negligence litigation.
- Veale Wasbrough Vizards (VWV)
- Known for their work in employment disputes, particularly in southern England.
- Handles lower-value claims and supports smaller Trusts with tailored services.
How Work is Distributed
The allocation of cases among these firms is influenced by several factors:
- Value and Complexity of Claims: High-value cases, such as catastrophic birth injuries, are often assigned to experienced firms like Hempsons and DAC Beachcroft.
- Regional Presence: Firms like Ward Hadaway dominate in the North, while London-based firms handle the bulk of claims in the South.
- Specialisation: Certain firms focus on specific areas, such as Capsticks’ dominance in employment disputes or Hempsons’ expertise in high-value clinical negligence cases.
The Hidden Costs of Legal Defence
The £772 million framework value suggests an organised and controlled legal strategy. Yet scepticism abounds about whether this figure accurately reflects the true cost of defending claims. Key concerns include:
- Additional Costs: Barristers’ fees, consultancy charges, and outsourced legal work are not captured within the framework.
- Duplication of Effort: Employment tribunals often involve local solicitors or in-house legal teams alongside panel firms, further inflating costs.
- Opaque Reporting: The NHS does not routinely disclose granular details of its legal spending, leaving taxpayers in the dark about how funds are allocated.
Non-Clinical Claims: The Cost of Defending the Indefensible
While clinical negligence dominates NHS litigation, non-clinical claims such as employment tribunals reveal a troubling use of public funds. Whistleblowers like Dr. Serryth Colbert at the Royal United Hospitals Bath NHS Foundation Trust (RUH) face relentless legal battles funded by NHS Trusts, often with panel firms engaging in aggressive tactics to suppress dissent.
For example:
- NDAs and Coercion: Trusts frequently attempt to silence whistleblowers through Non-Disclosure Agreements, further escalating legal fees.
- Reputation Over Reform: Legal resources are used to defend institutional reputations rather than addressing the underlying issues raised by whistleblowers.
This approach not only wastes public money but also undermines trust in the NHS as an organisation committed to patient safety and accountability.
Calls for Reform: Transparency and Accountability
To address these issues, the NHS must adopt bold reforms to ensure transparency, accountability, and ethical use of taxpayer money. Key measures include:
- Detailed Reporting: NHS Trusts should disclose annual legal spending at a granular level, including specific costs for panel firms, barristers, and case outcomes.
- Independent Oversight: A watchdog body should review NHS litigation practices to ensure value for money and ethical conduct.
- Ban on NDAs: Prohibiting NDAs in whistleblower cases would signal a commitment to transparency.
- Focus on Prevention: Addressing systemic failures proactively would reduce litigation rates and associated costs over time.
Conclusion: A Question of Priorities
The NHS’s legal spending reveals a troubling culture of defensiveness, prioritising reputation management over meaningful reform. While the official figures are already staggering, hidden costs and opaque reporting fuel scepticism about the true financial burden of litigation.
As the NHS continues to allocate vast sums to legal defence, taxpayers deserve to know whether their money is funding justice or simply enabling institutional self-preservation. Without meaningful reform, the NHS risks not only financial ruin but also a profound erosion of public trust.
Disclaimer
This article is based on publicly available information, research, and illustrative commentary. Allegations and interpretations are presented in good faith but may not reflect the full complexity of specific cases or financial practices. Readers are encouraged to seek independent verification and legal counsel where appropriate. Neither the author nor the publisher accepts liability for any decisions or actions taken based on this material.