How Much Is NHS Clinical Negligence Costing Taxpayers?

NHS clinical negligence is the fastest-growing cost pressure in the health service that almost nobody talks about. NHS Resolution — the arm's-length body that handles NHS litigation — paid out £3.1 billion in compensation in 2023/24, more than three times the £1.1 billion paid a decade earlier. The total future liability — the estimated cost of all outstanding and expected future claims — stands at £89 billion, an enormous contingent liability on the public balance sheet.^[1,2] These costs are driven partly by rising claims volumes, partly by growing compensation amounts for brain-damaged babies — where care packages can run to £20–30 million per case — and partly by the Ogden discount rate change in 2017, which significantly increased lump-sum compensation values.

Maternity negligence is the most striking component. Although maternity cases represent around 9% of claims by number, they account for 58% of costs — because a severely brain-injured baby requires a lifetime of intensive care, therapy, and support. Reviews including the Ockenden report into Shrewsbury and Telford NHS Trust (2022) and the East Kent Maternity Services Review have exposed systemic failures in safety culture, staffing, and learning from incidents.^[3] NHS Resolution argues that every £1 spent on prevention saves approximately £8 in future compensation costs. But progress is slow and the liability is already locked in for decades to come.^[2]