In this report, clinical / social care negligence is defined as:
“A breach of duty of care by members of the health and social care professions employed by HSC organisations or by others consequent on decisions or judgments made by members of those professions acting in the course of their employment, and which are admitted as negligent by the employer or determined as such through the legal process.”
The information presented in this publication is sourced from two Departmental returns:
CN1a - aggregate information on cases including the amount paid out each quarter.
CN1 - annual patient level return including the amount paid on each case since it opened.
During the last five years, the amount paid in clinical / social care negligence cases decreased by £12.1 million (29.4%), from £41.4 million in 2014/15 to £29.2 million in 2018/19 (Figure 1).
During 2018/19, £29.2 million was paid on clinical / social care negligence cases in Northern Ireland, with almost three quarters (72.7%, £21.2 m) paid in damages, £5.8 million (19.9%) in plaintiff costs and £2.1 million (7.4%) in defence costs (Figure 1).
Figure 1: Amount paid out in each year (2014/15 - 2018/19)
Source: Hospital Information Branch - CN1a Information Return
Between 2014/15 and 2018/19, the number of cases opened increased by 394 (10.9%), from 3,601 to 3,995 (Figures 2 & 3).
Figure 2: Cases open at any stage (2014/15 - 2018/19)*
Cases open at any stage in 2018/19:
Belfast: 1,604
Northern: 595
South Eastern: 599
Southern: 558
Western: 526
Legacy HSS Boards: 92
NIAS / NIBTS: 21
* NIAS / NIBTS not included in the graph due to small numbers
Source: Hospital Information Branch - CN1 Information Return
Outcome of cases at 31st March 2019
Of the 3,995 cases open at any stage in 2018/19, three quarters (75.0%, 2,995) remained open at 31st March 2019, 211 (5.3%) were settled and 789 (19.7%) were closed. Of the 3,995 cases, 704 were newly opened during 2018/19 (Figures 3 - 6).
Open cases
Across HSC Trusts, the number of cases open ranged from 88 in the Legacy HSS Boards, NIAS & NIBTS to 1,201 in Belfast HSC Trust (Figure 3).
Figure 3: Open cases at 31st March (2015 - 2019)
Source: Hospital Information Branch - CN1 Information Return
Settled cases
Between 31st March 2015 and 2019 the Belfast HSC Trust reported the largest increase (27.3%, 18) in settled cases, from 66 to 84 at 31st March 2019 (Figure 4).
Figure 4: Settled cases at 31st March (2015 - 2019)
Source: Hospital Information Branch - CN1 Information Return
Closed cases
Since 2014/15, the number of cases closed in the Belfast HSC Trust increased, from 221 to 319 in 2018/19 (Figure 5).
Figure 5: Closed cases (2014/15 - 2018/19)
Source: Hospital Information Branch - CN1 Information Return
New cases
Since 2014/15, the Legacy HSS Boards, NIAS & NIBTS reported the largest percentage increase in the number of new cases opened during the year (8, 72.7%), from 11 to 19 in 2018/19 (Figure 6).
Figure 6: New cases (2014/15 - 2018/19)
Source: Hospital Information Branch - CN1 Information Return
Age of case
Age of case:
The average length of time a case had been open in 2018/19 was 2.8 years.
On average, 1.9 years pass between the alleged incident taking place and a case being opened.
Of the 2,995 cases that remained open at 31st March 2019, almost two thirds (1,866) had been open for less than three years, whilst 71 (2.4%) had been open for 10 years or more (Figure 7).
Cases open at any stage in 2018/19, had been open on average for 2.8 years.
Figure 7: Cases open at any stage during the year, by age of case
Source: Hospital Information Branch - CN1 Information Return
38 cases accounted for almost three quarters (£79.0m) of damages paid
At 31st March 2019, £138.3 million had been paid on the 3,995 clinical / social care negligence cases that were open at any stage in 2018/19. Of this, £106.3 million (76.9%) had been awarded in damages, £21.4million (15.5%) in plaintiff costs and £10.6 million (7.7%) in defence costs (Figure 8).
The plot below details the amount of money paid on cases from date opened up to the 31st March 2019 on the x-axis, and the amount of this paid in 2018/19 on the y-axis. Information on i) damages, ii) defence costs and iii) plaintiff costs are included for each HSC Trust / Legacy HSS Board, with larger circles indicating larger payments.
Figure 8: Paid from open date to 31st March 2019 vs paid in 2018/19 only
Source: Hospital Information Branch - CN1 Information Return
The Belfast HSC Trust paid the largest amount in damages and legal costs (£49.7m) on cases which were open in 2018/19, over a third (36.0%) of all monies paid (Figure 8).
Almost three quarters (74.3%, £79.0m) of the total amount paid in damages related to 38 (1.0%) of the 3,995 open during 2018/19.
Payments by specialty and nature of incident
Over half (56.2%, £77.7m) of the amount paid out on cases open at any stage in 2018/19 related to the ‘Obstetrics’ specialty (Figure 9).
Over a third (32.3%, £44.7m) of the total amount paid to date, on clinical / social care negligence cases open at any stage during 2018/19, related to the ‘Pregnancy & Childbirth’ nature of incident group (Figure 9).
The plot below details the amount of money paid by specialty and nature of incident from the date opened up to the 31st March 2019 on the y-axis, and the number of cases on the x-axis, with larger circles indicating larger payments.
Figure 9: Amount paid on cases by specialty and nature of incident (2018/19)
Source: Hospital Information Branch - CN1 Information Return
The plot below details the average (median) amount paid by specialty and case outcome from the date opened up to the 31st March 2019. Each circle represents the average payment for a particular specialty.
The largest average payouts by specialty related to settled obstetrics cases, with a median payment of £1.5 million (Figure 10).
Figure 10: Average amount paid on cases by specialty (2018/19)*
*To avoid disclosure of personal data only specialties with more than one payment are included.
Source: Hospital Information Branch - CN1 Information Return
The plot below details the average (median) amount paid by nature of incident and case outcome from the date opened up to the 31st March 2019. Each circle represents the average payment for a particular nature of incident.
The largest average payouts by nature of incident related to settled pregnancy & childbirth cases, with a median payment of £0.5 million (Figure 11).
Figure 11: Average amount paid on cases by nature of incident (2018/19)*
*To avoid disclosure of personal data only specialties with more than one payment are included.
Source: Hospital Information Branch - CN1 Information Return
PPO cases:
33 PPOs accounted for over half (52.1%) of all monies paid
Periodic payment orders
Of the £138.3 million paid up to 31st March 2019, over half (52.1%, £72.0m) had been paid on 33 PPO cases.
Of the £72 million paid in cases with PPOs, £57.6 million (79.9%) was paid in damages, £10.4 million (14.5%) in plaintiff costs and £4.1 million (5.6%) in defence costs.
Figure 12: Amount paid on PPO cases (2014/15 - 2018/19)
Source: Hospital Information Branch - CN1 Information Return
Payments by outcome
Median payments by outcome:
Open cases: £1,825
Settled cases: £65,547
Closed cases: £29,061
Of the £138.3 million that had been paid on cases up to the 31st March 2019, over four fifths (82.0%, £113.8m) was paid on settled cases, £20.6 million (15.0%) on closed cases and £3.9 million (3.0%) on open cases.
During 2018/19, 789 (19.7%) cases were closed, with almost two thirds (63.6%, 502) closed without payment.
The plot below details the amount paid by nature of incident and case outcome from the date opened up to the 31st March 2019. Each circle represents the average payment for a particular nature of incident.
The plot below details the amount paid on each case, by the case outcome, from the date opened up to the 31st March 2019. Each circle represents a payment on a particular case. The dashed vertical grey line indicates the average (median) payment for all cases, whilst the three larger circles indicate the median payment by outcome at the 31st March.
Figure 13: Amount paid by case outcome at 31st March 2019*
*To avoid disclosure of personal data only cases with £500 or more paid are included.
Source: Hospital Information Branch - CN1 Information Return
Cases closed with legal costs exceeding damages
One in five (19.3%, 152) cases closed in 2018/19 had legal costs exceeding the amount awarded in damages. Overall, double (£2.6m) was paid in legal costs compared with damages (£1.3m), with the Belfast Trust recording the largest difference (0.7m).
Payments on cases closed with no damages
One in twelve (8.0%, 63) cases closed in 2018/19 had no damages awarded but had legal fees amounting to £0.2 million. This accounted for 1.1% of all monies paid out on cases closed during 2018/19.
This statistical release summarises information collected from Health & Social Care (HSC) Trusts, Agencies and Legacy Health and Social Services (HSS) Boards on clinical / social care negligence cases in Northern Ireland open during the year ending 31st March 2019. Information includes all cases currently open and settled, including those withdrawn or closed with details of any monies paid.
Authors
Michael O’Donnell
Kieran Taggart
Siobhan Morgan
Issued by
Hospital Information Branch
Information & Analysis Directorate
Department of Health
Stormont Estate
Belfast
BT4 3SQ
Information detailed in this release has been quality assured with HSC Trusts and other Agencies prior to release.
Target audience
DoH, Chief Executives of HSC Board and Trusts in Northern Ireland, health care professionals, academics, Health & Social Care stakeholders, media and general public.
