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 2020/21, £21.9 million was paid on clinical / social care negligence cases in Northern Ireland, with over two thirds (69.7%, £15.2 m) paid in damages, £4.2 million (19%) in plaintiff costs and £2.5 million (11.3%) in defence costs (Figure 1).
During the last five years, the amount paid in clinical / social care negligence cases decreased by £6.7 million (23.4%), from £28.5 million in 2016/17 to £21.9 million in 2020/21 (Figure 1).
Figure 1: Amount paid out in each year (2016/17 - 2020/21)
Source: Hospital Information Branch - CN1a Information Return
Between 2016/17 and 2020/21, the number of cases opened increased by 225 (6.2%), from 3,647 to 3,872 (Figures 2 & 3).
Figure 2: Cases open at any stage (2016/17 - 2020/21)*
Cases open at any stage in 2020/21:
Belfast: 1,615
Northern: 516
South Eastern: 559
Southern: 518
Western: 520
Legacy HSS Boards: 115
NIAS / NIBTS: 29
Source: Hospital Information Branch - CN1 Information Return
Outcome of cases at 31 March 2021
Of the 3,872 cases open at any stage in 2020/21, three quarters (82.3%, 3,187) remained open at 31 March 2021, 251 (6.5%) were settled and 434 (11.2%) were closed. Of the 3,872 cases, 483 were newly opened during 2020/21 (Figures 3 - 6).
Open cases
Across HSC Trusts, the number of cases open ranged from 105 in the Legacy HSS Boards, NIAS & NIBTS to 1,397 in Belfast HSC Trust (Figure 3).
Figure 3: Open cases at 31 March (2017 - 2021)
Source: Hospital Information Branch - CN1 Information Return
Settled cases
Between 31 March 2017 and 2021 the Southern HSC Trust reported the largest increase (58%, 15) in settled cases, from 26 to 41 at 31 March 2021 (Figure 4).
Figure 4: Settled cases at 31 March (2017 - 2021)
Source: Hospital Information Branch - CN1 Information Return
Closed cases
Since 2016/17, the number of cases closed in the Legacy HSS Boards, NIAS & NIBTS HSC Trust increased, from 20 to 26 in 2020/21 (Figure 5).
Figure 5: Closed cases (2016/17 - 2020/21)
Source: Hospital Information Branch - CN1 Information Return
New cases
Since 2016/17, the Legacy HSS Boards, NIAS & NIBTS reported the largest percentage increase in the number of new cases opened during the year (2, 15%), from 13 to 15 in 2020/21 (Figure 6).
Figure 6: New cases (2016/17 - 2020/21)
Source: Hospital Information Branch - CN1 Information Return
Age of case
Age of case:
The average length of time a case had been open in 2020/21 was 2.9 years.
On average, 2.3 years pass between the alleged incident taking place and a case being opened.
Of the 3,187 cases that remained open at 31 March 2021, almost two thirds (1,772) had been open for less than three years, whilst 98 (3.1%) had been open for 10 years or more (Figure 7).
Cases open at any stage in 2020/21, had been open on average for 2.9 years.
Figure 7: Cases open at any stage during the year, by age of case
Source: Hospital Information Branch - CN1 Information Return
43 cases accounted for almost three quarters (£96.2m) of damages paid
At 31 March 2021, £152.4 million had been paid on the 3,872 clinical / social care negligence cases that were open at any stage in 2020/21. Of this, £119.3 million (78.2%) had been awarded in damages, £21.6million (14.2%) in plaintiff costs and £11.6 million (7.6%) in defence costs (Figure 8).
The plot below details the amount of money paid on cases from the open date to 31 March 2021 on the x-axis, and the amount of this paid in 2020/21 on the y-axis. Information on damages, defence costs and plaintiff costs are included for each HSC Trust / Legacy HSS Board, with larger circles indicating larger payments.
Figure 8: Paid from open date to 31 March 2021 vs paid in 2020/21 only
Source: Hospital Information Branch - CN1 Information Return
The Belfast HSC Trust paid the largest amount in damages and legal costs (£48m) on cases which were open in 2020/21, over a third (31.5%) of all monies paid (Figure 8).
Almost three quarters (80.7%, £96.2m) of the total amount paid in damages related to 43 (1.1%) of the 3,872 open during 2020/21.
Payments by specialty and nature of incident
Over three fifths (63%, £95.9m) of the amount paid out on cases open at any stage in 2020/21 related to the ‘Obstetrics’ specialty (Figure 9).
Over a third (38%, £57.9m) of the total amount paid to date, on clinical / social care negligence cases open at any stage during 2020/21, 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 open date to 31 March 2021 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 (2020/21)
Source: Hospital Information Branch - CN1 Information Return
The plot below details the average (median) amount paid by specialty and case outcome from the open date to 31 March 2021. 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 £0.9 million (Figure 10).
Figure 10: Average amount paid on cases by specialty (2020/21)*
*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 open date to 31 March 2021. 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 £0.3 million (Figure 11).
Figure 11: Average amount paid on cases by nature of incident (2020/21)*
*To avoid disclosure of personal data only specialties with more than one payment are included.
Source: Hospital Information Branch - CN1 Information Return
PPO cases:
30 PPOs accounted for over half (49%) of all monies paid
Periodic payment orders
Of the £152.4 million paid up to 31 March 2021, over half (49%, £74.3m) had been paid on 30 PPO cases.
Of the £74.3 million paid in cases with PPOs, £60.1 million (81%) was paid in damages, £10.3 million (14%) in plaintiff costs and £3.9 million (5.3%) in defence costs.
Figure 12: Amount paid on PPO cases (2016/17 - 2020/21)
Source: Hospital Information Branch - CN1 Information Return
Payments by outcome
Median payments by outcome:
Open cases: £2,420
Settled cases: £59,083
Closed cases: £42,978
Of the £152.4 million that had been paid on cases up to 31 March 2021, over four fifths (91%, £138.7m) was paid on settled cases, £9.7 million (6%) on closed cases and £4 million (3.0%) on open cases.
During 2020/21, 434 (11%) cases were closed, with three quarters (76%, 329) closed without payment.
The plot below details the amount paid by nature of incident and case outcome from the open date to 31 March 2021. 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 open date to 31 March 2021. 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 31 March.
Figure 13: Amount paid by case outcome at 31 March 2021*
*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 six (11.8%, 51) cases closed in 2020/21 had legal costs exceeding the amount awarded in damages. Overall, (£1.1m) was paid in legal costs compared with damages (£0.6m), with the Belfast Trust recording the largest difference (£0.2m).
Payments on cases closed with no damages
Over one in twenty (5.3%, 23) cases closed in 2020/21 had no damages awarded but had legal fees amounting to £0.1 million. This accounted for 1.5% of all monies paid out on cases closed during 2020/21.
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 31 March 2021. 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.
