Why the NHS, despite minor improvements, is still far from being a picture of health

richard_kayserClinical negligence solicitor Richard Kayser, from our London office, reflects on problems the NHS still needs to address…

Now qualified as a specialist clinical negligence lawyer for three years, I thought I’d take a look back at what I have learnt and to see what results our fight for a better and safer health system has achieved.

 Is there a difference in the types of claim seen?

There is certainly a difference in the types of claims that I’m now dealing with, and there’s no doubt that lessons have been learnt by the healthcare professionals.

When I first started it was not uncommon to receive calls from potential clients advising that a hospital had failed to diagnose a fracture. One type of injury especially springs to mind – a missed scaphoid fracture.

The NHS has now introduced a double-check policy where x-rays are reviewed by a senior radiologist within two weeks. This has led to patients being recalled, and previously missed fractures being diagnosed. Furthermore, it’s now commonplace for hospitals to undertake investigations without the need for the patient even raising concern about treatment received.

Is a new sort of problem developing?

Unfortunately the answer to this is yes, and it can be split into four main categories:

  • Birthing centres. As I raised in my blog in September 2012 and again in January 2013, the current government is encouraging women to give birth in midwifery centres. Furthermore, they are downgrading obstetric units from being consultant-led – where a doctor is always present – to midwifery-led, where a doctor may not even be in the building. So when problems do arise, help is often too far away
  • Missed tendon injuries. I have recently written (https://pattinsonbrewer.co.uk/the-sort-of-cuts-we-urgently-need-the-nhs-to-look-at/) about my growing concern about A&E departments failing to consider a tendon injury when a patient arrives with a severe cut to the hand
  • Private treatment undertaken under the NHS. One of my biggest concerns is the growing number of claims against the NHS I’m coming across, where the patient was seen by a private doctor. A few years ago, there was a government initiative to speed up the time it took for a patient to have surgery. The local health authority would pay for that patient to have the treatment from an outside consultant which, in principle, sounded like a great idea. Unfortunately I’ve spoken to a number of patients where the treatment went horribly wrong – from incorrectly performed knee surgery to prosthetics being wrongly inserted
  • Patients not receiving basic medical attention. The recently reported Mid-Staffordshire NHS Foundation Trust Inquiry Report made 18 serious recommendations for change. It stated that the evidence gathered by the Inquiry showed clearly that, for many patients, the most basic elements of care were neglected. Staff failed to make basic observations, and pain relief was provided late or, in some cases, not at all. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards.

Speaking at the publication of his final report, Robert Francis QC said:

“I heard so many stories of shocking care. These patients were not simply numbers they were husbands, wives, sons, daughters, fathers, mothers, grandparents. They were people who entered Stafford Hospital and rightly expected to be well cared for and treated. Instead, many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives.

The inquiry found that a chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care. Morale at the Trust was low, and while many staff did their best in difficult circumstances, others showed a disturbing lack of compassion towards their patients. Staff who spoke out felt ignored and there is strong evidence that many were deterred from doing so through fear and bullying.”


Unfortunately these failures are not just confined to one hospital or trust. I have recently been involved in two cases where children have lost their lives and, during investigations following their deaths, it was found that basic observations – including blood pressure and temperatures – were not taken.

So what can be done?

Our specialist clinical negligence team at Pattinson & Brewer will continue to fight for the rights of individuals. Not just for them to be compensated, but to have answers. And to understand what went wrong, and why.

Richard Kayser   –   Direct Dial: 020 7653 3236

Marcus Weatherby, Medical Negligence,
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