Almost £400m is expected to be spent settling legal claims caused by alleged blunders in Northern Ireland’s health system in just five years.
Costs linked to medical negligence claims have risen by 56% since 2012.
It is costing the health service more than £215,000 every day on average. Part of the expenditure relates to legal costs, with some cases dragging on for more than 15 years without being settled.
A total of 349 serious adverse incidents (SAIs) were also recorded here last year. And the number of complaints received across the health and social care (HSC) sector has increased by 24% since 2012.
The findings are set out in a report published today by the Northern Ireland Audit Office.
It examines progress made in the safety of services provided across the health and social care sector in recent years.
The report states that in the five years to April 2017, the total cost of settling clinical negligence claims, plus the estimated costs of unsettled cases, totalled over £393.5m.
That is a 56% increase on the £252.3m costs for the previous five-year period to April 2012.
Auditor General Kieran Donnelly said: “The very significant rise in the costs of settling clinical negligence claims is concerning. These costs divert scarce resources away from frontline services and potentially result in patients waiting longer for treatment.
“Whilst steps have been taken to try and enhance local patient safety standards, and evidence suggests that more incidents are being reported, further work is required to embed a strong safety culture across the HSC sector.
“It is essential that the HSC sector exercise constant vigilance in this area to ensure the safety of patients.”
Medical negligence costs include estimated expenditures because cases can often take years to settle. Today’s report notes that, as of March 2017, some 317 cases had been open for between five and 10 years. A further 49 had been pending for between 11 and 15 years, and 21 had been pending for 15 years or more. The report also notes that 349 SAIs were reported in 2018. An SAI is any event or circumstance that led or could have led to serious unintended or unexpected harm, loss or damage to patients.
The number of SAIs has risen from 2012, when 298 were recorded, but has fallen from the 2014 peak of 760. The Audit Office’s 2012 report highlighted evidence of significant under-reporting of SAIs.
At that time, only 35% of SAIs in Northern Ireland were reported from acute settings, compared to 75% in England and Wales.
Over the last five years the figure here has risen to 46%, leading auditors to conclude that while progress has been made, under-reporting may still exist.
A total of 92,091 adverse incidents, similar to but less serious than SAIs, were recorded last year, up from 74,689 five years ago. Today’s report notes the Department of Health has undertaken preparatory work on developing a statutory ‘duty of candour’ for Northern Ireland, which would require patients be told if a safety incident has occurred.
However, full implementation of this will require ministerial approval. It also states 6,189 complaints were received across the health and social care sector in 2016/17, around a fifth relating to quality of treatment and care.
The number of complaints has increased annually since 2009, when around 5,000 were made.
Complaints about health and social care providers continue to form a significant element of the Northern Ireland Public Services Ombudsman’s workload.
They accounted for 42% of the 665 new complaints received in 2017/18, and some 76% of the cases taken forward for detailed investigation in that year. The main category of complaint is linked to concerns over clinical care and treatment.
The Audit Office report states: “In addition to the number of incidents reported, the level of complaints by patients or their families provides further measurement of the extent of local patient safety concerns.”