By Matthew Best, Director – ATE Partnerships, Head of Personal Injury & Clinical Negligence
Estimate read time 5 minutes 19 seconds
The start of 2026 finds the sector in a familiar yet more finely balanced position. Political attention remains on the wider economic climate, and apparently this has pushed technical reforms such as fixed recoverable costs for lower-value clinical negligence claims into the background.
Yet the financial ‘weight’ of negligence itself has become harder to ignore. Rising compensation liabilities, new parliamentary scrutiny and a series of official reports have placed the cost of unsafe care firmly within wider discussions about the future of NHS spending.
A clearer picture from recent data
Over the past year, several publications have highlighted the growing scale of the issue. The National Audit Office reported that the long-term estimated cost of clinical negligence in England is now close to £60 billion, following several years of rising annual expenditure. The Medical Protection Society noted that £3.6 billion was spent on claims last year alone, describing the position as unsustainable for a health service already under severe financial strain.
More detailed data has also drawn attention to the concentration of high-value claims. Penningtons Manches Cooper reported that just 14 NHS trusts accounted for 47 High Court clinical negligence cases issued during 2025, many involving complex injuries or long-term care needs.
At the same time, serious avoidable errors have remained in the public eye. It has been reported recently that millions of pounds in compensation were paid for surgical Never Events being paid in the last year, including operations on the wrong body part and foreign objects left inside patients. Taken together, and there may well be others, these figures present a system struggling with the dual pressures of increased demand and repeated failings.
They also explain why clinical negligence is no longer being examined simply as a litigation problem but as a financial challenge with implications for NHS resource allocation.
Why attention is shifting from legal costs to the cost of harm
For many years, debate has circled around the legal costs associated with clinical negligence claims, especially in lower-value cases. That conversation has not disappeared, but recent developments suggest a decisive shift.
The Public Accounts Committee has begun examining whether current care award structures lead to duplication of state and private provision, and whether this contributes to rising claim values. During its hearings, NHS Resolution highlighted that private care costs remain a major driver of high-value cases and drew comparisons with other jurisdictions that apply caps or top-up models.
Yet a parallel message has come through just as strongly: a significant portion of the financial burden originates not in litigation behaviours but in repeated clinical failings. The NAO report emphasised that preventing harm is by far the most important factor in reducing overall cost. NHS Resolution echoed this view, stressing that the priority must be learning from claims and improving patient safety, particularly in maternity care.
This shift in emphasis is important. It places responsibility on the system to address underlying causes rather than to restrict access to redress. It also aligns with the lived experience of claimant solicitors, who regularly deal with the consequences of serious avoidable injury.
A changed backdrop for claimant solicitors
For claimant firms, the pause on fixed recoverable costs for sub-£25,000 claims has offered temporary stability but not certainty. The Law Gazette reported parliamentary concern that in some lower-value cases legal costs can exceed damages by several multiples, and this remains a potential catalyst for renewed reform.
Against this background, firms continue to face the everyday pressures of presenting viable cases, meeting disclosure expectations and managing the costs and recovery of expert evidence.
The judgments considered in Temple’s 2025 articles remain directly relevant. The decision in JXX v Archibald placed new emphasis on the transparency of medical agency fees, with implications for recoverability where a breakdown is not supplied. At the same time, the continued scrutiny of hourly rates, narrative detail in bills and the handling of vulnerability all point towards a more exacting environment for cost recovery.
Claimant clinical negligence solicitors therefore also face a dual challenge: preparing cases to a standard that withstands detailed assessment while remaining alert to the possibility of renewed policy intervention.
How NHS finance pressures may affect claims
As financial pressures on NHS trust budgets grow, several effects may emerge. Some trusts may become more risk sensitive, more cautious about admissions and more inclined to explore early resolution.
Others, particularly those under enhanced oversight following league table rankings or safety inquiries, may face increased claim volumes due to heightened awareness among patients. The pattern of High Court cases identified in 2025 suggests that both systemic pressures and reputational concerns are contributing to variations between trusts.
The broader question is whether the financial strain will lead to calls for further limitations on damages or legal costs. While this remains possible, especially given the scrutiny of care awards, the competing argument that reducing harm is the only credible long-term answer continues to carry weight.
The Temple perspective
Temple does not take sides in political debates about NHS funding, but we do recognise the importance of a balanced and informed approach. The figures published in recent months underline a simple truth: when patient safety fails, the human and financial consequences are severe. Any long-term reduction in cost must come from addressing these root causes rather than narrowing the routes available to injured patients.
From an underwriting standpoint, our focus remains on supporting strong, well-prepared claims. That includes clear risk assessments, transparent expert evidence and early identification of the issues most likely to influence liability or quantum. We continue to work closely with claimant solicitors as expectations around scrutiny, case preparation and recoverability develop.
Looking ahead
Although fixed recoverable costs may not be an immediate priority for government, the wider financial debate around clinical negligence is gaining momentum. As more data emerges from the National Audit Office, NHS Resolution and parliamentary committees, the question of how the NHS manages both safety and financial risk will remain central.
In this context, as we know, claimant solicitors will continue to play a vital role. The work they do helps families secure the support they need after avoidable harm. It also contributes to the learning process that underpins safer care.
Temple will monitor developments closely throughout 2026 and remain committed to supporting firms in delivering access to justice during what is likely to be a year of continued and ever-increasing financial and operational pressure for the NHS.
If you’d like to talk about what these developments mean for your firm or your clients, please contact me on 01483 514804 or email
Relevant previous articles you may also like to read –
- https://www.temple-legal.co.uk/news/clinical-negligence-in-2025-steady-headlines-shifting-pressures/
- https://www.temple-legal.co.uk/news/nhs-league-tables-what-the-first-published-rankings-could-mean-for-clinical-negligence-claims/
Matthew Best Cert CII
Head of Personal Injury & Clinical Negligence
Matthew Best Cert CII
Matt has an insurance background and joined Temple in 2011 having worked for 4 years in a leading insurance company where he was dealing with personal injury work. Matthew was promoted to Underwriting Manager and subsequently Senior Underwriting Manager taking on overall responsibility for Temple’s personal injury and clinical negligence underwriting department.
In 2022 Matt joined the board of directors as Director of ATE Partnerships. Matthew has cultivated fantastic relationships with our business partners for many years. His ability to build a clear understanding of their requirements and more importantly what is required to fulfil such requirements means he is ideally placed to support the strategic direction of the company.
Matt remains the head of the personal injury and clinical negligence department and is committed to all Temple’s business partners in order to deliver the highest level of service they expect. He is also responsible in making sure that Temple’s ATE and disbursement funding products remain competitive, but most importantly that they are fit for purpose for solicitors and their clients.
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