By Bipin Regmi, Senior Underwriter
Estimate read time 5 minutes 15 seconds
Clinical negligence costs have returned to professional discussion following the publication of the ‘Costs of clinical negligence’ report by the Public Accounts Committee. Scrutiny of NHS clinical negligence spending is not new, but the committee’s findings have prompted renewed coverage across the legal press, particularly in relation to damages, claimant legal costs and the lack of progress on reform.
For practitioners, the significance of this moment lies less in the figures themselves and more in what this renewed attention may indicate about future areas of focus, both within claims handling and across the wider environment in which the claims arise.
How the Report has Been Presented in the Legal Press
Coverage of the committee’s report has been consistent in substance but framed through two connected perspectives.
- One strand of reporting has focused on the scale and growth of NHS expenditure on clinical negligence, including damages and claimant legal costs. There is particular emphasis on proportionality, especially in lower-value claims, and on long-standing questions around how future care costs are assessed.
- Alongside this is a parallel narrative giving greater weight to patient safety and systemic failure. From this perspective, rising costs are presented less as a standalone financial issue, more as the outcome of repeated failures to address known risks within healthcare delivery.
Both perspectives draw from the same committee findings and together shape the current professional discussion.
Key Issues Emerging for Clinical Negligence Practitioner
Several technical themes recur across the reporting and worth closer consideration.
- Future care assessment – The continued assumption that future care will be privately funded remains a central issue. MPs have questioned whether this reflects reality in many cases and whether it contributes to inflated awards. For practitioners, this underlines the importance of careful evidence gathering and clear reasoning where future care forms a significant part of valuation.
- Claimant legal costs and proportionality – Disproportionate legal costs in lower-value claims have again been highlighted, including cases where costs exceed damages by a substantial margin. While familiar, the renewed parliamentary interest suggests that proportionality will remain under examination, even if immediate reform does not follow.
- Reform uncertainty – As we all know, fixed recoverable costs and alternative processes have been discussed for several years, yet progress has remained limited. The committee’s intervention reinforces that these issues have not gone away, even if the timing and direction of any change remain unclear.
- Wider system pressures – The growing link being drawn between cost growth and patient safety puts clinical negligence claims within a broader context. This has the potential to influence expectations around litigation conduct, settlement approach and longer-term reform priorities.
The Temple Perspective
From an underwriting and claims perspective, many of these themes reflect issues already encountered in day-to-day practice.
- Future care remains one of the most challenging aspects of claim valuation, particularly where assumptions around provision, duration and dependency carry significant financial consequences. Early clarity and realistic assessment are often critical in managing exposure and maintaining proportionality.
- Cost scrutiny is also an increasingly common feature of strategic discussion, especially in lower-value claims. Balancing efficient resolution with appropriate challenge continues to require careful judgement, supported by clear evidence and robust case preparation.
- Importantly, uncertainty itself has become a practical consideration.
The possibility of renewed reform or increased scrutiny, even without immediate change, could influence how cases are assessed, budgeted and reviewed over time.
What Practitioners May Wish to Keep Under Review
Against this background, practitioners may wish to keep the following areas under consideration:
- The assumptions underpinning future care awards and how they are evidenced
- Exposure to proportionality challenges in lower-value claims
- The likelihood of continued focus on costs and process
- How wider scrutiny may shape expectations around conduct and resolution
While the committee’s report does not point to immediate change, it does reinforce that clinical negligence costs remain under close attention.
For those working in clinical negligence, including insurers and solicitors alike, understanding how this discussion develops may prove as important as the figures themselves.
If you would like to discuss any of the details raised in this article, please call Bipin on 01483 514414 or send an email to
Bipin Regmi
Senior Underwriter
Bipin Regmi
Bipin qualified as a Solicitor in 2019. He has extensive experience dealing with personal injury, clinical negligence and professional negligence claims.
Bipin joined Temple as a Senior Underwriter in 2024.
With his knowledge of legal practice and understanding of risk assessment, Bipin brings a unique perspective to the underwriting process, ensuring that all decisions are informed by thorough analysis and sound judgement. His legal experience is invaluable to the business and our clients.
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