By Matthew Best, Director – ATE Partnerships, Head of Personal Injury & Clinical Negligence
While the pause on fixed recoverable costs has lowered the temperature, underlying pressures around patient safety, NHS accountability and claim funding remain a live issue across the sector.
A pause for breath?
With the issue of fixed recoverable costs (FRC) now paused rather than pursued, 2025 began with a somewhat quieter backdrop for clinical negligence. That said, ‘less noise’ doesn’t mean less significance.
Here at Temple, we’ve always tried to take a balanced view. Our work with claimant solicitors gives us a front-row seat to the legal and procedural challenges in this area – but our view is shaped just as much by recent case developments, national policy shifts and, most recently, the worrying rise in high-profile maternity failings.
This article reflects on a few of these developments and offers some thoughts from our perspective on what they may mean in practice.
What’s changed – and what hasn’t – since late 2024
The temporary shelving of fixed recoverable costs for claims under £25,000 is arguably one of the most significant recent decisions. While this may have offered welcome relief for claimant solicitors, the issue is far from settled. It remains unclear whether this is a pause for reflection or simply a delay in implementation.
In the meantime, NHS negligence spending continues to climb. According to NHS Resolution, compensation and related costs reached £2.8 billion in 2023–24, up from £2.64 billion the year before. These are sobering figures, and as Lord Darzi’s 2024 review pointed out, they reflect not only the scale of the challenge but also its underlying causes – repeated clinical errors that, in many cases, could have been avoided.
So while the policy environment may feel more stable for now, the broader context remains one of pressure, both operational and financial.
Recent maternity failings and the national inquiry
A series of cases in early 2025 have brought maternity care back into sharp public and professional focus.
- Nottingham University Hospitals NHS Trust received a £1.6 million fine in February after failings were found to have contributed to the deaths of three babies. This has since escalated into a corporate manslaughter investigation – a development that is unusual, if not unprecedented. More than 2,500 historical cases are now being examined.
- Elsewhere, Great Western Hospitals NHS Trust in Swindon was ordered to pay £35 million following a catastrophic group B strep infection that left a child with lifelong injuries. It is one of the largest single clinical negligence settlements in recent memory.
In June 2025, the government launched a national inquiry into maternity and neonatal care across ten trusts. The first report is due later this year.
While these are difficult and often tragic cases, they also raise important points about how the legal system – and ATE insurers – support families seeking redress. Many of these claims are both emotionally and procedurally complex. Without appropriate funding mechanisms, they could become inaccessible to those most affected.
Hospital league tables – incentive or added risk?
Alongside the above, 2025 also saw the publication of new NHS hospital league tables. Intended to boost transparency and encourage accountability, these rankings could have a mixed impact.
Maternity units are again under the spotlight. A large proportion of services have been flagged as inadequate, and some trusts have found themselves facing increased scrutiny as a result.
One possible effect is an increase in claims – particularly where patients now feel more confident challenging poor care, or where lower-ranked hospitals find themselves repeatedly linked to adverse outcomes. Whether this drives genuine improvement or creates defensive practices remains to be seen.
At Temple, we support greater transparency – but with a note of caution. Public rankings alone do not guarantee systemic improvement. Nor do they always reflect the nuance of clinical care or the realities facing overstretched staff.
The position for claimant solicitors
For many claimant firms, the pause on FRC has not changed day-to-day pressures. Cost risk, case selection and funding constraints remain live issues, particularly where complex lower-value claims are concerned.
Recent case law is also shaping the landscape. The Supreme Court’s judgment in Paul v Royal Wolverhampton NHS Trust provided some clarity on secondary victim claims but also left important procedural questions. Will this now lead to greater certainty, or further litigation?
In this environment, reliable ATE insurance and disbursement funding remain essential. The right structure can offer protection for both firms and their clients, without undermining commercial viability.
The Temple perspective
We’ve long supported responsible reform – but only when it supports the dual goals of access to justice and improved patient care. Cost savings alone are not a sustainable basis for change.
That’s why we’re keeping a close eye on how league tables, maternity inquiries and paused reforms interact. Together, they reflect both the risks and opportunities within clinical negligence as we head into the second half of 2025.
For our part, we continue to work with our partners to provide ATE cover that reflects the needs of modern litigation. Our aim is to support strong claims, encourage early resolution where appropriate, and make sure claimants are not left exposed when things go wrong.
Final thoughts
It may feel like the pace of reform has slowed – but the underlying issues remain very much alive. Recent maternity failings and a renewed focus on NHS accountability are likely to shape discussions for some time to come.
At Temple, we remain committed to helping our business partners meet these challenges. 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
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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