By Matthew Best, Director – ATE Partnerships, Head of Personal Injury & Clinical Negligence
Estimated Reading Time – 3 minutes 41 seconds
This article reflects on the league tables’ introduction, some of the early feedback following their release, and how these developments sit alongside Temple Legal Protection’s continuing support for constructive engagement with healthcare reform and access to justice.
The recent publication of NHS hospital league tables marks a significant shift in how trust performance is being presented and scrutinised. For claimant clinical negligence solicitors, this development does not directly alter how cases are pursued or funded, but it does form part of a wider shift in how hospital standards are being measured and made public.
1.The rankings so far
In September 2025, NHS England published its first full set of trust performance rankings, as part of the updated Oversight Framework. Every NHS trust in England has now been assessed and segmented, with the intention of this being updated quarterly.
The performance measures used span a range of indicators – including waiting times, financial management and patient outcomes – with trusts grouped into categories reflecting the level of support or intervention required. Those in the highest performing group may be given greater financial autonomy, while those at the lower end face enhanced oversight.
While the approach has been described as ‘light-touch’, the publication of this data has attracted widespread media attention. Trusts such as Moorfields Eye Hospital have been highlighted as top performers, while others have been named as needing significant improvement. The data is available publicly and intended to contribute to greater transparency and accountability across the NHS.
2.A measured response from across the sector
Early reactions to the league tables have been mixed. While some have welcomed the visibility and ambition for higher standards, others have cautioned against the unintended consequences of ranking institutions in this way.
In particular, concerns have been raised that the metrics chosen may overemphasise financial performance or short-term throughput, while failing to account for local complexity or long-standing resource challenges. There is also a risk that ranking systems may undermine morale among clinical staff and contribute to a culture of blame, rather than improvement.
As with previous efforts to ‘score’ NHS providers, questions remain about how useful this information is in isolation, and whether it can fairly capture the quality of care being delivered on the ground.
3.Clinical negligence: possible indirect effects
For those involved in clinical negligence work, the league tables do not change the legal standards for bringing a claim, nor do they replace the need for detailed evidence of breach and causation.
However, they may signal areas where trusts are under performance pressures, or where systemic issues have already been identified. In some cases, claim volumes may reflect broader operational difficulties. In others, trust-level changes prompted by rankings may influence how cases are handled – whether through greater risk sensitivity, reputational concern or more centralised management of complaints and claims.
Here at Temple we will continue to monitor how such developments may affect the context in which claims arise, and how its ATE insurance cover can respond to the practical realities faced by claimant solicitors and their clients.
4.Wider context and Temple’s ongoing approach
Temple Legal Protection has consistently supported thoughtful discussion on healthcare reform and its impact on patient safety and access to justice. The publication of NHS league tables fits into a broader pattern of efforts to improve standards, manage resources and address failings within the system.
As an ATE provider, Temple remains committed to offering robust cover, but also to contributing to a fairer and more transparent environment for resolving clinical negligence claims. That includes recognising where systems are under strain, where patients may be at risk and where reforms may shift the dynamics of accountability.
5.Conclusion
The introduction of NHS trust rankings is unlikely to have any immediate impact on how individual claims are investigated or funded. However, claimant solicitors may benefit from being aware of how trusts are being assessed publicly and how that may reflect wider pressures within the healthcare system.
While Temple does not rely on league tables in its underwriting, such data can offer a broader understanding of the conditions in which clinical care is delivered. As part of its wider role, Temple will continue to monitor these developments and support constructive engagement with efforts to improve both healthcare standards and the legal process for injured patients.
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
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-and-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.
Read articles by Matthew Best Cert CII
