New NHS claims 2024/25
14,428
NHS Resolution annual report
Total payout 2024/25
£3.1bn
Compensation and costs
Time limit to claim
3 years
from injury or awareness date
Upfront cost
£0
No Win No Fee
Written By
Rizwan Shabir
Every guide we publish is verified against UK statute and current case law before release.
What qualifies as medical negligence is not simply a bad medical result. For a claim to succeed in the UK, four things must be shown: the healthcare professional owed you a duty of care, that duty was breached, the breach directly caused your injury, and you suffered measurable harm as a result. A poor outcome without a breach of the expected standard of care does not constitute medical negligence.
One of the most common questions after an unsatisfactory medical experience is whether what qualifies as medical negligence applies to their situation. The answer is not always straightforward. Medicine involves clinical judgment, and complications can arise even when care meets a perfectly acceptable standard. This distinction matters because it shapes whether a claim has any real prospect of success.
This guide explains the legal tests that define what qualifies as medical negligence, how courts assess the standard of care, what common examples look like, and how to think about your own situation before speaking to a solicitor.
What qualifies as medical negligence?
Medical negligence, also known as clinical negligence, is substandard care by a healthcare professional that directly causes a patient harm. It is not the same as a poor outcome. What qualifies as medical negligence requires a failure to meet the accepted standard of care, not simply an unfortunate result from treatment that was properly carried out.
In 2024/25, NHS Resolution received 14,428 new claims in which what qualifies as medical negligence was in dispute, up 5% on the previous year. Total payouts across all NHS clinical schemes reached £3.1 billion, including £1.3 billion related to maternity cases alone. A record 83% of claims were resolved without formal court proceedings, reflecting a growing preference for negotiation and mediation over litigation.
Behind those numbers are real patients trying to understand whether what qualifies as medical negligence applies to their situation. Many do not know whether their situation qualifies, which is often the first and most important question to answer before any other decision is made.
14,428
New clinical negligence claims received by NHS Resolution in 2024/25
83%
Claims resolved without court proceedings in 2024/25, the highest proportion ever recorded
54%
Clinical negligence claims that closed with damages awarded in 2024/25
The four legal tests you must meet
Short answer
To establish what qualifies as medical negligence, four legal elements must all be present: duty of care, breach of that duty, causation, and damages. If any one of these cannot be proven on the balance of probabilities, the claim is unlikely to succeed.
Claims in which what qualifies as medical negligence is in dispute are assessed against the same legal framework as other personal injury claims, but with one important additional layer: the clinical standard of care test. Courts do not judge healthcare professionals by what was theoretically possible, but by what a reasonable and competent professional in the same field would have done at the time.
| Element | What It Means | In Practice |
|---|---|---|
| 1. Duty of Care | The healthcare professional owed you a legal obligation of care | Applies automatically in almost all treatment settings |
| 2. Breach of Duty | The standard of care provided fell below what a competent practitioner would have delivered | Assessed using the Bolam test; requires independent expert evidence |
| 3. Causation | The breach directly caused the harm you suffered | Must be proven on the balance of probabilities (more likely than not) |
| 4. Damages | You suffered measurable physical, psychological, or financial harm | Covers injury, lost earnings, additional treatment, future care |
Causation is often the hardest element to establish. It is not enough to show that care was substandard, you must also show that the substandard care is what caused your specific injury, rather than the underlying condition itself. This is why independent medical expert evidence is central to almost every case where what qualifies as medical negligence is in dispute.
The Bolam test explained
The Bolam test, established in Bolam v Friern Hospital Management Committee [1957], sets the legal standard for assessing breach of duty in medical negligence. A healthcare professional is not negligent if their actions are supported by a responsible body of medical opinion. The test was refined in Bolitho v City and Hackney Health Authority [1997], which requires that supporting opinion must also be logically defensible.
Definition
The Bolam test
A healthcare professional is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of medical professionals skilled in that field, even if other practitioners would have done something different. The key question is not whether the best possible care was given, but whether the care given fell within an acceptable range of professional practice.
The Bolam test matters for two practical reasons when assessing what qualifies as medical negligence. First, it means that if a reasonable body of medical opinion would have made the same decision, the care is unlikely to be found negligent regardless of the outcome. Second, it means that having a doctor who would have done something differently is not sufficient on its own. What qualifies as medical negligence requires that no reasonable body of medical opinion would have acted the same way.
The Bolitho refinement added an important safeguard for patients seeking to establish what qualifies as medical negligence. Even if the defendant’s treatment was supported by a body of medical opinion, courts can reject that defence if the supporting opinion is not logically defensible. Expert evidence that relies on outdated practice or circular reasoning can be set aside when determining what qualifies as medical negligence.
Common examples in the UK
The most common patterns of what qualifies as medical negligence in the UK involve delayed or missed diagnosis, surgical errors, medication mistakes, birth injuries, and failure to obtain informed consent. Obstetrics and general surgery together account for the largest share of NHS clinical negligence claims by value.
Understanding the common patterns helps patients recognise situations that may be worth reviewing with a solicitor. Most of the following scenarios would need independent expert evidence to confirm whether the treatment fell below the accepted standard in the specific circumstances.
- Delayed or missed diagnosis: failure to identify cancer, sepsis, or another serious condition when a competent clinician should have done so, leading to avoidable deterioration
- Surgical errors: operating on the wrong site, leaving instruments inside a patient, or causing avoidable damage to surrounding tissue or nerves
- Medication errors: prescribing the wrong drug or dose, or failing to check for known interactions, leading to serious side effects or harm
- Birth injuries: avoidable harm to mother or baby during delivery, including oxygen deprivation resulting in brain damage or cerebral palsy
- Failure to obtain informed consent: since Montgomery v Lanarkshire Health Board [2015], doctors must warn patients of all material risks relevant to their decision, not just significant ones; failure to do so can ground a separate head of claim
- GP negligence: failure to refer urgently, failure to act on test results, or failure to follow up on symptoms that later proved serious
Obstetric claims in 2024/25 represented only 11% of all new NHS clinical negligence claims but accounted for 53% of total claim value. This reflects the catastrophic and lifelong nature of many birth injury outcomes, where a single incident of what qualifies as medical negligence can result in decades of care costs and lost earnings. Emergency medicine claims are also rising sharply compared with previous years.
The concentration of claim value in maternity cases reflects a genuine and longstanding patient safety concern. For individuals and families navigating what qualifies as medical negligence after a birth injury, understanding the legal framework early, before significant time passes, preserves the strongest possible position for a future claim.
Negligence vs. a bad outcome
A bad medical result is not the same as what qualifies as medical negligence. Medicine carries inherent risks, and complications can arise even when a clinician has followed a perfectly acceptable course of treatment. The distinction, when asking what qualifies as medical negligence, lies in whether the standard of care fell below what a competent professional would have provided in the same circumstances.
This is one of the most important distinctions in clinical negligence law. Courts do not hold healthcare professionals to a standard of perfection. The question is not whether anything could have been done better in hindsight, but whether the care fell within the range that a responsible body of medical opinion would consider acceptable at the time.
“Not every poor medical result means something was done negligently. The key question is whether the care fell below the standard expected of a competent medical professional at the time. That distinction is often where a claim begins or ends.”
Mohammed Rizwan Shabir
| Situation | Likely Negligence? | Why |
|---|---|---|
| Known surgical complication despite proper technique | Usually not | Risk was inherent; standard of care was met |
| Cancer diagnosis missed despite clear symptoms and normal protocols not followed | Likely yes | Departure from accepted standard; avoidable harm caused |
| Drug side effect occurred despite correct prescription | Usually not | Correct treatment given; side effect was known risk |
| Wrong dose prescribed, causing harm | Likely yes | Clear departure from expected standard; directly caused harm |
| Condition worsened despite treatment | Depends | Depends on whether treatment met the accepted standard |
If you are unsure whether your situation meets the threshold for what qualifies as medical negligence, the uncertainty itself is itself a reason to seek legal advice. A specialist solicitor will commission independent expert evidence to assess the standard of care provided, which is the only reliable way to move from uncertainty to a clear answer.
How to assess your case
The starting point for assessing whether your situation qualifies as medical negligence is gathering your medical records and speaking to a solicitor experienced in clinical negligence. Independent expert evidence is almost always required to confirm whether the standard of care was breached and whether the breach caused your harm.
Warning signs worth reviewing
Certain circumstances suggest the care received may not meet the threshold for what qualifies as medical negligence, and each is worth discussing. None of these is conclusive, but each is worth discussing with a solicitor.
- Your symptoms were dismissed or key tests were not ordered, and the condition worsened as a result
- You were given conflicting explanations for what went wrong after a procedure
- Complications arose that independent experts later described as avoidable
- You were not warned about significant risks before giving consent to a procedure
- A diagnosis was made significantly later than it should have been given the presenting symptoms
Practical steps
1. Request your medical records
You have a legal right to access all documentation of your care under the Data Protection Act 2018 and NHS guidelines.
2. Speak to a specialist solicitor
A solicitor experienced in assessing what qualifies as medical negligence can review your records and advise whether the case warrants independent expert review.
3. Commission independent expert evidence
A clinician in the relevant specialty will review your care against the accepted standard, which is the foundation of any viable claim where what qualifies as medical negligence is being assessed.
4. Act within the time limit
Most claims must begin within three years of the negligent treatment, or from the date you first became aware your harm may have been caused by negligence.
| Stage | Action | Typical Timing | Who Leads |
|---|---|---|---|
| 1. Records | Request full medical records from the provider | Within 30 days of request | You |
| 2. Legal Review | Free solicitor assessment of records and circumstances | Initial meeting | Solicitor |
| 3. Expert Evidence | Independent clinician reviews standard of care | Weeks to months | Solicitor |
| 4. Decision | Proceed or not based on expert opinion | After expert report | Joint |
| 5. Letter of Claim | Formal claim sent to defendant healthcare provider | If claim is viable | Solicitor |
What compensation may cover
Compensation in a medical negligence claim covers both the injury itself (general damages) and financial losses caused by the negligence (special damages). The amount depends on the severity and permanence of the harm, the impact on daily life and working capacity, and the cost of any additional treatment or care required as a result of the negligent care.
Definition
General damages vs special damages
General damages compensate for pain, suffering, and loss of amenity caused by the injury.
Special damages cover financial losses that can be evidenced with receipts, payslips, and invoices, including the cost of corrective treatment, rehabilitation, lost earnings, travel to appointments, and future care needs. Both categories apply in medical negligence claims where what qualifies as medical negligence has been confirmed by expert evidence.
- Pain, suffering, and loss of amenity for the injury caused by the negligence
- Cost of additional treatment required to correct or manage harm caused by substandard care
- Rehabilitation costs including physiotherapy, psychological support, and specialist care
- Lost earnings during recovery and, where the injury is permanent, projected future loss of income
- Long-term care needs where the harm caused requires ongoing professional support
- Out-of-pocket expenses including travel, prescription costs, and equipment
Compensation amounts in cases where what qualifies as medical negligence has been proven depend on the specific facts and financial impact. No figures should be treated as a guarantee of outcome. A solicitor can give a more specific indication once independent expert evidence has been reviewed.
Summary
Understanding what qualifies as medical negligence is the starting point for any patient who has suffered harm after medical treatment and is trying to work out whether they have grounds for a claim. The answer depends on four legal elements: a duty of care, a breach of that duty assessed against the Bolam standard, a direct causal link between the breach and the harm, and measurable damages.
A poor outcome on its own does not establish medical negligence. Courts do not judge clinicians by the standard of perfection, but by what a competent professional in the same field would reasonably have done at the time. Independent expert evidence is the only reliable way to answer that question, and a specialist solicitor is the right person to help obtain and interpret it.
Key takeaways
- What qualifies as medical negligence requires four elements: duty of care, breach, causation, and measurable damages
- Breach is assessed against the Bolam test: whether a responsible body of medical opinion would have acted the same way
- A bad outcome is not the same as what qualifies as medical negligence, and courts apply the Bolam test to draw this line
- In 2024/25, NHS Resolution received 14,428 new clinical negligence claims and paid out £3.1 billion in compensation and costs
- 54% of claims closed with damages awarded, which underlines why specialist legal advice matters
- The standard time limit is three years from the date of harm, or from the date of awareness
- Independent expert evidence is required in almost every case where what qualifies as medical negligence is being assessed
Sources & References
- NHS Resolution Annual Report and Accounts 2024/25, published July 2025. Source for all NHS clinical negligence figures: 14,428 new claims, £3.1 billion paid out, 83% resolved without court proceedings, £1.3 billion maternity-related, 54% of claims closed with damages.
- Bolam v Friern Hospital Management Committee [1957] 1 WLR 582, the leading case establishing the standard of care test for medical negligence. Refined by Bolitho v City and Hackney Health Authority [1997] AC 232, which requires supporting medical opinion to be logically defensible.
- JMW Solicitors, NHS Clinical Negligence Statistics 2025, analysis of NHS Resolution 2024/25 data including specialty breakdown: obstetrics 11% of claims by volume, 53% by value; surgical and emergency medicine patterns.
- Limitation Act 1980, s.11, sets the three-year limitation period for personal injury claims including medical negligence. The period runs from the date of the negligent act or from the date of knowledge, whichever is later.
- Solicitors Regulation Authority, the regulatory framework governing how Claim Time Solicitors conducts medical negligence claims on a No Win No Fee basis. SRA No. 444171.
Frequently asked questions
1. What qualifies as medical negligence in the UK?
Medical negligence occurs when a healthcare professional provides care that falls below the accepted standard and that failure directly causes harm. Four elements must be present: a duty of care, a breach of that duty, a direct causal link between the breach and the harm, and measurable damages. Not every poor outcome qualifies, courts apply the Bolam test to assess whether a responsible body of medical opinion would have acted differently.
2. Is every poor medical outcome considered negligence?
No. Medicine involves risk, and complications can occur even when a clinician has done everything correctly. What qualifies as medical negligence is not simply a bad result, it is a failure to meet the standard of care expected of a competent professional in the same field, where that failure directly caused harm. An independent medical expert would need to confirm that the treatment fell below an acceptable standard before any claim could proceed.
3. What is the Bolam test in medical negligence?
4. How long do I have to make a medical negligence claim?
5. What can compensation cover in a medical negligence claim?
Glossary of Key Terms
- Bolam Test
- The legal standard used to assess breach of duty in cases where what qualifies as medical negligence is in question. A clinician is not negligent if their actions are supported by a responsible body of medical opinion skilled in that field, even if other practitioners would have acted differently. Established in Bolam v Friern Hospital Management Committee [1957].
- Bolitho Refinement
- A refinement to the Bolam test established in Bolitho v City and Hackney Health Authority [1997]. Courts can reject a medical defence if the body of professional opinion supporting it is not logically defensible, even if that opinion is genuinely held.
- Causation
- The legal requirement that the breach of duty directly caused the harm suffered. In cases where what qualifies as medical negligence is being determined, causation must be proven on the balance of probabilities, meaning it is more likely than not that the negligent care caused the specific injury, rather than the underlying condition.
- Duty of Care
- The legal obligation a healthcare professional owes to their patient to provide a reasonable standard of care. In almost all clinical settings, this duty arises automatically from the treating relationship.
- Informed Consent
- Since Montgomery v Lanarkshire Health Board [2015], doctors must inform patients of all material risks relevant to their treatment decision, not merely significant ones. Failure to obtain proper informed consent can form a separate head of claim, and is its own form of what qualifies as medical negligence.
- Limitation Period
- The legal deadline for starting a claim once what qualifies as medical negligence has been identified. In most cases this is three years from the date of the negligent act or from the date you first became aware the harm was caused by negligence. Missing this deadline will almost always bar your claim.
- CFA (Conditional Fee Agreement)
- A No Win No Fee arrangement. If your medical negligence claim succeeds, a success fee of up to 25% (including VAT) of the compensation recovered is deducted. Nothing is owed for legal costs if the claim is unsuccessful. Terms are agreed before the case begins.
Disclaimer: This article provides general legal information about UK clinical negligence law and is not a substitute for tailored legal advice. Outcomes depend on the specific facts of each case. For advice on your circumstances, please contact a member of our team. Information correct as of June 2026. Claim Time Solicitors is regulated by the Solicitors Regulation Authority (SRA No. 444171).
