Following the Public Accounts Committee’s (PAC) critical report on the “two decades of inaction” regarding clinical negligence costs, the Department of Health and Social Care has confirmed that its strategy now rests on the ongoing independent review led by David Lock KC.

While the PAC report focused on the staggering £60 billion liability facing the taxpayer, the Lock Review is tasked with the practical—and potentially radical—restructuring of how those costs are managed. Commissioned as part of the government’s 10-Year Health Plan, David Lock KC is providing expert policy advice on two primary fronts: improving the patient experience of claims and curbing the “spiralling” legal costs that currently account for a significant portion of settlement totals.

Key Areas of Scrutiny

The review is expected to move beyond discussion points to provide actionable recommendations in several high-impact areas:

• The “Private Care” Assumption: Under current legislation dating back to 1948, courts must ignore the existence of the NHS when calculating future care costs. The review is evaluating whether this “paying twice” model remains sustainable or if reform is required to reflect modern healthcare delivery.
• Legal Fee Transparency: Amidst concerns from the National Audit Office (NAO) regarding claimant legal fees—which have tripled in the last two decades—the review is exploring mechanisms for greater transparency and control over fee deductions from damages.
• Alternative Dispute Resolution (ADR): With 83% of claims now settling without litigation, the review is looking at how to formalize “upstream” resolutions to prevent cases from entering the high-cost court system in the first place.

The Road Ahead for 2026

The PAC has recently demanded that the Department of Health publish the Lock Review’s findings within six months of its completion, along with a formal operational plan to tackle negligence costs.

For solicitors and medico-legal experts, the findings will mark a shift from identifying the financial burden of clinical negligence to rewriting the rules of engagement.

As David Lock KC moves toward a final report, the outcome will likely dictate the next decade of practice standards, expert instruction, and case valuation across the UK.

UKExpertMedical Comment

At UKExpertMedical, we view these policy shifts  as a validation of our core standards. By investing in advanced clinical data collation training and technology for our nurse analysts and ensuring our experts are vetted against the most recent judicial benchmarks, we provide our clients with a “litigation-ready” foundation.

In an era of high-stakes reform, the accuracy of the initial medical record review is often the difference between a protracted dispute and a swift, fair resolution. Our focus remains on delivering the technical excellence that ensures our clients can navigate these changes with confidence.

Contact us to find out more.