Clinical negligence claims are taking longer to settle than they did a decade ago, according to new research from the Association of Personal Injury Lawyers (APIL).
APIL says it now takes NHS Resolution more than two years on average to settle a clinical negligence claim, around 10 months longer than in 2013/14. For the highest-value claims, the average wait is now more than eight years.
The figures have renewed debate around the causes of delay in clinical negligence litigation- and the effect this can have on both claimants and the overall cost of resolving claims.
We look at where delays can arise in the evidential process, and what can be done to avoid unnecessary hold-ups.
Clinical negligence claims now take longer to settle
APIL’s research shows a significant increase in the average time taken to resolve clinical negligence claims.
Compared with 2013/14, settlement times have increased by around 58%, with claimants now waiting an average of 10 months longer for their cases to conclude. Those with the most severe injuries face the longest delays, with the highest-value claims taking more than eight years on average to settle.
APIL argues that delay can itself increase legal costs and has called for stronger compliance with the Pre-Action Protocol for Clinical Disputes.
Its proposals include changes intended to improve early communication and ensure that meaningful investigations take place sooner in the life of a claim.
The organisation also acknowledges that there can be legitimate reasons for some claims to take longer, particularly where the long-term impact of an injury is still developing and future care needs cannot yet be assessed reliably.
Why can clinical negligence claims take so long?
Clinical negligence claims are rarely straightforward.
Before liability and compensation can be properly assessed, the parties may need to establish exactly what happened, whether the treatment provided fell below a reasonable standard and whether any breach caused or materially contributed to the patient’s injury.
In the most complex cases, delay may also reflect the litigation process itself. Disputed liability, causation and quantum can require extensive disclosure, multiple expert disciplines, joint statements, witness evidence, costs budgeting and ultimately court listing. High-value claims involving serious or life-changing injury may therefore take longer because several issues remain contested, not simply because evidence has been slow to obtain.
NHS Resolution has pointed to these factors in response to APIL’s research. It said that progress can depend on the availability of medical records, expert evidence and information from third parties, as well as information required from claimant representatives in order to assess the value of a claim.
Medical records can affect the pace of a claim
Obtaining complete medical records is often one of the earliest stages in investigating clinical negligence.
But medical records may be held by several organisations, particularly where a patient has received care from GPs, NHS trusts, community services and specialist providers.
Missing or incomplete records can prevent an expert from reaching a reliable opinion and may result in further requests being made later.
The organisation of those records also matters.
A clear medical chronology can help solicitors and experts identify the sequence of events, locate key entries and highlight apparent gaps before formal expert evidence is obtained.
That does not necessarily make a complex claim quick to resolve. But addressing obvious gaps at an early stage can reduce the risk of avoidable supplementary work later.
Getting the expert evidence right
Clinical negligence claims often require evidence from several medical specialties.
The challenge is not simply finding an expert. It is identifying the right discipline for the questions that need to be answered.
A claim involving delayed diagnosis, for example, may require evidence about the initial assessment, radiology, specialist treatment and ultimately the effect that earlier intervention would probably have had on the patient’s outcome.
If an important specialty is identified only after reports have already been obtained, further evidence may be needed and the timetable can lengthen.
Expert instructions also need to be sufficiently focused.
Providing experts with complete records, a clear chronology and well-defined questions can help ensure that the resulting report addresses the issues that actually determine breach and causation.
Early liability decisions
APIL’s report places particular emphasis on earlier engagement and compliance with the Pre-Action Protocol.
NHS Resolution is also pursuing an early-resolution strategy.
Its 2025/26 Annual Report states that a record 84% of clinical negligence claims were resolved without formal legal proceedings, as part of its wider Resolution Through Collaboration strategy.
That is an important counterpoint to the increase in average settlement times.
More claims may be resolving without litigation, while complex or high-value cases can still take many years to conclude.
Claims involving catastrophic or life-changing injury may require time for prognosis to become clearer, care requirements to be assessed and future losses to be properly calculated. At the same time, disputes where liability can be established earlier may benefit from earlier admissions, interim payments or other forms of resolution.
The relationship between delay and cost
The length of time taken to resolve clinical negligence claims also matters because of the continuing scrutiny of legal costs.
APIL argues that unnecessary delay contributes directly to those costs.
NHS Resolution has itself recognised the relationship between duration and expenditure, while current policy increasingly emphasises resolving disputes before they enter litigation.
Longer claims can require updated expert reports, additional medical evidence, further conferences and continued case management.
But reducing costs cannot simply mean resolving every claim as quickly as possible.
Where prognosis remains uncertain or a patient has complex long-term needs, waiting may be necessary to ensure compensation accurately reflects the consequences of the injury.
What is imporatnt is whether the the delay is necessary or avoidable.
What can help reduce avoidable delay?
No single part of the claims process is responsible for how long every case takes.
However, good preparation can reduce some of the practical causes of delay.
For solicitors and claims professionals, that can include:
- requesting relevant medical records as early as possible;
- checking that the records received are complete;
- identifying the likely expert disciplines at an early stage;
- providing experts with organised records and focused instructions;
- investigating breach and causation in parallel where appropriate;
- responding promptly when further evidence or information is required.
For healthcare organisations and defendants, timely investigation and early decisions on liability can also help narrow the issues that remain in dispute.
A more complicated picture
APIL’s research reveals the ongoing trend- clinical negligence claims are taking substantially longer to settle than they did a decade ago.
But the reasons behind that increase are more complicated than any single statistic can show.
Some delay may arise from the complexity of serious injury claims and the need to establish a reliable prognosis. Other delays may result from incomplete records, late evidence, slow investigations or issues that could have been identified sooner.
For medico-legal practitioners, complete records, appropriate expert evidence and early identification of the key issues can help prevent unnecessary delay from being added to an already complex process.
Need support with medical records or expert evidence?
UKExpertMedical supports solicitors with medical record review, chronologies and access to the right medical experts, helping identify key evidence, gaps and issues earlier in the claim.
To discuss support for a current or upcoming case, please contact our team.
Sources
- Association of Personal Injury Lawyers, Victims of clinical negligence wait longer than ever for justice, 22 September 2026.
- APIL, The Justice Gap, 2026.
- Law Society Gazette, ‘Deny and delay’ blamed for surge in clinical negligence waiting times, September 2026, including NHS Resolution response.
- NHS Resolution, Annual Report and Accounts 2025/26.
