The cost of clinical negligence continues to put severe pressure on the NHS. Annual spending now exceeds £3 billion, with liabilities projected well into the tens of billions. Against this backdrop, government, professional bodies, and patient groups are re-examining how the system works—and whether it can be made faster, fairer, and more sustainable (BMA, 2025).

Why Reform Is Back On The Agenda

The British Medical Association (BMA) and other organisations have highlighted the unsustainable growth of negligence costs. At present, claims are handled through civil litigation, with damages often reaching very high sums for life-changing injuries. While this provides important redress for patients, the financial burden on the health service is immense (Legal Futures, Sept 2025).

Reform discussions focus on three key questions:

• How can patients receive timely, fair compensation?
• How can the NHS reduce the spiralling costs of claims?
• How can standards of care be maintained and improved without fear of defensive medicine?

Options Under Consideration

Several proposals are being debated:

• Fixed recoverable costs for lower-value claims – extending fixed fees to claims under a certain threshold to improve proportionality (NHS Resolution, 2025).
• Alternative dispute resolution – wider use of mediation or early neutral evaluation to reduce reliance on court proceedings (Law Gazette, 2025).
• Administrative compensation schemes – exploring models similar to those in Scandinavia, where no-fault schemes provide quicker settlements (BMA, 2025).
• Caps on damages or legal costs – politically sensitive but being raised in policy discussions (Parliament.uk briefing, 2025).

Implications For Legal Practice

If reforms progress, solicitors and medico-legal experts will face a changed environment:

• More emphasis on early triage and robust medical evidence, as weaker claims may be filtered out sooner.
• Potential increase in ADR processes, requiring different case management skills.
• Greater scrutiny of expert reports, as courts and tribunals look for efficiency and consistency.

For firms handling clinical negligence, preparing now—by strengthening case assessment processes and expert partnerships—will be critical.

Comment From UKExpertMedical

Whatever the final shape of NHS clinical negligence reform, one factor will remain constant: the need for clear, comprehensive, and defensible medico-legal evidence.

Our nationwide panel of experts ensures solicitors have access to the specialist insight required to navigate an evolving claims landscape—helping to secure fair outcomes for clients while meeting new expectations on efficiency and quality.