NHS Resolution annual report shows more cases resolved with litigation than ever before
Claimant legal costs increased at twice the rate of the NHS’s in clinical negligence claims in the past year, the NHS Resolution (NHSR) annual report has shown.
The NHS paid out £621m in claimant legal costs in the year to 31 March 2025, a 14% jump on the previous 12 months, while the NHS’s own legal costs were up 7% to £181m. Claimants received approaching £2.3bn in damages, up 8%.
It attributed this increase in the £3.1bn overall cost of claims – £4.9bn when ongoing periodical payments orders (PPO) were included – to more cases resolved between £250,000 and £4.8m and a larger volume of cases settled with a PPO.
Last year was the first time that average claimant costs on claims valued up to £25,000 exceeded damages and this upward trend has continued, with the average rising 5% from £26,095 to £27,380. For clinical claims valued between £25,001 and £100,000, the average claimant legal costs paid per claim were £55,767, a 1% increase on 2023/24 and the highest since 2017/18, when they were £60,391.
NHSR trumpeted the record level of claims resolved without going to litigation, reaching 83%, having risen steadily since 2016/17, when the figure was 66%.
“It is a reflection of the success of our first strategic priority: commitment to fair resolution while keeping patients and healthcare staff out of formal processes. We recognise this upward trend cannot continue indefinitely but… will always continue to promote dispute resolution over litigation.”
NHSR received 14,428 new clinical negligence claims and reported incidents in the year, an increase of 5% and surpassing the previous peak in 2019/20, prior to the pandemic. In 2024/25 NHSR closed 14,431 clinical claims, an increase of 4%; 54% of them saw a damages payout, up two percentage points on the previous year.
Only 24 clinical and 21 non-clinical claims were litigated to trial in the year, with no damages awarded in 60% of them, compared with 66% in 2023/24.
Take-up of mediation remained low, with 138 claims proceeded to mediation in the year and 73% of them settling on the day or within 28 days. Other forms of ADR used by the service are resolution meetings and stock take meetings, while the outcome of an early neutral evaluation pilot should be published by the end of 2025. There was no reference in the report to the costs mediation scheme NHSR runs.
The report also described how innovations such as NHSR’s ‘early notification’ scheme for birth injury have enabled families to access compensation for immediate needs more rapidly.
NHSR chief executive Helen Vernon said: “We unequivocally support and promote candour and that clinical staff should be open and transparent. Where there is a claim for compensation, this needs to be investigated in line with the law but we always aim to resolve cases as quickly as possible to avoid distress to the family, with four in five cases resolving early on without the need to involve the courts.”