title: Current cost of medical negligence in NHS hospitals: analysis of claims database.
abstract: OBJECTIVE
  To identify trends in the incidence and cost of clinical negligence claims. To determine the current annual cost to the NHS as a whole in terms of cash paid out to patients and their solicitors and the defence costs incurred.
  
  
  METHODS
  Analysis of records on database.
  
  
  METHODS
  A well defined group of hospitals within one health authority which collected information on a consistent basis over many years.
  
  
  METHODS
  Data on individual claims. Trends in incidence of claims and costs identified independently from organisational reforms and changes in accounting practices.
  
  
  RESULTS
  The rate of litigation increased from 0.46 to 0.81 closed claims per 1000 finished consultant episodes between 1990 and 1998. Overall expenditure on clinical negligence by the NHS in England in 1998 was estimated at 84 pound sterling million (95% confidence interval 48 pound sterling million to 130 pound sterling million).
  
  
  CONCLUSIONS
  After adjustment for hospital activity, the rate of closed claims increased during the 1990s by about 7% per annum, a substantial rate of growth but not the uncontrolled explosion sometimes alluded to in the wider media. More coordination and openness are needed in data collection.
authors.affiliation: University of Nottingham Business School, Nottingham NG7 2RD. paul.fenn@nottingham.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Fenn
authors.forename: S
authors.initials: S
authors.lastname: Diacon
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.forename: R
authors.initials: R
authors.lastname: Hodges
authors.forename: N
authors.initials: N
authors.lastname: Rickman
mesh_terms: D003365:Costs and Cost Analysis; D003625:Data Collection; D016208:Databases, Factual; D004739:England; D006783:Hospitals, State / Q000331:legislation & jurisprudence*; D006801:Humans; D015994:Incidence; D016365:Liability, Legal / Q000191:economics*; D006113:United Kingdom