Three recent high-profile news stories are examples of how NHS system failures, not just substandard care by an individual health professional, may possibly result in a legal claim for clinical negligence.
First, a whistle-blowing paramedic has claimed that patients can come to serious harm, and even die, because of ambulance delays. The Trust concerned, the East of England Ambulance Service NHS Trust (EEAST), is investigating 8 cases in question and the EEAST has already admitted that the service had fallen short. The paramedic referred to the incidents in question as “time-critical”, in which rapid response is essential, and in 4 such incidents the patient died. It is possible that such delays could constitute negligence, as Department of Health guidelines state that ambulances should respond to the most urgent calls within 8 minutes, but in some instances delays of over 2 hours occurred. The previous Chairman of the Trust resigned in March following criticism that response times had worsened over the preceding 12 months.
The second report relates to the breast screening unit at The Royal Bournemouth Hospital in Dorset, in which a junior doctor, who is no longer working at the Trust, failed between January 2011 and July 2012 to follow correct procedures in the way that he assessed patients attending for breast screening. Over 250 women were told that they did not need to attend for a follow up, but have now been offered a further consultation and assessment. Whilst the junior doctor in question is now being investigated by the General Medical Council, and might have been negligent in his practice, one might also wonder what the supervision arrangements were at the Trust and why such practice was allowed to persist for such a long period of time. The Trust has officially stated that there is no evidence of any harm having been caused; however, it is difficult to know how that can be a confident statement until all the new assessments have been carried out. Furthermore, the simple fact of an avoidable recall will no doubt cause many of those women a degree of anxiety and concern that otherwise they would not have had.
Finally, NHS 111, the new non-emergency (i.e. non-999) care telephone number in England, has recently come under intense scrutiny. It was intended to replace NHS Direct in relation to urgent but non-life threatening calls but, rather than being run centrally, it is run by 46 different local services around the country. The scheme was piloted in 2010 and was due to be rolled out by the beginning of April 2013, but not all the local services have yet been able to go live. Of those that have, the scheme has been beset with problems, with emergency services claiming that they have had to deal with patients either incorrectly referred by NHS 111 or who could not get through at all. A recent individual survey of GPs polled about NHS 111 found that nearly two-thirds considered its service to be “poor” or “very poor” and that it was worse than NHS Direct. On 3 May, Pulse published that 22 possible “serious untoward incidents” had been recorded in connection with 111, 3 of them deaths. It is quite feasible that the failure to respond to calls rapidly enough could be negligent, as well as there being the possibility of negligent advice being given even when a caller does get through.
In all three of the above recent reports harm may have come to patients as a consequence of unacceptable system failures and, whether there were additional failings of an individual health professional or not, it remains possible for a victim or their family to make a claim for clinical negligence.