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The NHS’s total liabilities for medical negligence have hit £60bn, driven by a jump in childbirth injury cases that cost more than £11m each on average to settle.
The total sum of money the health service in England may have to pay out to settle lawsuits for mistakes by staff has quadrupled from £14.4bn in 2006-07, amid more claims and rising legal costs.
The cost of settling clinical negligence legal actions has soared over the same period from £1.1bn to £3.6bn, with much of that jump related to babies suffering brain damage while being born.
The figures are contained in a report by the National Audit Office (NAO), which urged NHS chiefs to do more to prevent the harm.
The £60bn liability that the NAO has identified is an increase on the £58.2bn at which the Commons public accounts committee (PAC) put the figure in May.
Geoffrey Clifton-Brown MP, the PAC chair, said the £60bn bill was “astounding”.
“This is the second largest liability across government [after public sector pensions] and forecasts predict that these costs could continue to grow substantially,” he said.
During 2024-25 GP services accounted for the largest number of cases the NHS settled – 2,914. However, while cases involving obstetrics where a child was left with cerebral palsy or other brain damage were fewer in number – 1,016 – they were very costly to settle.
They cost £1.6bn to settle, more than four times the next most expensive type of injuries – “other” (£337m) – and paediatrics (£325m).
“Despite progress in containing the number of clinical negligence claims in some specialities, the increasing cost of the small number of very high value claims is driving higher costs for taxpayers”, said Gareth Davies, the head of the NAO.
Maternity claims cost £11.2m each on average to settle, the NAO revealed. It also disclosed that:
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the bill for negligence is expected to reach £4.1bn in 2029-30
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the number of cases settled has more than doubled from 5,625 in 2006-07 to 13,329 in 2024-25
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the total number of settlements has fallen in 11 specialties but risen in six others
“There has been an unacceptable rise in the cost of clinical negligence claims – billions that should have been spent on frontline services, ” a Department of Health and Social Care spokesperson said.
“From overhauling our broken safety landscape to grasping the serious problems in maternity care, this government is grabbing hold of this problem and taking the decisive action patients and taxpayers deserve.
“Our 10-year health plan makes clear that patient safety is the bedrock of a healthy NHS and we are working to ensure we reduce the incidents that lead to claims.”
Meanwhile, the total cost of repairing hospitals in England has soared to almost £16bn, NHS figures showed.
The disclosure prompted NHS leaders to warn that patients are being put at risk from “decrepit” buildings that in some cases are “falling to bits, literally”.
The bill for repairing and properly maintaining the NHS’s stock of hospitals has jumped from £13.8bn last year to £15.9bn – a 16% rise – according to the NHS’s annual estates return information collection dataset.
Daniel Elkeles, chief executive of hospitals body NHS Providers, said: “Critical parts of the NHS are falling to bits, literally, after years of underinvestment nationally. The safety of patients and staff is at risk.
“We can’t keep wasting money propping up ageing buildings not fit for purpose.”
Siva Anandaciva, director of policy at the King’s Fund thinktank, said the £15.9bn figure is “more than the entire capital budget for this year and £2.2bn higher than last year”.
“Decrepit NHS buildings have a real and detrimental impact on patient care, with regular examples of flooded corridors, reduced theatre capacity and roofs at risk of falling in,” he added.
