Clinical Report: Litigation Trends and Costs in Paediatric Urology NHS England

Overview

Analysis of NHS Resolution data from 2006 to 2025 reveals an increasing trend in paediatric urology litigation claims within NHS England, with 216 claims notified and 62% successful. The cumulative financial burden for successful claims reached over £10 million, driven primarily by failures or delays in diagnosis and treatment.

Background

Litigation in clinical care imposes significant financial and operational burdens on healthcare systems such as the NHS. Paediatric Urology, involving complex and high-risk interventions, is among specialties vulnerable to litigation. NHS Resolution manages clinical negligence claims and aims to promote learning to improve patient safety. Understanding litigation drivers and costs in paediatric urology is critical for clinicians and policymakers to enhance care quality and resource allocation.

Data Highlights

Key Findings

• Paediatric urology claims increased from 5 in 2006/07 to 18 in 2024/25, with the largest annual rise between 2016/17 and 2017/18.
• Successful claims rose proportionally from fewer than 5 to 10 annually over the study period.
• Failure or delay in diagnosis accounted for 29.1% of successful claims, the leading cause of litigation.
• Failure or delay in treatment was the second most common cause at 24.6%.
• Other notable causes included inappropriate treatment (4.4%), delay in performing operations (4.4%), and failure to organise follow-up (3.7%).
• The average total cost per successful claim was approximately £76,000, including damages and legal fees.

Clinical Implications

Clinicians should prioritise timely and accurate diagnosis and treatment in paediatric urology to reduce litigation risk. Enhanced follow-up arrangements and careful procedural planning may also mitigate claims. Awareness of rising litigation costs underscores the need for systemic improvements in patient safety and risk management within paediatric urology services.

Conclusion

Litigation in paediatric urology within NHS England has increased over the past two decades, with failures in diagnosis and treatment as primary drivers. Addressing these areas may improve patient outcomes and reduce the financial burden on the NHS.

References

1. NHS Resolution 2023/2024 -- Clinical Negligence Indemnity Expenditure
2. NHS Resolution -- Strategic Approach and Organisational Learning
3. Freedom of Information Act 2000 -- Data Request for Litigation Claims