Total NHS medical negligence liabilities have reached £60 billion, driven by a surge in childbirth injury cases that cost on average more than £11 million each to settle.
The total amount of money the health service in England may have to pay out to settle claims over staff errors has quadrupled from £14.4 billion in 2006-07 as claims rise and legal costs rise.
The cost of settling clinical negligence claims has risen over the same period from £1.1bn to £3.6bn, with much of the jump related to infant brain damage at birth.
The figures are contained in a report by the National Audit Office (NAO), which called on NHS chiefs to do more to prevent damage.
The £60 billion commitment that the NAO has identified is an increase £58.2 billion, which the House of Commons Public Accounts Committee (PAC) estimated in May..
Geoffrey Clifton-Brown MP, chairman of the PAC, called the £60 billion bill “astonishing”.
“This is the government's second largest commitment [after public sector pensions] and forecasts predict that these costs could continue to rise substantially,” he said.
In 2024-25, GP services accounted for the largest number of NHS settled cases – 2,914. However, while obstetrics-related cases where the baby was left with cerebral palsy or other brain damage were fewer – 1,016 – they were very expensive to settle.
Their settlement cost £1.6 billion, more than four times the cost of the next most expensive type of injury – “other” (£337 million) – and pediatric injuries (£325 million).
“Despite progress in curbing the number of clinical negligence claims in some specialties, the rising cost of a small number of very high value claims is resulting in increased costs for taxpayers,” said Gareth Davies, head of the NAO.
Maternity claims cost an average of £11.2 million each to settle, according to the NAO. It was also reported that:
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The negligence bill is expected to reach £4.1 billion in 2029-30.
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the number of settled cases more than doubled, from 5,625 in 2006–07 to 13,329 in 2024–25.
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the total number of settlements decreased in 11 specialties, but increased in six others
“There has been an unacceptable increase in the cost of clinical negligence claims – billions that should have been spent on frontline services,” the Department of Health said. Health and a Social Security spokesman said.
“From overhauling our broken safety net to recognizing the serious challenges in maternity care, this government is tackling the issue and taking the decisive action that patients and taxpayers deserve.
“Our 10-year health plan makes clear that patient safety is at the heart of a healthy NHS and we are working to reduce the number of incidents that lead to claims.”
Meanwhile, the total cost of hospital renovations in England has risen to almost £16 billion, according to the National Health Service.
The report prompted NHS bosses to warn that patients were being put at risk by “dilapidated” buildings which in some cases were “literally falling apart”.
The bill for repairs and proper maintenance of NHS hospitals has jumped from £13.8 billion last year to £15.9 billion – a rise of 16% – according to the NHS's annual property recovery data set.
Daniel Elkeles, chief executive of hospital body NHS Providers, said: “Critical parts of the NHS are literally falling apart after years of underinvestment at a national level. The safety of patients and staff is at risk.”
“We cannot continue to spend money maintaining old buildings that are unfit for use.”
Shiva Anandachiva, policy director at think tank King's Fund, said the £15.9bn figure was “more than this year's entire capital budget and £2.2bn higher than last year”.
“Dilapidated NHS buildings have a real and detrimental impact on patient care, with regular examples of flooded corridors, reduced operating theater capacity and roofs at risk of collapse,” he added.
