Ref: FOI-1819.658
Dear Mr Dale,
Re: Request for information
Thank you for your request for information, which we received on 19-02-19.
This information is being provided as a statutory obligation under the Freedom of Information Act 20 00.
Your request (in bold) and Our Response:
1. What is the number of serious incident reviews relating to clinical negligence at your hospitals in 2016, 2017 and 2018?
The care provided at St George's University Hospitals NHS Foundation Trust (the ‘Trust’) is overseen by NHS Improvement, the body responsible for overseeing that foundation trusts and NHS trusts provide patients with consistently safe, high quality and compassionate care.
The Serious Incident Framework under which the Trust operates is set out by NHS Improvement and seeks to support the foundation trusts and NHS trusts in implementing a systematic process to identify factors that contributed to an incident causing harm to patients and/or staff. The process looks beyond any individuals concerned and is designed to assist with understanding the underlying causes and environmental context in which an incident occurs. This will ensure lessons are learnt and necessary changes implemented to prevent reoccurrence of such incidents. For more information on the Serious Incident Framework please refer to https://improvement.nhs.uk/documents/920/serious-incidnt-framwrk.pdf
The Trust does not collect and centrally hold data regarding when a Serious Incident subsequently leads to a civil claim in clinical negligence.
The Trust is happy to provide the number of Serious Incidents declared in each financial year since 2016/2017 – tabulated below.
Financial year Number of Serious Incidents declared
2016/17 93
2017/18 70
2018/19 (up to and including February 2019) 48
2. What is the monetary value of successful clinical negligence claims made against your hospitals in 2016, 2017 and 2018?
The Trust is a member of the Clinical Negligence Scheme for Trusts, clinical risk pooling indemnity scheme which is administered on behalf of the Secretary of State by the National Health Service Litigation Authority (NHS Resolution) pursuant to Section 21 of the National Health Service and Community Care Act 1990 and Section 71 of the National Health Service Act 2006 as amended by the Health and Social Care Act 2012. The costs of the scheme are met by membership contributions.
All clinical claims brought against the Trust are reported to NHS Resolution who manage the claim from that point forth and make any necessary payments on behalf of the Trust.
You have not specified whether the amounts requested are the contributions made by the Trust to NHS Resolution or amounts paid out by NHS Resolution as results of claims brought against the Trust. We have made the assumption that the request is for amounts paid out by NHS Resolution as results of claims brought against the Trust
You have not specified whether the total amount requested is the total amount of damages paid to claimants or the total including legal costs. We have made the assumption that total amounts including legal costs have been requested.
An injured person has three years from the date of the incident/act or omission leading causing their injury (or from the date of knowledge) to bring a claim against the Trust. Further depending on complexities of a case a claim may take a number of years to reach settlement. Similarly a claim may be closed with no damages paid out, only to be reopened a number of years later. Therefore the amounts paid out in any given year are not reflective of the claims brought against the Trust in that year.
Please note that payments made in each year will include interim payments and periodic payments from claims which may have reached their conclusion a number of years ago.
The Trust considers the requested information to be exempt under Section 21 of the Freedom of Information Act 2000 (‘FOIA’) as it can be accessed by other means. This information is published by NHS Resolution for each financial year and can be accessed from the NHS Resolution website.
Data for the financial year 2016/17 can be found at: https://resolution.nhs.uk/resources/factsheet- 5-trust-and-authority-claims-data-2016-17/
Data for the financial year 2017/18 can be found at: https://resolution.nhs.uk/resources/factsheet-5-trust-and-authority-claims-data-2017-18/
3. In the last three years (2016, 2017 & 2018), what is the number of settled negligence claims where damages have been paid (number of cases and total monetary value) in relation to:
- Allegations of late diagnosis / misdiagnosis
- Allegations of negligence leading to amputation
- Cases involving stillbirth or neonatal death - Cases involving delayed diagnosis of cancer
- Cases involving medication errors
- Legal cases alleging clinical negligence which have taken more than 5 years to reach
The Trust has considered this request and determined that this information is exempt under Section 12 of the Freedom of Information Act 2000 (‘FOIA’).
Section 12(1) of the FOIA allows the Trust to refuse an FOI request where the cost of compliance is estimated to exceed the appropriate limit. The appropriate limit for section 12 purposes is defined by The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulation 2004 SI 2004 No 3244 (‘Fees Regulation’).
Under regulation 3 of the Fees Regulation, the appropriate cost limit for the Trust is £450. The Fees Regulation also states that all authorities should calculate the time spent on the permitted activities at the flat rate of £25 per person, per hour. This means that the appropriate limit will be exceeded if it would require more than 18 hours’ work for the Trust to carry out the following activities in complying with the request:
• determining whether the information is held;
• locating the information, or a document containing it;
• retrieving the information, or a document containing it; and
• extracting the information from a document containing it.
The data you have requested is not held in a searchable centrally held format by the Trust. In order to retrieve and extract the data requested, the Trust will need to look at every case settled in the period specified and manually cross reference the data for accuracy with the case files held by NHS Resolution. The Trust estimates that in order to get the information you have requested it would take a member of staff on average 45 minutes to review each case and cross refer this with records held by NHS Resolution. Even if the average number of claims settled per year is taken to be 15 (estimated 45 for a three year period), it would take 2,025 minutes or in excess of 33 hours to retrieve and extract the requested information.
Re-use of information and copyright
This information has been provided for your own use. However, you do not have an automatic right to re-use it and if you wish to re-use the information for commercial purposes for any reason you must ask us for permission to do so. Re-use of information for some purposes, including commercial, may be subject to the provisions of the Re-use of Public Sector Information Regulations 2015. These regulations provide a framework for public sector organisations to decide issues relating to the re-use of their information. The provisions of current copyright law apply to information provided.
Further information can be found at: http://www.legislation.gov.uk/uksi/2015/1415/contents/made
If you are dissatisfied with the response provided you have the right to file a complaint and request an internal review of our decision. All complaints must be made in writing and sent to the Trust FOI Lead at [email protected].
If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the internal review procedure provided by the Trust. The Information Commissioner can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.
Please remember to quote the reference number above in any future communications.
Kind regards
FOI Lead
St George’s University Hospitals NHS Foundation Trust