Is integrating health and social care likely to reduce the number of negligence claims?


The short answer is yes.

However, life is rarely that straightforward particularly where healthcare is concerned. With the headlines dominated by several A & E departments reaching crisis point, observers have been quick to cite a number of reasons why some sections of the health service appear to be in chaos: lack of government funding, lack of staff, anti-social hours, local authority cuts to social care, and so it goes on. But there is an inescapable fact: hospitals have become the default option for many elderly people with chronic conditions who do not have proper community support and their numbers are growing.

The revolving door

The number of medical negligence claims faced by the NHS has increased by 82% since 2009/10. Although the majority will be maternity or surgery-related, an increasing number of claims have arisen from the ‘revolving door’ syndrome whereby vulnerable, elderly patients are discharged, only to be readmitted as they have neither the resources nor the wherewithal to organise their own, non-clinical care. Simon Stephens, CEO of NHS England, has already set out his vision for a new, improved NHS with a patient-centric approach at its heart, requiring closer coordination between the health and social care systems with the objective of reducing hospital admissions. This in turn should reduce the number of negligence claims arising from inadequate care.

The price of not integrating health and social care

From my viewpoint as a clinical negligence lawyer, better coordinated, integrated care will reduce the number of patients falling between the health and social care systems and coming to harm, so I welcome the acknowledgement by NHS England that the current system is unsustainable. Anyone 

who has looked after an elderly relative will understand the frustrations of trying to coordinate input from GPs, physiotherapists, occupational therapists and social workers so that they can stay, properly supported, in their own homes rather than end up, as so often happens, as an emergency admission. As the age profile of the UK population steadily grows, the problem of elderly people presenting with multiple, chronic conditions will increase, as will the pressures on an already overstretched NHS. Mistakes tend to happen when people are under pressure, corners get cut and those least able to speak up for themselves are normally the first to suffer. The price of not integrating health and social care will be a rising medical negligence bill.

Implementing change

There are already a number of examples of integrated care around the country all of which have been developed in accordance with local conditions and needs; and the common feature shared by all is the importance of the primary care system being at the heart of the model. The fact that some areas have proved that integrated care for specific patients can be introduced almost on a case by case basis within a relatively small area means that its implementation should be manageable.

Medical negligence claims arise for a number of reasons. Sometimes gross incompetence is to blame; more often it is errors of judgment caused by inexperience or pressure of work which result in patients being harmed. It is easy to see (but not to excuse) why hospital staff struggling to juggle genuine medical emergencies with patients who really need support either in their own homes or a care home can find themselves at the wrong end of a medical negligence claim. NHS England’s stated objective to promote a joined up approach to health and social care must be applauded:  the sooner integration can be achieved, the better for all.

Jeanette Whyman from Wright Hassall is a medical negligence solicitor with over 25 years’ experience and has acted both for and against hospital trusts. She now represents patients who are victims of medical negligence.

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