EWJ 60 April 2025 web - Journal - Page 16
Understanding Negligence in
Healthcare: Insights into the NHS
Resolution Early Notification Scheme
by Julia Parvia
Midwifery expert at Somek & Associates Ltd
Negligence in healthcare remains one of the most
pressing issues within medical practice. It’s a concept
that not only affects individual patients but also the
healthcare professionals and institutions involved.
Medical negligence occurs when healthcare professionals fail to provide a standard level of care, resulting in harm to patients. With the complexity of
modern healthcare, it’s essential for both legal and
medical professionals to understand the depth of negligence, its implications, and how schemes like the
NHS Resolution Early Notification Scheme (ENS) are
attempting to address it.
recovery times, additional medical expenses, or, in the
worst cases, death. Furthermore, medical negligence
can also damage the trust patients place in the healthcare system and undermine the overall confidence in
medical practitioners.
The Legal Framework: Bolam and Bolitho
The legal landscape surrounding medical negligence
is shaped by several key cases that establish how negligence should be assessed in court. Two particularly
important cases in this area are Bolam v. Friern Hospital Management Committee (1957) and Bolitho v. City and
Hackney Health Authority (1997).
This article delves deeply into the concept of medical
negligence, its legal underpinnings, and the vital role
that the NHS Resolution Early Notification Scheme
plays in mitigating the impact of clinical errors.
• Bolam v. Friern Hospital Management Committee (1957):
This case established the Bolam Test, which states that
a healthcare professional will not be held liable for
negligence if they have acted in a manner that is consistent with a practice that is accepted by a responsible
body of medical opinion. The Bolam Test effectively
shields healthcare providers from negligence claims,
as long as their actions align with recognised medical
practices.
What is Medical Negligence?
Medical negligence refers to the failure of a healthcare provider to exercise the standard of care
expected in a specific situation, which directly results
in harm or injury to the patient. It is important to
recognise that medical negligence does not merely
mean poor outcomes; it specifically involves a breach
in the expected standard of care.
However, the case also made it clear that if a
practitioner fails to follow standard procedures, or if
their actions are clearly unreasonable in the circumstances, they can still be found negligent. While this
ruling offered substantial protection for medical professionals, it also created a legal presumption that
medical opinions based on long-standing practices
were reasonable.
Negligence can manifest in various forms. Some
common examples include:
• Misdiagnosis: When a doctor incorrectly diagnoses
a condition, which could lead to delays in treatment or
incorrect treatments.
• Surgical Errors: Mistakes made during surgery,
such as operating on the wrong site, leaving surgical
instruments inside the patient, or causing unnecessary
harm during the procedure.
• Bolitho v. City and Hackney Health Authority (1997): The
Bolitho Case refined the Bolam Test by requiring that
medical opinions are not just widely accepted but
must also be logically sound and defensible in court.
The courts ruled that even if a medical practice is accepted by a body of professionals, it must also withstand judicial scrutiny. The decision in Bolitho helped
ensure that the Bolam Test didn’t become a mere formality; medical decisions must have sound and logical
reasoning behind them to be considered justifiable.
• Medication Errors: Incorrect medication dosages,
administering the wrong medication, or failing to
recognise allergic reactions.
• Failure to Monitor: Neglecting to monitor vital
signs, especially in critically ill patients, which can lead
to severe complications.
Together, these two cases provide a framework that
ensures medical decisions are reviewed from both a
medical consensus perspective and a logical, judicial
perspective, striking a balance between medical discretion and the protection of patient safety.
• Failure to Inform: Not providing adequate
information about a medical procedure or its risks,
leaving the patient unable to make an informed
choice.
The consequences of these errors are profound.
Patients may suffer unnecessary pain, prolonged
EXPERT WITNESS JOURNAL
14
APRIL 2025
