Ten years of clinical negligence claims in otolaryngology: trends, costs, and preventable harm in the UK national health service.

purposeLitigation across surgical specialties is rising amidst increasing pressures on the United Kingdom's National Health Service (NHS). However, national litigation trends in otolaryngology, particularly following the COVID-19 pandemic, remain underexplored. This study aimed to analyse NHS litigation data in otolaryngology over the past decade, assessing the pandemic's impact on claim volumes and costs. Our secondary objective was to identify key areas of concern in patient care.

methodsNational-level anonymised negligence claims data for the financial years 2013/14 to 2023/24 were obtained from NHS Resolution via a Freedom of Information request. Data included claim status, claimant age group, primary cause and injury codes, and associated costs.

resultsA total of 1,450 claims were received and 1,594 cases closed. Claim volumes declined from 2020/21 onward; however, closed claims and total costs increased, with notable spikes in 2018/19 and 2022/23. Costs were driven by a sharp rise in damages and a steadier increase in claimant legal fees. Among closed cases, 58% resulted in damages payments. The most frequent cause of claims were delays in treatment or diagnosis, while inadequate intra-operative monitoring had the highest mean payout. The most frequent injury was unnecessary pain, and brain damage, though rare, was the costliest. Six Never Event categories were identified, with retained foreign body being the most common.

conclusionLitigation costs in otolaryngology have increased despite a decline in new claims since the pandemic. Findings highlight diagnostic delays, intra-operative monitoring, and communication as key areas for improvement to reduce patient harm and legal risk.