NHS Resolution has reported a record number of new clinical negligence claims and reported incidents, with more than £3.2 billion paid out during 2025/26.
The latest NHS Resolution Annual Report and Accounts, covering the period 1st April 2025 to 31st March 2026, provides valuable insight into the scale and cost of clinical negligence claims within the NHS in England.
For patients and families affected by medical treatment, the figures offer an important snapshot of where standards of care are improving and where concerns remain.
What is the NHS Resolution Annual Report and what does it say?
Every year, NHS Resolution (NHSR) publishes its Annual Report and Accounts, providing one of the clearest insights into patient safety, clinical negligence claims and the challenges facing healthcare providers across England.
The 2025/26 report, published in July 2026, paints a complex picture. There are signs of progress in some areas, particularly around the early resolution of claims and maternity safety initiatives.
At the same time, the data highlights the continuing pressures facing the NHS and the impact those pressures can have on patients.
The NHS is facing more negligence claims than ever before
More than 15,000 new clinical negligence claims and incidents submitted
NHS Resolution received 15,236 new clinical negligence claims and reported incidents during 2025/26, with an estimated total value of £7.46bn.
By number of claims, that represents an increase of around 6% compared with the 14,428 recorded in 2024/25 and the highest number recorded by NHS Resolution to date in its 30-year history.
NHS Resolution says this included the largest volume of claims ever received under the Clinical Negligence Scheme for Trusts (CNST). There were 12,001 CNST claims received, up 5% from 11,396 the previous year (605 more).
There was also a 20% increase in the claims received against GPs, up to 3,091 from 2,575 the previous year (516 more).
While a rise in claims does not automatically mean standards of care are deteriorating or NHS care is becoming less safe, it does raise important questions about the pressures facing the health service.
The NHS continues to manage growing demand, workforce shortages, financial constraints and significant waiting lists. When services are stretched, patients may be more vulnerable to delays in diagnosis, communication failures and treatment errors.
NHS Resolution cautions that claim numbers do not necessarily relate to incidents occurring during the same year. There can be a significant delay between an incident occurring and a claim being notified.
A rise in claims can also be influenced by things like increased awareness of patient rights, improved reporting systems and changes in healthcare activity levels.
However, for patients and their families, the figure shows that thousands of people each year continue to experience outcomes serious enough to pursue concerns about the care they received.
Emergency medicine generates the largest number of claims
Looking at the number of claims rather than their financial value, emergency medicine was the largest individual specialty, with 1,623 claims reported in 2025/26, accounting for 13% of all claims received.
This speciality can include circumstances like missed diagnosis, delayed treatment, or delays in investigation. It is also an area of the NHS that faces some of the biggest pressure, from overcrowding on hospital wards to more people attending emergency departments due to lack of appointments in primary care, and communication and handover issues.
The report identifies emergency medicine as a specialty where claim numbers have been increasing year-on-year. Just five years ago, there were almost 500 fewer claims received with 1,151 in 2020/21.
The next largest categories were obstetrics (1,418) and trauma and orthopaedic surgery (1,128). Obstetrics has leapfrogged into second place, accounting for around 11% of all new claims received. While trauma and orthopaedic surgery claims accounted for around 9% of all new claims received.
However, again, claim numbers should not automatically be interpreted as proof that negligence occurred. A claim may ultimately be rejected or resolved without a damages payment.
A mixed picture for maternity care
While maternity claims make up around 11% of claims received in volume, the financial value is a much higher proportion. Obstetric claims account for 55% of the estimated £7.4bn for total claims received, around £4.1bn. Maternity also accounted for around £1.3 billion, or 40%, of clinical negligence settlements made during the year.
This is due in part to severe birth injuries most often requiring lifelong care and support for the child, particularly where a baby suffers brain injury around the time of birth. The resulting compensation can include the cost of care, accommodation, specialist equipment, therapies and support over many decades.
NHS Resolution itself acknowledges that avoidable maternity and neonatal harm continue to occur and remains a major focus of its work.
Its Early Notification scheme also continues to investigate certain serious brain injuries occurring around birth at an early stage. The aim is to identify whether negligence has caused harm, provide earlier support and compensation where appropriate, and ensure that lessons can be learned while events are still relatively recent.
Against that backdrop, one of the report's more encouraging findings is that 90% of maternity and neonatal trusts met all requirements of the Maternity Incentive Scheme, the highest compliance level since the programme was introduced. The previous year’s figure was 84%.
The scheme requires trusts to meet 10 safety actions designed to promote best practice in maternity and neonatal care.
While meeting standards is important, the ultimate measure is whether fewer families suffer avoidable harm. The challenge for the NHS is therefore not simply achieving compliance with safety standards, but ensuring those standards translate into measurable reductions in avoidable harm for mothers and babies.
Rising concerns about clinical performance
Away from negligence claims, NHSR recorded 1,576 requests for advice regarding concerns about healthcare practitioners, an 11% increase compared with 2024/25
Although these cases do not necessarily involve negligence or patient harm, they may indicate increasing concerns being raised by NHS organisations about professional performance, conduct or capability.
Viewed alongside the increase in negligence claims, the increase may suggest that healthcare organisations continue to face significant operational and workforce challenges.
Maintaining high standards of care depends not only on individual clinicians but also on the systems within which they work.
The financial impact remains substantial
£3.2 billion paid in clinical negligence claims
The financial cost associated with clinical negligence remains significant. Reports based on the NHSR data indicate that compensation payments and associated legal costs continue to run into billions of pounds annually.
NHS Resolution made £3.2385 billion in payments across its clinical schemes during 2025/26. This is around £150 million more than the previous year, which was £3.08bn.
Of this £3.285bn:
- £2.428 billion was paid in damages to claimants
- £622.2 million was paid in claimant legal costs
- £188.4 million was spent on NHS legal costs
- £80.3m was spent on NHS Resolution administration costs
These figures often attract headlines because of the impact on NHS finances. However, it is important to remember that compensation payments exist to support people whose lives may have been permanently changed by avoidable medical errors.
Many of the most expensive claims involve catastrophic injuries, particularly severe birth injuries, where affected individuals may require lifelong care, specialist equipment, rehabilitation and ongoing support. Compensation also accounts for any loss of earnings, pension or other financial consequences of an injury.
Not every clinical negligence claim results in compensation
Of the clinical claims resolved during 2025/26, 56% were closed with damages, compared with 52% in the previous year.
For claims resolved under the main clinical schemes, 6,673 resulted in a payment of damages.
For clinical negligence to be established, there generally needs to be evidence that the standard of care fell below what could reasonably have been expected and that this caused injury or loss.
The NHS has £60.26 billion set aside for future claims
Perhaps the biggest financial figure in the accounts is the £60.26 billion provision for claims at 31 March 2026. This was broadly unchanged from the previous year's £60.33 billion.
A provision is not money sitting in a bank account waiting to be paid out. Rather, it is an accounting estimate of the future cost of liabilities arising from incidents that have already happened, including claims that have not yet been formally received.
A significant part of this negligence bill – around £35bn – has been set aside for maternity related claims.
This indicates the long-term financial legacy of clinical negligence.
NHS Resolution also reports that the estimated cost of harm for CNST incidents in 2025/26 was £4.5 billion, a 2% reduction (or £89m) compared with the previous year's incidents. However, the report notes that before changes to Treasury discount rates were applied, the cost of harm would actually have increased by around 5%.
Resolution through collaboration
More claims, but fewer court battles
One of the report's most notable findings is that 84% of clinical negligence claims were resolved without formal court proceedings, the highest rate NHS Resolution has achieved.
This suggests that healthcare providers and claimants are increasingly able to reach agreements earlier in the process. NHS Resolution’s current three-year strategy ‘Resolution Through Collaboration’ seeks to settle claims through investigation, negotiation and alternative dispute resolution before litigation becomes necessary.
Last year, only 38 claims (1.5%) went to trial, and only 16 of these were for clinical cases. Whereas 143 claims went to mediation, with 71% of those cases settling on the day or within 28 days.
This is one of the most positive developments for injured patients and bereaved families. Early resolution can mean receiving explanations, admissions of liability and compensation more quickly, avoiding lengthy and costly litigation while still allowing compensation to be obtained where the evidence supports it. Court proceedings can be stressful and emotionally draining, particularly for those already dealing with the consequences of serious injury or bereavement.
It is worth stressing, however, that avoiding litigation does not mean that claims are not investigated rigorously. NHS Resolution says that it continues to investigate claims and make damages payments where the merits of a case justify doing so.
However, it also highlights the importance of independent legal advice to ensure settlements fairly reflect the impact of the injury suffered.
Decrease in resolved cases due to new system
While the majority of claims were settled without the need for court proceedings, there was a decrease in the number of cases resolved in 2025-26.
There were 11,841 claims resolved, a fall of 11% from 13,329 the previous year. There were also 10,047 claims for compensation closed, a 30% fall from 14,431 the previous year.
NHS Resolution says this is mainly due to the transition from their legacy Claims Management System to the new CaseHub system, which brought about significant organisational change and operational challenges.
The difference between resolved and closed claims is that a claim is resolved when NHSR has reached settlement about the payment or non-payment of damages. At this point, there may be claimant and NHS legal costs still to be agreed, so there will continue to be uncertainty over the total amount to be incurred on these claims.
When all elements of a claim have been agreed and paid, the claim is closed.
The time to resolution has also increased this year, again linked to CaseHub. However, NHSR also point out that multiple factors have the potential to increase the time it takes to reach a resolution, including issues in the justice system and availability of clinicians to provide expert advice.
The patients behind the statistics should not be overlooked
Clinical negligence claims are often discussed in terms of cost, but the real focus should always be on patient outcomes.
The figures in this report represent real patients and families. People who went into hospital expecting to be treated safely. Parents whose experience of childbirth changed the course of their family's lives. Patients whose diagnosis came too late. People living with injuries that could potentially have been avoided.
The question we should therefore be asking is not just “How much is clinical negligence costing the NHS?” but “What is the NHS learning from the harm that these claims reveal?”
As solicitors representing patients and families, we believe there is a responsibility to look beyond the value of individual claims.
Every properly investigated claim has the potential to tell the NHS something about patient safety: where communication failed, where warning signs were missed, where systems did not work as intended, or where a patient did not receive the standard of care they were entitled to expect.
We need to ask whether recurring themes in clinical negligence cases are being identified quickly enough, whether lessons are reaching frontline services, and whether the experiences of patients and families are being given sufficient weight in improving care.
Ultimately, the most meaningful measure of success for our clients is not that their case has settled. Often their main focus is whether lessons are learned so that the next patient doesn’t suffer the same harm.
What should you do if you believe you have suffered medical negligence?
If you believe that something went wrong with your medical treatment, it is important to obtain specialist legal advice from a medical negligence law firm.
A medical negligence solicitor can help establish whether the treatment you received fell below an acceptable standard, whether that caused an injury, and whether you may be entitled to compensation.
Get in touch with our team today for a free, no obligation chat about your specific circumstances.