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Written by Brad Askew
Legal Tech Founder
Civil & Commercial Law background · Founder of LegalDocuments.co.uk
We’re not a law firm — we help you find the right legal support. For advice on your situation, speak to a legal adviser or find a solicitor.
Updated April 2026 · England & Wales
BA
Written by Brad Askew Legal Tech Founder
Civil & Commercial Law background · Founder of LegalDocuments.co.uk
Updated May 2026
·
England & Wales
If you have been harmed by treatment, or the lack of it, while under the care of the NHS, you may have grounds to bring a clinical negligence claim. The process is not always straightforward, and the legal tests involved are stricter than many people expect, but it is there to give patients a route to compensation when something has genuinely gone wrong.
This guide sets out how claims against the NHS typically work in England and Wales: what counts as negligence, the evidence you will need, the role of the NHS complaints process, and the time limits that apply. It is written for patients and family members who want a plain-English picture of what is involved before deciding whether to take the matter further.
Overview
A clinical negligence claim (sometimes called medical negligence) is a civil claim for compensation brought against a healthcare provider whose care has fallen below an acceptable standard and caused harm as a result. When the treatment was provided by the NHS in England, the claim is handled on behalf of the relevant trust by NHS Resolution, the body that manages clinical negligence litigation for the health service.
In Wales, Scotland and Northern Ireland, separate bodies handle equivalent claims. Two legal tests must be satisfied. The first is breach of duty: the clinician or trust failed to provide care at the standard a reasonably competent professional in that field would have provided.
The second is causation: that failure actually caused the injury, loss or worsened outcome you are complaining about. Both elements need to be proved, usually with the help of independent medical expert evidence. A poor outcome on its own, even a tragic one, is not enough. If the same harm would likely have happened with competent care, a claim will usually fail.
Key steps
01
Raise concerns through the NHS complaints procedure. Before jumping to litigation, it is often worth using the formal NHS complaints process or PALS (the Patient Advice and Liaison Service). This can produce an explanation, an apology, or changes to practice, and the trust's written response often becomes useful background material if you later pursue a claim.
02
Collect your records and a timeline. Request copies of your medical records from the GP surgery, hospital or trust involved. You have a right of access under data protection law. Write a clear chronology of what happened, including dates of appointments, treatments, symptoms and anything you were told. Keep receipts for any costs you have incurred.
03
Get an early view from a specialist. Clinical negligence is a technical area and not every solicitor handles it. Speak to a firm or adviser with experience in NHS claims. Many offer an initial assessment and work on a conditional fee (no win, no fee) basis if the case looks viable. They will want to see whether both breach and causation are realistically arguable.
04
Obtain independent expert evidence. Your legal team will instruct medical experts in the relevant specialty to report on whether the care fell below standard and whether that failing caused your injury. These reports are central to the case. Without supportive expert opinion on both limbs of the test, a claim is unlikely to progress.
05
Letter of claim, response and negotiation. Your solicitor sends a formal letter of claim to NHS Resolution setting out the allegations and the injuries claimed. The NHS then has a set period to investigate and respond, either admitting liability, denying it, or making an offer. Many claims settle at this stage. If they do not, court proceedings may be issued, though the majority still resolve before trial.
Common questions
QHow long do I have to bring an NHS negligence claim?
The general time limit in England and Wales is three years, running from the date of the negligent treatment or from the date you first knew (or reasonably should have known) that your injury was linked to that treatment. Different rules apply for children, where the three years does not start until their 18th birthday, and for people who lack mental capacity, where the clock may not run at all. Fatal cases have their own rules.
QDo I have to complain to the NHS before I can sue?
No, the complaints process and a legal claim are separate routes. You can go straight to a solicitor if you prefer. That said, using the complaints procedure first is often sensible: it can give you written answers from the trust, sometimes prompts an apology, and may clarify whether there is a genuine legal issue worth pursuing without the cost and stress of litigation.
QWhat might compensation cover?
Damages in a successful claim are designed to put you, so far as money can, in the position you would have been in without the negligence. They can include an amount for the pain, suffering and loss of amenity you have experienced, plus financial losses such as lost earnings, care costs, travel, equipment, home adaptations and ongoing treatment. The figures depend heavily on the severity and long-term impact of the injury.
QWho actually pays if a claim succeeds?
Claims against NHS trusts in England are handled and paid through NHS Resolution under the Clinical Negligence Scheme for Trusts. Individual doctors or nurses are not pursued personally for damages in the normal course of events. GPs have separate indemnity arrangements. The practical effect is that you are dealing with an organisation set up to manage these claims, not chasing a named clinician for money.
QCan I bring a claim if my relative died because of NHS treatment?
Yes. The estate of the person who died can bring a claim for the pain and suffering they experienced before death, and certain dependants may also claim for their own losses such as loss of financial support and a statutory bereavement award. An inquest may run alongside these issues. Time limits still apply, and early advice is particularly important in fatal cases.
QHow long does an NHS claim usually take?
It varies widely. Straightforward cases where liability is admitted early can resolve within a year or so. Complex cases involving disputed causation, serious long-term injury or catastrophic birth injury can take several years, partly because the full impact of the injury needs to be understood before damages can be valued properly. Interim payments can sometimes be arranged along the way.
QWill I have to go to court?
Probably not. The large majority of clinical negligence claims settle through negotiation or alternative dispute resolution without a trial. Court proceedings are often issued as a procedural step to protect the time limit or push the case forward, but a contested hearing in front of a judge is the exception rather than the rule. Your solicitor will talk you through any decision point as it arises.
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Brad Askew Legal Tech Founder
Brad has a background in civil and commercial law and founded LegalDocuments.co.uk to make clear, reliable legal information accessible to everyone. This site is not a law firm and does not provide regulated legal advice.
Legal disclaimer
This article is for general information only and does not constitute legal advice. We are not solicitors. For advice on your specific situation, please consult a qualified solicitor.
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