What Are the First Steps to Claiming Against the NHS for Negligence?

Every year, thousands of people in England and Wales bring clinical negligence claims against NHS bodies, and the process is well established. What most people do not know when they start is where the process actually begins — and the answer is not a court. It begins with your own notes and your medical records. This guide walks through the first steps in order, with the time limits that matter.

Can you sue the NHS?

Yes. NHS hospitals, community services and GP practices owe their patients a duty of care, and if the care you received fell below an acceptable standard and caused you harm, you can claim compensation. Two points are worth understanding early.

First, the claim is brought against the organisation — the NHS trust, or the GP practice — rather than the doctor or nurse personally. The law treats the employer as responsible for the acts of its staff, and in practice NHS claims are handled and paid through NHS Resolution, the body that manages claims on behalf of NHS organisations.

Second, a claim is not a disciplinary complaint. It does not remove anyone from the register or get anyone struck off. Its purpose is compensation for the harm you suffered. If you also want the incident investigated, that happens through a separate complaints process, covered below.

Step 1: Write down what happened, while it is fresh

Before anything else, sit down and record your account:

• Dates of appointments, admissions, procedures and follow-ups.
• Names of clinicians where you know them, or descriptions where you do not.
• What you were told, what you asked, and what you expected to happen.
• What went wrong, when you realised it, and what has happened since.

Keep any letters, discharge summaries, test results and emails. This timeline becomes the backbone of your case later, and memories fade faster than people expect — particularly after something traumatic.

Step 2: Request your medical records

You are entitled to copies of your medical records under UK data protection law, free of charge, by making a subject access request to the NHS trust or GP practice that holds them. Write to the medical records or information governance team — every trust has one — and include your full name, date of birth, address and the period of treatment you are asking about. They have one calendar month to respond.

These records are the foundation of everything that follows. Any specialist who assesses your case will want them, and asking for them now saves weeks later. Requesting your records does not commit you to a claim and does not alert anyone that you are considering one.

Step 3: Consider the NHS complaints procedure

The NHS has its own complaints process, and it is separate from claiming. A complaint can get you an explanation, an apology and a review of what happened — which many people want regardless of any claim. Complaints should generally be made within 12 months of the incident, or of you finding out about it.

Two practical notes. A complaint does not stop the clock on your claim, so do not wait for the complaints outcome before getting legal advice if time is tight. And the responses you receive can be useful evidence later, so keep them.

Step 4: Get a specialist assessment of your case

Clinical negligence is a specialist field, and not every personal injury firm does it. A proper assessment means a lawyer with clinical negligence experience reviewing your records and, where the case looks arguable, obtaining an opinion from an independent medical expert in the relevant specialty.

What a good assessment will tell you: whether the care appears to have fallen below an acceptable standard, whether that failure caused your harm, what your claim might be worth if it succeeds, and how it should be funded. Most viable claims can be run on a no win, no fee basis. Legal aid survives for a small number of clinical negligence cases — principally severe birth injuries and some neurological injuries — and a specialist firm will tell you if you qualify.

Step 5: The letter of claim and the formal process

If your solicitor believes the claim should proceed, they send a letter of claim to the NHS trust setting out what happened, the allegations, and the losses involved. Under the pre-action protocol for clinical negligence claims, the defendant is expected to respond within four months, and NHS Resolution usually handles that response.

From there, the case either settles through negotiation or, where liability is denied, proceeds to court. Most clinical negligence claims settle without a trial. Typical timescales are 12 to 24 months for a claim of ordinary complexity, longer where the injuries are severe and the evidence takes time to gather.

What are the time limits?

For most adults, court proceedings must be issued within three years of the negligent treatment, or within three years of the date you first knew (or reasonably could have known) that you had suffered a significant injury that might be attributable to it. There are important exceptions:

• Children. The three-year period does not start until their 18th birthday, so they have until they turn 21. A parent or guardian can bring a claim on their behalf at any point before then.
• Lack of capacity. Where the injured person lacks the mental capacity to bring a claim, there is no time limit for as long as that incapacity continues.
• Fatal cases. Where someone has died, the usual limit is three years from the date of death or from the date of knowledge of the person bringing the claim.

Courts can extend these limits in limited circumstances, but relying on that is unwise. If you think you may have a claim, get advice early.

FAQs

Will claiming against the NHS affect my ongoing treatment?

No. Your right to NHS treatment is not affected by a claim, and clinicians are bound by professional duties that do not change because of litigation. It is a common worry, but it does not happen.

Who actually pays the compensation?

NHS Resolution pays on behalf of NHS organisations, from funds set aside for that purpose. The individual clinician does not pay out of their own pocket.

Do I need money to start a claim?

Usually not. Most clinical negligence claims are funded on a no win, no fee basis, with insurance arranged to cover the other side’s costs if the claim fails. Legal aid is available for a small number of serious cases.

Will my claim go to court?

Most claims settle before trial. Court proceedings are sometimes issued to protect your position or to move things along, but the large majority of cases resolve through negotiation.

What can I claim compensation for?

Compensation covers the injury itself, plus the financial consequences of it — loss of earnings, care you have needed, treatment costs, adaptations and any ongoing support. Serious injuries attract substantially larger awards because the lifetime losses are greater.

Start your claim or read more about medical negligence claims generally.

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MayIClaim is a trading name of R Costings Limited, regulated by the Financial Conduct Authority (FRN 836625). This article is general guidance and does not constitute legal advice for any individual case.