Staggering Cost of Spinal Surgery Negligence – 1/3 of NHS Litigation Budget

In a recent report commissioned by Watchdog NHS Improvement it has been revealed that for every £3 spent on spinal surgery in the NHS, the health service pays out £1 on litigation. While the annual budget for spinal surgery is £300 million, litigation after spinal surgery averages more than £100 million.

One of the main reasons why this may be happening is because, it was concluded by the report that specialist units are failing to learn lessons from previous claims to avoid errors because very little information was available. It has been determined that the average litigation cost per admission is £1,654.

Mike Hutton, the lead author and a consultant spine surgeon at the Royal Devon and Exeter Hospital, said that was the highest cost of any speciality examined so far. Last year the NHS carried out 52,523 procedures on the spine. While litigation fees and pay-outs come from a different pot, he said: “It is equivalent to a third of our budget. It is a staggering figure; it is not a sustainable situation.” In some regions it is now standard practice to discuss claims in meetings and Mr Hutton is now calling for the same system to be adopted everywhere as well as Trusts being shown how their litigation costs compare against national averages.

Almost a quarter of these claims relate to a rare condition called Cauda Equina Syndrome (CES), which occurs when the bundle of nerves below the end of the spinal cord is damaged. Without swift treatment, it can cause lasting damage, including incontinence and paralysis of the legs. Patients with suspected CES should be given an emergency MRI scan immediately, according to national guidance, with MRI available round the clock at local hospitals. However, the report stated that patients were not receiving prompt scans, often because of a lack of radiographers to operate scanners outside of normal working hours.

More than half of claims in spinal surgery between 2012 and 2017 were on matters of judgment or timing. A quarter involved the interpretation of results or scans, a fifth unsatisfactory surgical outcomes, and 8 per cent a failure to get informed consent from patients. A man was left paralysed after medics at the Royal Derby Hospital failed to diagnose and treat a spinal abscess has received £2m in compensation. Kevin Greenfield has been left unable to walk and has to use a wheelchair after doctors performed emergency surgery to drain the abscess – more than 24-hours after he was admitted to hospital. After developing back pain the 61-year-old was admitted to hospital just before 4pm on March 2, 2012.

At 6.30pm, Mr Greenfield was examined by a doctor who noted he was suffering from numbness from the waist down. An observation the following morning noted he was completely numb from the waist down. He was seen again by a doctor at 3.30pm and sent for an MRI scan at 6.45pm. Mr Greenfield then underwent emergency surgery at 8pm on March 3.

Following the surgery there was then a delay in administering antibiotics which allowed the infection to escalate, resulting in additional surgery to remove infected tissue. After the incident, Mr Greenfield instructed expert medical negligence lawyers to fight his case. Now Derby Teaching Hospitals NHS Foundation Trust, which runs the Royal Derby, has agreed to a £2 million settlement. The NHS have been urged to learn lessons from this sad case so others don’t have to suffer the pain but if you have been affected by medical negligence please contact us.