Department of General Surgery, Huddersfield Royal Infirmary, Huddersfield, UK.
Colorectal Dis. 2014 Jan;16(1):48-56. doi: 10.1111/codi.12408.
Under the current increased financial constraints affecting the National Health Service (NHS), clinical negligence claims and associated compensations are constantly rising. Our aim was to identify the magnitude, trends and causes of malpractice claims in relation to a common pathology such as colorectal malignancy in the NHS.
Data requests were submitted to the NHS Litigation Authority (NHSLA) and to the Medical Defence Union (MDU) and Medical Protection Society (MPS). Data were reviewed, categorized clinically and analysed in terms of causes and costs behind claims.
Data from the MPS and MDU were unavailable. In all, 169 claims were identified from the NHSLA database between 2003 and 2012; 123 (73%) cases had been closed, 80 (65%) of which were successful. An increasing overall claim frequency and success rate were found over the last few years. Total litigation expenses were £8.6 million, with 39% paid out as legal expenses. The commonest cause of complaint in successful claims was in relation to diagnostic delays or failures (58%, £5.1 million), with a delay or failure by the clinician to take action in response to an abnormal investigation result being a major factor. The occurrence of peri-operative complications (20%, £1.6 million) was the second commonest cause.
Average frequency and success rates of malpractice claims in secondary care in the NHS are rising, leading to significant overall payouts. The failure or delay in diagnosing colorectal malignancy or its postoperative complications is a common cause behind malpractice claims. Improvement in these areas could enhance patient care and reduce future claims.
在当前国家卫生服务体系（NHS）面临的财政压力不断增大的情况下，临床医疗事故索赔和相关赔偿不断上升。我们的目的是确定 NHS 中常见疾病（如结直肠恶性肿瘤）相关医疗事故索赔的数量、趋势和原因。
向 NHS 诉讼管理局（NHSLA）和医疗辩护联盟（MDU）和医疗保护协会（MPS）提交数据请求。对数据进行审查，根据病因和索赔背后的费用进行临床分类和分析。
MPS 和 MDU 的数据无法获得。在 NHSLA 数据库中，2003 年至 2012 年共发现 169 例索赔；123 例（73%）已结案，其中 80 例（65%）成功。过去几年，总体索赔频率和成功率呈上升趋势。诉讼总费用为 860 万英镑，其中 39%用于支付法律费用。成功索赔中最常见的投诉原因是诊断延误或失败（58%，5.1 百万英镑），临床医生未能采取行动应对异常检查结果是一个主要因素。围手术期并发症（20%，160 万英镑）是第二常见的原因。
NHS 二级保健中医疗事故索赔的平均频率和成功率正在上升，导致总体支出巨大。未能或延迟诊断结直肠恶性肿瘤或其术后并发症是医疗事故索赔的常见原因。在这些方面的改进可以提高患者护理质量并减少未来的索赔。
