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Trends and causes of litigation in paediatric surgery within the National Health Service (NHS) England: a 19-year analysis

Year: 2026

Type: article

Abstract: INTRODUCTION: The aim of this study was to assess litigation patterns within paediatric surgery in the National Health Service (NHS) England by analysing long-term trends, financial costs and causes of successful claims over the past 19 years. METHODS: Litigation data were obtained from NHS Resolution via a Freedom of Information (FOI) Act 2000 request covering financial years 2006/2007 to 2024/2025. For paediatric surgery cases (patients <18 years), extracted variables included total claims, successful claims, damages paid and associated legal costs. Successful claims were categorised by primary cause and primary injury incurred. RESULTS: Over the study period, 591 litigation claims were submitted in paediatric surgery, of which 332 (56.2%) were successful. Damages paid amounted to £48.05 million. Annual claims rose 5.1-fold, from 10 in 2006/2007 to 51 in 2024/2025. Damages increased 1.98-fold, from £1.47 million in 2006/2007 to £2.91 million in 2024/2025. The most frequent causes of successful claims were failure or delay in diagnosis (15.1%, 50/332), failure or delay in treatment (13.9%, 46/332), and intraoperative problems (10.8%, 36/332). Operative-related factors accounted for 27.4% (91/332), whereas non-operative causes comprised 57.2% (190/332). The most reported primary injuries were: additional or unnecessary procedures (15.7%, 52/332), unnecessary pain (15.1%, 50/332) and fatality (14.2%, 47/332). CONCLUSION: Paediatric surgery litigation in NHS England has increased over 19 years, driven predominantly by diagnostic and treatment delays rather than operative error. Improvement of time-critical diagnostic pathways, enhanced follow-up systems and targeted claims resolution strategies represent the most impactful approaches to reducing litigation burden in this specialty.

Source: Annals of The Royal College of Surgeons of England

DOI: 10.1308/rcsann.2026.0061

Authors: P Nikolinakos, MM Antonaraki, I Donkov, N Zavras, KH Pang

Institutions: National and Kapodistrian University of Athens, Chelsea and Westminster Hospital NHS Foundation Trust, University General Hospital Attikon, University College London

Language: English

Topic: Medical Malpractice and Liability Issues

Subfield: Pharmacy

Field: Health Professions

Domain: Health Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: hybrid

OpenAlex ID: W7167054731

FWCI:

Cites: 11

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