NHS Resolution has published its 2025/26 Annual Report and Accounts, marking the first year of its new Resolution Through Collaboration strategy. As expected, much of the media coverage has focused on the financial cost of medical negligence claims.
However, the report tells a far more nuanced story.
It highlights increasing demand on NHS Resolution's services, rising numbers of medical negligence claims, significant investment in learning from harm and continued efforts to resolve claims earlier and without litigation. Most importantly, it provides valuable insight into where avoidable harm continues to occur and where improvements in patient safety remain urgently needed.
A Record Number of New Medical negligence Claims
During 2025/26, NHS Resolution received 15,236 new medical negligence claims, an increase of 6% compared with 14,428 claims in 2024/25.
NHS Resolution suggests that increased NHS activity may partly explain the rise. While that may account for some of the increase, the figures also reflect the continuing reality that thousands of patients continue to experience avoidable harm each year.
Importantly, an increase in claims does not necessarily indicate more claims being advanced. Medical negligence claims are notoriously difficult, expensive and emotionally demanding to pursue. Most people seek legal advice only after suffering life-changing injury, bereavement or significant financial loss.
Earlier Resolution Continues to Improve
One of the most encouraging statistics in this year's report is that 84% of medical negligence claims were resolved without formal court proceedings, the highest figure NHS Resolution has recorded.
This demonstrates that early investigation, constructive engagement and alternative dispute resolution are becoming increasingly effective.
From a claimant perspective, this is a positive development.
Earlier resolution can mean:
- quicker admissions of liability where appropriate;
- earlier access to rehabilitation and treatment;
- reduced stress for injured patients and bereaved families;
- lower legal costs; and
- faster implementation of learning by healthcare providers.
Avoiding litigation should never mean avoiding accountability. Rather, where liability is accepted promptly, patients can often achieve better outcomes than through prolonged adversarial proceedings.
Claims Are Taking Longer to Conclude
Despite progress in resolving claims outside formal litigation, there is an important caveat.
NHS Resolution resolved 11,841 claims, an 11% reduction compared with the previous year. Claims formally closed fell by 30%, to 10,047.
The report attributes much of this to the implementation of its new CaseHub case management system, involving the migration of tens of thousands of claims and millions of documents. NHS Resolution expects this to be a temporary operational issue rather than a long-term trend.
For patients, however, delays still matter.
Every additional month spent waiting for liability decisions or settlement can delay access to rehabilitation, adapted accommodation, professional care, specialist equipment and financial security.
Compensation Payments Continue to Rise
Medical negligence payments reached approximately £3.24 billion during 2025/26.
Of that total:
- around £2.43 billion was paid directly to injured patients and families as damages;
- approximately £622 million represented claimant legal costs; and
- around £188 million related to NHS legal costs.
These figures frequently generate headlines about the "cost of litigation".
That interpretation overlooks an important point.
The largest proportion of expenditure is compensation paid directly to injured patients.
In many catastrophic injury cases, particularly severe birth injury claims, damages are not a windfall. They fund lifelong care packages, adapted accommodation, specialist therapies, equipment, case management and future loss of earnings. Without compensation, these costs would often fall directly upon families or wider public services.
Maternity Remains Central
Although maternity claims represent a relatively small proportion of the total number of claims, they continue to account for a disproportionately large share of NHS liabilities because of the severity and lifelong consequences of avoidable birth injuries.
The report places considerable emphasis on maternity safety.
Among the key developments are:
- 90% of NHS maternity providers achieved full compliance with the Maternity Incentive Scheme, the highest level since the scheme began.
- NHS Resolution continues to expand learning through its Early Notification Scheme, enabling earlier investigation of certain severe brain injuries occurring at birth.
- Further evaluation of the Early Notification Scheme is expected during 2026/27.
These initiatives are welcome.
However, the continued financial significance of maternity claims demonstrates that substantial work remains to reduce avoidable harm in obstetric and neonatal care.
Learning Rather Than Simply Defending Claims
One of the most encouraging aspects of the report is NHS Resolution's continued focus on using claims data to improve patient safety.
During 2025/26 it:
- delivered 1,029 learning and engagement sessions;
- reached an estimated 25,000 healthcare professionals;
- delivered 57 educational workshops involving 880 delegates;
- published major thematic reviews examining delayed diagnosis of cancer in primary care and obstetric anal sphincter injuries.
This reflects an important shift.
Medical negligence claims should not simply be viewed as legal disputes. Properly analysed, they provide one of the richest sources of information about recurring patient safety risks.
Patterns repeatedly emerge across different specialties:
- failures to recognise deterioration;
- delayed diagnosis;
- communication failures;
- inadequate escalation;
- poor documentation;
- failures to follow national guidance; and
- missed opportunities for earlier intervention.
Each claim presents an opportunity to reduce the likelihood of similar harm occurring again.
The Cost of Prevention Is Lower Than the Cost of Harm
Much public debate focuses on reducing the cost of medical negligence claims.
A better question is how to reduce the number of patients who require compensation in the first place.
Investment in safer staffing, education, digital systems, early diagnosis, multidisciplinary communication and learning from previous incidents is likely to produce far greater long-term financial savings than attempts to restrict compensation or litigation.
Every preventable birth injury avoided, every delayed cancer diagnosis prevented and every medication error intercepted benefits patients first. The resulting reduction in litigation costs is a consequence of safer healthcare, not the objective.
Final Thoughts
The 2025/26 NHS Resolution Annual Report should not be read simply as an account of rising litigation costs.
Instead, it demonstrates a healthcare system managing increasing demand while continuing to learn from patient harm, improve early dispute resolution and strengthen maternity safety. At the same time, the rise in new claims serves as a reminder that avoidable harm remains a significant challenge across the NHS.
For claimant lawyers, clinicians and healthcare leaders alike, the message is the same: the ultimate measure of success is not fewer claims because patients are deterred from bringing them. It is fewer claims because fewer patients suffer avoidable harm.
Until that point is reached, medical negligence litigation will continue to play an essential role in providing answers, accountability, financial support and, perhaps most importantly, lessons that improve care for future patients.
Hannah Carr, Legal Director and Specialist Medical Negligence Solicitor from MDS, said “"Every medical negligence claim begins with a patient whose life has been changed by avoidable harm. If we focus on learning from those experiences and improving patient safety, we can reduce not only the cost of claims, but more importantly the number of patients who need to bring them."
