Waverley Gate 2-4 Waterloo Place Edinburgh EH1 3EG

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Lothian NHS Board Waverley Gate 2-4 Waterloo Place Edinburgh EH1 3EG Telephone: 0131 536 9000 www.nhslothian.scot.nhs.uk Date: 22/01/2018 Our Ref: 2232 Enquiries to : Bryony Pillath Extension: 35676 Direct Line: 0131 465 5676 bryony.pillath@nhslothian.scot.nhs.uk Dear FREEDOM OF INFORMATION CLINICAL NEGLIGENCE I write in response to your request for information in relation to clinical negligence claims made to NHS Lothian. 1. How much did your Trust spend on its Legal Department per annum in the following years: 2012; 2013; 2014; 2015; Please note that there are no NHS Trusts in NHS Scotland. NHS Health Boards due to the different population and range of services may not be directly comparable with NHS Trusts. NHS Lothian does not have a department called the legal department. NHS Lothian refers to solicitors in NHS National Services Scotland (NSS) Central Legal Office (CLO) for legal advice. NHS Lothian has a Litigation Team which deals with litigation cases, and a legal team within the Health Records Department, which deals with subject access requests and requests from solicitors for patient notes. The table below details the costs of each of these teams: Legal teams cost, NHS Lothian Litigation Team Health Records Legal Team 2012/13 0 83,000 2013/14 52,000 85,000 2014/15 62,000 92,000 2015/16 63,000 92,000 2016/17 72,000 52,000

2. How many whole time equivalent members of staff did you have in your Legal Department (please organise by pay grade) in the following years: 2012; 2013; 2014; 2015; The table below details the number of whole time equivalent staff employed in the Litigation Team and the Health Records Legal Team in the years requested: Litigation Team and Health Records Legal Team WTE employees, NHS Lothian Date Litigation Team Health Records Legal Team December 2012 4.0 0.0 December 2013 3.8 1.0 December 2014 3.8 1.8 December 2015 4.0 1.8 December 2016 4.0 1.8 December 2017 5.0 1.4 3. What was the total number of allegations or attempted clinical negligence claims against your Trust per annum for the following years by incident year: 2012; 2013; 2014; 2015; Medical negligence claims, NHS Lothian Medical negligence claims 2012 60 2013 66 2014 110 2015 80 2016 72 2017 (to 8 December 2017) 70 4. What was the total number of cases and enquiries handled by your Trust s legal department per annum in the following years by incident year: 2012; 2013; 2014; 2015; Page 2 of 7

The table below details all claims made to NHS Lothian, including clinical and non-clinical claims. Total claims, NHS Lothian Total claims 2012 130 2013 144 2014 200 2015 155 2016 146 2017 (to 8 December 2017) 149 5. What was the total number of successful clinical negligence claims against your Trust in the following years by incident year: 2012; 2013; 2014; 2015; Clinical negligence claims where an award was paid, NHS Lothian Clinical negligence claims where an award was paid 2012 23 2013 24 2014 25 2015 36 2016 47 2017 (to 8 December 2017) 27 6. What was the median and mean time (in days) from complaint to closure of each case / enquiry handled by your Trust s legal department in 2015 and 2016? Please only supply data for cases which did not result in a successful claim. Of the claims closed in the years 2015 and 2016 which were unsuccessful the median number of calendar days from claim received to closure was 392 days, and the mean was 420 days. 7. What was the median and mean time (in days) from complaint to closure of each successful claim against your Trust s legal department in 2015 and 2016? Page 3 of 7

Of the claims closed in the years 2015 and 2016 which were successful the median number of calendar days from claim received to closure was 778 days, and the mean was 839 days. 8. What was the total sum paid out in successful and settled clinical negligence claims in the following years by incident year: 2012; 2013; 2014; 2015; Payments made for successful negligence claims, NHS Lothian Total paid 2012 2,638,257 2013 7,966,802 2014 10,953,394 2015 3,305,225 2016 1,874,575 2017 (to 20 December 2017) 2,028,088 9. What was the total sum paid out for legal costs (not damages) for completed clinical negligence claims in the following years by incident year: 2012; 2013; 2014; 2015; 2016; 2017? The table below details the legal costs for completed clinical negligence claims. This includes claimants costs and defence costs. A record of charges was not kept until part way through the year 2012, so the figure for 2012 is incomplete. Legal costs for all completed clinical negligence claims, NHS Lothian Total legal costs 2012 492,365 2013 215,246 2014 528,444 2015 1,013,761 2016 844,027 2017 (to 20 December 2017) 416,337 Page 4 of 7

10. What was the total sum paid out in completed clinical negligence claims in the Neurosurgery Department in the following years by incident year: 2012; 2013; 2014; 2015; 11. What was the total sum paid out in completed clinical negligence claims in the Spinal Surgery Department (if separate from Neurosurgery) in the following years by incident year: 2012; 2013; 2014; 2015; 12. What was the total sum paid out in completed clinical negligence claims in the Cardiology Department in the following years by incident year: 2012; 2013; 2014; 2015; 13. What was the total sum paid out in completed clinical negligence claims in the Oncology Department in the following years by incident year: 2012; 2013; 2014; 2015; 14. What was the total sum paid out in completed clinical negligence claims in the Trauma and Orthopaedic Department in the following years by incident year: 2012; 2013; 2014; 2015; As the number of claims made in neurosurgery, spinal surgery, cardiology and orthopaedics was less than five in each department in each year, I am not able to release the sums paid out as this may this information may identify the individuals involved. Since we do not have their consent to release their personal data, the information is exempt under section 38 of the Freedom of Information (Scotland) Act 2002 as to provide it would breach the 7 th principle of the Data Protection Act 1998. There were no completed clinical negligence claims in oncology in the years specified. 15. What proportion of completed clinical negligence claims in the Spinal Surgery and Neurosurgery departments were attributed to the following in 2014, 2015, 2016 and 2017: a) Delay in diagnosis; b) Delay in treatment; c) Poor communication or documentation; d) Poor clinical decision making? As the number of claims made in neurosurgery and spinal surgery was less than five in each year, I am not able to release this breakdown as this may this information may identify the individuals involved. Since we do not have their consent to release their personal data, the information is exempt under section 38 of the Freedom of Information (Scotland) Act 2002 as to provide it would breach the 7 th principle of the Data Protection Act 1998. Page 5 of 7

The table below details the total number of claims of clinical negligence in spinal surgery and neurosurgery for the whole period 2014-17 by reason for claim. Spinal surgery and neurosurgery clinical negligence claims by reason, NHS Lothian, 2014-2017 Claim reason Number of claims Delay in diagnosis 5 Delay in treatment 5 Poor communication or documentation 0 Poor clinical decision making 0 16. Does your Trust use a digital or online referral system in any of its acute medical or surgical specialties and when was it implemented? 17. Who is the Vendor of this referral system? The online referral system for all specialties was implemented in 2005. The Vendor is NHS Scotland. I hope the information provided helps with your request. If you are unhappy with our response to your request, you do have the right to request us to review it. Your request should be made within 40 working days of receipt of this letter, and we will reply within 20 working days of receipt. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal complaint to the Scottish Information Commissioner within 6 months of receipt of our review response. You can do this by using the Scottish Information Commissioner s Office online appeals service at www.itspublicknowledge.info/appeal. If you remain dissatisfied with the Commissioner s response you then have the option to appeal to the Court of Session on a point of law. If you require a review of our decision to be carried out, please write to the reviewer at the address at the top of this letter. The review will be undertaken by a Reviewer who was not involved in the original decision-making process. FOI responses (subject to redaction of personal information) may appear on NHS Lothian s Freedom of Information website at: http://www.nhslothian.scot.nhs.uk/yourrights/foi/pages/default.aspx Page 6 of 7

Yours sincerely PROFESSOR ALEX MCMAHON Nurse Director Cc: Chief Executive Page 7 of 7