How is a UK clinical negligence claim actually run?
Short answer
From start to finish, a UK clinical negligence claim moves through eight broadly recognisable stages: an initial discussion with a specialist firm, a written funding agreement, securing the full medical records, instructing independent medical experts, sending a Letter of Claim under the Pre-Action Protocol, receiving the defendant's Letter of Response, negotiation or court proceedings and finally settlement or judgment. Timescales vary, but many adult claims conclude in roughly 18 months to three years.
1. The first conversation
Most clinical negligence specialists offer a no-cost, no-obligation initial discussion. They listen to what happened, ask about the impact on your day-to-day life, and give a preliminary view on whether the case looks worth investigating. Nothing is signed and no work begins at this stage.
2. Putting funding in writing
If the firm believes the matter has merit, they will set out — in writing — how the case can be paid for. For the great majority of UK clinical negligence claims this means a No Win No Fee Conditional Fee Agreement (CFA), often paired with After the Event insurance. You receive the figures and percentages before being asked to sign anything.
3. Securing the medical records
Your solicitor formally requests the full clinical records from every relevant provider — hospital, GP, dentist, ambulance service, private clinic. Reading those records carefully is one of the longest tasks in the early stages of a case; it is not unusual for them to run to several thousand pages, and they are reviewed by both the legal team and the medical experts.
4. Independent medical expert opinion
One or more experts in the relevant specialism are instructed — for example, an obstetrician, neuroradiologist, vascular surgeon, or oncologist. Their job is impartial: to give a frank, evidence-based opinion on breach of duty and on causation. A claim cannot reasonably proceed without supportive expert evidence on both points.
5. The Letter of Claim
Under the Pre-Action Protocol for the Resolution of Clinical Disputes, the next step is a detailed Letter of Claim sent to the defendant — NHS Resolution for NHS care, or the relevant medical defence organisation or insurer for private treatment. It sets out the allegations, the harm caused, and the remedy sought.
6. The Letter of Response
Under the Pre-Action Protocol, the defendant has four months from receipt of the Letter of Claim to investigate and reply. They may admit the allegations in full, admit them in part, or deny liability and explain why. Many cases are resolved at this point through negotiation, without the need to formally start court proceedings.
7. Negotiation, mediation, or issuing proceedings
Where liability is admitted, attention shifts to valuing the claim. Where it is denied, court proceedings may be issued — sometimes purely to protect the three-year limitation deadline while negotiations continue. Even after issue, mediation and structured settlement discussions resolve most cases without a trial.
8. Settlement or judgment
Compensation is paid most commonly as a single lump sum. For the most serious lifelong injuries, the court can also order Periodical Payments — index-linked annual payments that fund care for the rest of the claimant's life. Once funds are released, the solicitor's costs are recovered from the defendant in line with the funding agreement.
What does compensation actually pay for?
UK damages in clinical negligence are designed, so far as money can, to put you in the position you would have been in had the negligence never occurred. They are calculated under two heads:
- General damages compensate for pain, suffering and loss of amenity. They are valued by reference to the Judicial College Guidelines and relevant decided cases at appellate level.
- Special damages reimburse the financial consequences of the negligence — past and future loss of earnings, the cost of professional or family care, mobility equipment, prosthetics, home adaptations, ongoing treatment, and travel costs incurred because of the injury.
Where do solicitors fit in?
A specialist clinical negligence solicitor — ideally one accredited by the Law Society's Clinical Negligence Panel or by Action against Medical Accidents (AvMA) — manages every step above on your behalf. They instruct the experts, draft the legal documents, handle correspondence and negotiation, and represent you if the case proceeds to court. To see how their fees work in practice, read our guide to No Win No Fee funding, revisit our overview of the categories of UK clinical negligence, or read more about what UK patients are entitled to.
Frequently asked questions
How long does a UK clinical negligence claim usually take from start to settlement?
Timescales vary considerably with the complexity of the case and whether liability is contested. Many adult claims conclude in roughly 18 months to three years from instructing a solicitor, but cases involving lifelong injury — particularly cerebral palsy and other catastrophic birth injuries — usually run longer, because the medical prognosis must stabilise before the long-term value of the claim can be properly calculated.
What is the deadline for starting a claim?
The Limitation Act 1980 gives most adult claimants three years from either the date of the negligent act or their date of knowledge — that is, the moment they could reasonably have known the harm was caused by clinical care. For under-18s, the three-year clock only begins on their eighteenth birthday. Adults who lack mental capacity are not subject to a fixed limitation period while incapacity continues.
Will my case end up in front of a judge?
In most situations, no. Most UK clinical negligence cases are settled without a contested trial — through written negotiation under the Pre-Action Protocol, formal mediation, or without-prejudice discussions after court proceedings have been issued (sometimes purely to protect the limitation deadline).
What evidence will my solicitor need to gather?
Two pieces of evidence are non-negotiable: a complete copy of your medical records and an independent expert report from a clinician practising in the same specialism as the alleged negligent treatment. The expert addresses both whether the standard of care was breached and whether that breach actually caused the harm. Witness statements and detailed evidence of financial losses are added as the claim develops.
Sources & further reading
Primary statute, case law and regulator guidance referenced in this article.
- Limitation Act 1980 — legislation.gov.uk
- Pre-Action Protocol for the Resolution of Clinical Disputes — Justice.gov.uk (Civil Procedure Rules)
- Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 — BAILII
- Bolitho v City and Hackney HA [1998] AC 232 — BAILII
- Civil Procedure Rules — Part 36 (Offers to Settle) — Justice.gov.uk
- NHS Resolution — Annual Report and Accounts — NHS Resolution