Reviewed by Independent editorial panelLast reviewed April 2026 · Next review October 2026
Legal tests
- Bolam test
- The classic test for breach of duty in UK clinical negligence.
- Drawn from Bolam v Friern Hospital Management Committee [1957]: a clinician is not negligent if their conduct accords with a practice accepted as proper by a responsible body of medical opinion skilled in that particular art.
- Bolitho qualification
- The body of medical opinion must itself withstand logical scrutiny.
- From Bolitho v City and Hackney HA [1998]: the court is not bound by a body of opinion that is not capable of withstanding logical analysis. This prevents the Bolam test from being applied uncritically.
- Montgomery duty
- Modern UK standard for informed consent.
- From Montgomery v Lanarkshire Health Board [2015] UKSC 11: a clinician must take reasonable care to ensure the patient is aware of any material risks involved in a recommended treatment, and of any reasonable alternatives. The test of materiality is patient-centred.
- Causation
- The link between the substandard care and the injury.
- Even where breach of duty is proved, a claimant must show that the breach caused (or materially contributed to) the injury — typically on the 'but for' test. Causation is the most common reason clinical-negligence claims fail.
Procedure
- Limitation period
- Three years to issue court proceedings, from the date of knowledge.
- Under the Limitation Act 1980, most adult clinical-negligence claims must be issued at court within three years of either the negligent act or the date the claimant first reasonably knew their injury was significant and attributable to it. Different rules apply for children and protected parties.
- Pre-Action Protocol
- The CPR-mandated steps before issuing clinical-negligence proceedings.
- The Pre-Action Protocol for the Resolution of Clinical Disputes governs how letters of claim, letters of response, expert evidence and settlement discussions are exchanged before court proceedings are issued.
- Letter of Claim
- Formal notification of the allegations to the defendant.
- A structured letter, required by the Pre-Action Protocol, setting out the allegations of breach, causation, the injuries and the basis for the proposed claim. The defendant has four months to respond with a Letter of Response.
Damages
- General damages
- Compensation for the injury itself — pain, suffering, loss of amenity.
- Assessed by reference to the Judicial College Guidelines and comparable case law. General damages reflect the nature, severity and duration of the injury rather than financial loss.
- Special damages
- Compensation for quantifiable financial losses.
- Past and future financial losses caused by the negligence — for example loss of earnings, the cost of care, equipment, adapted accommodation, and treatment that the NHS will not provide.
Funding
- Conditional Fee Agreement (CFA)
- The technical name for a No Win No Fee agreement.
- An agreement between solicitor and client under which the solicitor's fees are payable only if the claim succeeds. A success fee may be added, capped by statute at 25% of certain heads of damages in personal-injury and clinical-negligence claims.
- QOCS
- Qualified One-way Costs Shifting — protection from the other side's costs.
- A CPR mechanism that prevents an unsuccessful claimant in personal-injury and clinical-negligence claims from being ordered to pay the defendant's costs, subject to defined exceptions (such as fundamental dishonesty).
- ATE insurance
- After-the-Event insurance against disbursements.
- A policy taken out after the cause of action arises, typically to cover the cost of medical-records fees, expert reports and (where QOCS does not apply) adverse costs.
Patient rights
- Duty of Candour
- Statutory duty on providers to be open about safety incidents.
- Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires CQC-registered providers to notify patients of notifiable safety incidents, give a truthful account, apologise, and offer support.
Bodies & regulators
- NHS Resolution
- The NHS body that handles clinical-negligence claims against trusts in England.
- An arm's-length body of the Department of Health and Social Care. It indemnifies NHS trusts under schemes such as CNST and handles defence and settlement of clinical-negligence claims arising from NHS treatment in England.
- AvMA
- Action against Medical Accidents — UK patient-safety charity.
- Independent UK charity supporting people affected by medical accidents and accrediting clinical-negligence specialist solicitors. AvMA's accreditation is one of the recognised UK trust marks for specialist representation.
- GMC
- General Medical Council — statutory regulator for UK doctors.
- Maintains the medical register, sets standards through Good Medical Practice, and investigates fitness-to-practise concerns. GMC outcomes are admissible as evidence in civil claims but do not themselves prove negligence.
Where to read next
For the practical context in which these terms apply, see our pages on patient rights, the claim process and No Win No Fee funding.