NHS Trust receives warm reception from Court of Appeal

The Court of Appeal held an NHS Trust should not be held liable for a receptionist’s alleged negligence.

Background

The claimant attended Accident & Emergency (A&E) on 17 May 2010 with a head injury, following an assault. The A&E receptionist noted the claimant’s details and completed an A&E card. The receptionist asked the claimant to wait in the waiting area and stated it could be up to four or five hours before he could be seen by a medical professional.

At the time, NICE Guidelines stated that patients presenting a head injury at A&E should be assessed within 15 minutes of arrival. However, at joint expert discussions, experts agreed it was reasonable for patients with a head injury to be assessed within 30 minutes.

The claimant left A&E after 19 minutes. A triage nurse came to look for the claimant shortly after.

Later that evening, the claimant’s condition deteriorated and his family called an ambulance. A CT scan at the Trust showed the claimant had an extradural haematoma. He was transferred for removal of the haematoma. Unfortunately, it was too late to prevent permanent injury. The claimant sustained left hemiplegia and long-term disabilities.

Decision

Lord Justices Jackson and Sales were in the majority which held that it was not fair, just and reasonable to impose a duty on a receptionist to provide accurate information about waiting times. The provision of waiting times was considered to be a courtesy. The receptionist’s role being predominantly clerical.

This case centred around the question of whether there was a duty on the receptionist to give full and correct advice. By majority the NHS Trust succeeded. However, it will be interesting to see if this case is pursed to the Supreme Court by way of appeal.

Implications

Significant cost of imposing such a duty of care was avoided. Had such a duty been imposed then undoubtedly further litigation would have followed. Further, there would have been the risk that healthcare providers might have sought to limit future risk by seeking that reception staff say very little to patients, except asking their details. Such a state of affairs would of course be unhelpful.

However, the lack of imposing such a duty is time specific. If this case is pursued to the Supreme Court and the claimant is successful, then the extension of the duty of care to non-clinical A&E receptionists will have far-reaching effects on NHS Trusts. Scope for litigation will increase via any failings in the operational role of such staff.

The fact that this was a majority judgment is evidence in itself of the unpredictable nature of trial, with Lord Justice McCombe dissenting. He found the hospital as a whole, had to be considered, with functions of the hospital not divided between receptionists and medical staff.

The hospital did have a duty and information provided was deemed by him to be incomplete and inaccurate. Had the claimant been aware he would not have suffered injury.

The Supreme Court may well echo such views, and NHS Trusts will need to be alive to this risk in the future.