Clinical Negligence: Mainly Claimant: A London (Firms) Overview
2026 is expected to see the conclusion of two government-commissioned investigations and an increase in the effect of ongoing changes in healthcare, all of which will impact clinical negligence litigation.
Clinical Negligence Litigation Funding
In 2026 we can expect to see the clinical negligence market, in London in particular, shrink as increasing numbers of firms decline to act in claims under GBP100,000 given the challenges to profitability and need to make significant deductions from damages that Fixed Recoverable Costs (FRC) continue to bring. Although FRC have applied to cases valued at between GBP25,000 and GBP100,000 since 2023, given the long lead-in time of many clinical negligence claims we have not yet seen their full effect, and we still await the introduction of FRC to claims under GBP25,000. Given this, in 2026 we are likely to see increased competition and focus on high-value, in particular maximum-severity, claims to avoid FRC.
Funding is also expected to be impacted by the conclusions of David Lock KC, who was commissioned by the Secretary of State for Health and Social Care to provide expert advice to the government on claimant clinical negligence costs, alongside patients’ experiences of claims. Commentary on this topic has focused on claimants’ solicitors’ costs, but those of us in the claimant clinical negligence field do hope that all factors influencing those costs are being considered, including the role defendants play in increasing costs and the ever-rising court fees, experts’ fees and insurance premiums. Otherwise, there is a danger that there will be more reform to funding which may well further restrict access to justice for patients.
No-fault compensation schemes for clinical negligence remain under discussion, but as Wes Streeting rightly noted in Parliament, such schemes are not a panacea. Serious questions remain about how realistic, affordable, cost-effective and just such schemes would be in the UK. The triage, risk assessment and early advice that claimant clinical negligence solicitors provide, which reduces the number of claims, should not be underestimated.
In October 2025 the National Audit Office (NAO) suggested that firms’ deductions from damages should be investigated. Whilst the protection of clinical negligence clients must be paramount, the NAO’s comments suggest a troubling intent to interfere with private cost arrangements – an approach that appears less about saving NHS funds and more about limiting injured patients’ and bereaved families’ ability to seek redress and hold healthcare providers to account.
NHS Maternity Services
The second report commissioned by the Secretary of State for Health is the one chaired by Baroness Amos into NHS maternity and neonatal services. NHS Resolution’s annual report for 2024/25 revealed that 42% of payments out for clinical negligence claims in 2024/25 were for maternity-related claims and, looking at future liabilities, 62% of the total clinical negligence provision is connected to maternity claims.
In December 2025, Baroness Amos published her initial impressions. Her observations were stark, though unsurprising to those working in this field.
Clinical negligence solicitors handling birth injury cases will be watching closely for the outcome of this review. The scale of the issues within maternity services – and the fact that 740 previous recommendations have not been implemented – helps explain the rising number of maternity claims. We can expect this trend to continue as the Baroness Amos’ review raises public awareness (she has just issued a call for evidence) and validates families’ concerns.
The review is likely to provide valuable evidence for claimant solicitors, particularly in relation to the twelve trusts under investigation, and may increase pressure on those trusts and NHS Resolution to consider early settlement of cases. Conversely, there is a risk that some trusts, especially those without prior damning inquiries, may resist claims more vigorously. The review will undoubtedly highlight systemic failures – such as shortages of staff, equipment, and adequate facilities – which raise important questions about the extent to which these factors should be considered in claims.
The Supreme Court’s 2024 decision in Paul and another v Royal Wolverhampton NHS Trust [2024] UKSC1, means that the claims arising from maternity care currently remain limited to mothers and babies; fathers are currently excluded from bringing claims. It is very much hoped that the growing number of cases and the voices of affected families will prompt discussion and reconsideration of the fairness of that decision, particularly in the context of maternity-related claims.
Patient and Family Advocacy
Over the course of the last few years, we have seen the increasing impact of patient and family advocacy. Many of the past maternity inquiries came about with pressure from families such as James Titcombe in relation to Morecambe Bay maternity services and Derek Richford into East Kent’s maternity services, and this pressure is continuing as can be seen by the October 2025 announcement of an investigation into Leeds maternity care.
However, it is not only in maternity services that patients’ and families’ campaigning is having an effect, as can be seen from other changes in healthcare, such as Martha’s Rule and Jess’s Rule, and it is likely that that same self-advocacy will extend to the claims arena.
With Martha’s Rule giving patients and their families the right to request an urgent second opinion if they are concerned about the care their loved one is receiving, claims arising from the failure to provide those second opinions or calling into question the independence of that second opinion from a colleague in the same Trust can be anticipated. Considering that, by September 2025, almost 5,000 calls had been made to the Martha’s Rule helpline, of which 71.9% were calls from families seeking help, the numbers could be significant.
Jess’s Rule, a new NHS primary care safety initiative in England that mandates that GPs must reflect, review and rethink a diagnosis if a patient presents three times with the same or escalating symptoms, was launched in September 2025, and again the failure to follow this rule could give rise to further potential breaches of duty which clinical negligence lawyers should have in mind when assessing potential claims.
Alongside these new rules, we are starting to see the introduction of new tools for patients and families to assist them with obtaining the safe medical care they need. Charities, such as Five X More and Sepsis UK Trust, have created apps for patients and their families to use when requiring medical help to better inform them of what safe care should look like and what signs and symptoms to look out for to recognise when all is not well. Such educational tools will mean that those injured will be better informed of what a reasonable standard of care is and may feel more willing to ask questions and seek legal advice if they have doubts. The tools may also be useful in providing clinical negligence solicitors with additional evidence for claims.
Artificial Intelligence
As artificial intelligence (AI) develops rapidly, in the clinical negligence field it promises to offer the ability to summarise large quantities of information, such as medical records, and we could see it being used to provide and analyse expert opinions. This has the potential to revolutionise initial triage and risk assessment processes and save costs, but only if the well-known issues with accuracy, “fake cases” and data protection and confidentiality can be overcome.
AI is not only changing how clinical negligence lawyers work; its impact is also being felt across healthcare, which has been keen to adopt these developments.
With the ability to analyse imaging to identify patterns, diagnose illness, review medical notes, provide clinical support and treatment plans, AI has the potential to revolutionise medicine.
However, AI’s incorporation into healthcare services raises important and novel questions about who is responsible when things go wrong. It is well established that clinicians owe a duty of care to their patients, but where does responsibility lie when decisions are made or procedures performed by AI? Practitioners will, of course, remain liable for the use and interpretation of AI in their practice; however where the AI tool itself gets it wrong, there is the potential for adding the manufacturer of the AI tool as a defendant to a claim. Product liability claims may be outside of the scope of many clinical negligence lawyers’ practice, requiring retraining or close work with product liability colleagues on what once would have been pure clinical negligence claims. In these circumstances, we are likely to see an increase in the number of defendants to a claim and likely complicated and prolonged proceedings involving arguments about issues such as apportionment and cost recovery, requiring multiple experts.