Sector · Clinical negligence

Clinical negligence costs.

Specialist costs support for clinical negligence claims, where expert evidence, long investigations and high-value outcomes make budgeting and recovery especially demanding.

Qualified Costs Lawyers, regulated by the Costs Lawyers Standards Board (CLSB), supported by experienced Costs Draftsmen.

Stethoscope resting on a medical report in front of thick clinical negligence litigation bundles — Clinical negligence costs are shaped by the expert evidence long before proceedings are issued.

Overview

Clinical negligence costs, explained.

Written by Robert Collington

Clinical negligence claims are among the most costs-intensive areas of civil litigation. Investigations can last years before liability is clear, several medical disciplines may be needed and the defendant, often represented through NHS Resolution, will scrutinise costs carefully. We prepare and review budgets, draft Bills that explain the investigative work and prepare or respond to detailed challenges on assessment.

Complex matters

High-value and multi-expert claims

Birth injury, delayed diagnosis and surgical error claims can involve obstetric, neonatal, neurological and care experts, as well as lifetime quantum. Pre-action work may be extensive and proportionality arguments are common. We understand how to present that investigative phase, separate recoverable work from non-recoverable client care and explain why particular experts and conferences were reasonably required for the claim as it developed.

Why clinical negligence costs are distinctive

Unlike many injury claims, clinical negligence cases often turn on breach of duty and causation that cannot be assessed without detailed expert review. Records must be obtained, sorted and analysed, and early screening reports may lead to further disciplines or to a claim being discontinued.

That front-loaded work is legitimate but highly visible on assessment. A paying party will look closely at pre-action costs, the number of experts instructed and whether investigations were proportionate to the value and issues in the claim.

Costs budgeting in clinical negligence

Multi-track clinical negligence claims will usually be costs managed under CPR Part 3. Realistic assumptions are essential: the number of expert disciplines, joint statements, the likelihood of a split trial and the time needed for quantum all affect the phases.

We help claimant and defendant teams prepare and test Precedent H budgets, prepare budget discussion reports and identify significant developments, such as a new expert discipline or a change to the trial structure, that may justify a revision.

Bills of Costs and Points of Dispute

A clinical negligence Bill should explain the chronology clearly: investigation, letter of claim, response, issue, expert evidence and settlement or trial. The narrative helps the court understand why work was done and by whom.

When acting for paying parties, we focus Points of Dispute on the issues that matter, including duplication between fee earners, excessive time on records, expert fees, counsel’s fees and the proportionality of the overall sum claimed.

Assessment and negotiated outcomes

Most clinical negligence costs claims settle through negotiation, often after Points of Dispute and Replies have narrowed the issues. Well-judged offers, including Part 36 and Calderbank offers on costs, can shift the risk of the assessment proceedings themselves.

Where agreement cannot be reached, we prepare the papers for detailed assessment and can attend the hearing. We keep the commercial picture in view throughout, including the costs of the assessment and interest.

Experts, counsel and disbursements

Expert and counsel’s fees often form a large part of a clinical negligence Bill. Paying parties may question the number of disciplines, cancellation fees, conference attendance and the hourly rates charged by leading experts.

We check that disbursements are supported by invoices and instructions, explain why each expert was reasonably required and, for paying parties, identify fees that were duplicated, premature or unrelated to the issues that were ultimately pursued.

How we help in clinical negligence matters

Costs Budgets Bills of Costs Detailed Assessment Points of Dispute Replies to Points Assessment Advocacy

Frequently asked questions

Clinical negligence costs questions

Are clinical negligence claims subject to fixed costs?

Many lower-value clinical negligence claims are treated differently from other injury claims under the fixed costs rules. The current CPR should be checked for the specific claim, value and track.

Do clinical negligence claims need a costs budget?

Multi-track claims are usually costs managed, subject to the rules and any court order. A realistic budget is important given the number of experts often involved.

Can you challenge an NHS Resolution offer on costs?

We can review the Bill and the offer, advise on the strengths and weaknesses of each item and help negotiate or proceed to detailed assessment.

Do you act for defendants in clinical negligence?

Yes. We act for receiving and paying parties, including preparing Points of Dispute and attending assessment hearings.

This page provides general information, not advice on a specific case. Rules and figures change, so check the current position for your matter. Contact our team to discuss it.

Rules and further reading

Civil Procedure Rules: Part 3 Civil Procedure Rules: Part 44 Civil Procedure Rules: Part 47

Other sectors: Personal injury, Housing disrepair, Commercial litigation, Industrial disease, Court of Protection, Professional negligence, Employment tribunal.

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