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Accurate Waiting Time Information - Does the NHS Owe a Duty of Care to Patients?

on Monday, 14 January 2019.

We review the case of Darnley v Croydon Health Service NHS Trust [2018] UKSC 50 where by a unanimous decision...

...the Supreme Court found that the NHS Trust, via its receptionist, owed a duty of care to provide accurate information concerning waiting times.

The Facts

The Claimant in Darnley v Croydon Health Service NHS Trust [2018] UKSC 50 sustained a head injury and attended an A&E department with a friend. 

Upon arrival, the claimant reported to reception where he informed the receptionist that he was feeling very unwell and enquired as to how long he would need to wait before being seen. The receptionist reportedly informed the claimant and his friend that they would need to wait for up to 4 or 5 hours. The claimant left A&E around 20 minutes later.

In fact, it was likely that the claimant would have been seen by a triage nurse within around 30 minutes had he stayed but the claimant was not informed of this. The trial judge found that, had the claimant been told this, he would not have left A&E.

The claimant's condition deteriorated after he returned home and, by the time he finally received medical attention about 4 or 5 hours later, he had suffered permanent brain damage.

The Decision

Both the trial judge and the Court of Appeal found for the NHS on the basis that:

  • it was not fair, just and reasonable that the defendant should owe a duty of care in relation to the provision of accurate waiting times;
  • there was no assumption of responsibility of the possible consequences the claimant might face if he left A&E;
  • the waiting times were provided by non-medical staff (i.e. the receptionist); and
  • the claimant was responsible for his actions as he willingly chose to leave the A&E department.

In contrast, however, the Supreme Court found that:

  • a duty of care had arisen as soon as the claimant had entered A&E seeking medical attention;
  • the standard of duty was held to be that of a reasonably competent and well-informed receptionist working in an emergency medical facility; and
  • the scope of this duty extended to not providing misleading information that could foreseeably cause injury.

Accordingly, the Supreme Court overruled the Court of Appeal and found that the NHS Trust had been in breach of its duty. The Supreme Court accepted that A&E departments operated in "very difficult circumstances and under colossal pressure", but found that the receptionist in question had been charged with providing accurate and correct information.

The claimant's decision to leave the hospital did not break the chain of causation and his decision to do so was, in part, made in light of the misleading information he had received.

Summary

Whilst this decision does not materially change anything in terms of the law, it is a stark reminder that all hospital staff owe a duty to those seeking medical assistance to provide accurate information about its availability.

Best Practice

Whilst the case relates specifically to NHS Hospital staff, the principle is likely to be extended more widely and we would recommend that other healthcare organisations review their procedures as they apply to communications about waiting times and provide guidance to employees, particularly front-line non-clinical staff members, of their obligation to provide accurate timescales information to guard against liability for misleading information communicated to patients.


For more information on waiting time misinformation, please contact Ben Willis in our Healthcare team on 0117 314 5394