England's Health Department Expects to Pay £59.9 Billion for Past NHS Clinical Negligence, Its Newly Published Accounts Show
Payouts reached £3.2 billion last year, including £0.8 billion in legal costs. If every claim succeeded, the bill would be £85.2 billion.
Original reporting from public records by Watchman Report staff ·
The Department of Health and Social Care's 2025-26 annual report and accounts, which the National Audit Office posted with its audit opinion on Nov. 2, put the department's provision for clinical negligence at £59.9 billion as of March 31, 2026, down marginally from £60.0 billion a year earlier. The provision is the department's best estimate of what it will pay for incidents in NHS care in England up to that date, including claims not yet made.
NHS Resolution paid £3.2 billion on clinical negligence claims in 2025-26, up from £3.1 billion the year before, the accounts say. That included £2.5 billion in damages to patients and families and £0.8 billion in legal costs. The department wrote that "the rising costs of clinical negligence claims against the NHS in England are of great concern to the government," and that costs are likely rising because of higher compensation and legal costs "rather than more claims or a decline in patient safety."
The accounts also list a £25.4 billion contingent liability for clinical negligence, the amount above the provision that would be owed if damages were awarded on every case. Together, the two total £85.2 billion, up £220 million on the year.
Changes in assumptions, including discount and inflation rates, reduced the estimated cost of future clinical negligence liabilities, contributing to a £5.1 billion underspend at NHS Resolution against its budget for this kind of spending, the accounts say. The largest scheme, the Clinical Negligence Scheme for Trusts, makes up £20.8 billion of the £22.4 billion set aside for incidents that have happened but not yet been reported.
The Comptroller and Auditor General gave the accounts a clean audit opinion.
Watchman Report read the Department of Health and Social Care Annual Report and Accounts 2025-26 (HC 696, ordered printed Oct. 29, 2026; published on GOV.UK) and the National Audit Office's page on the accounts dated Nov. 2, 2026. All figures and quotations are taken from those documents. The £85.2 billion total and the £220 million change are stated in the accounts.
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