Introduction Subarachnoid haemorrhage (SAH) causes high mortality and morbidity. Learning lessons from litigation is a standard aspect of risk management in many industries. This study, therefore, examined data from the NHS Litigation Authority (NHSLA) on SAH to determine its usefulness in informing clinical risk management.
Methods Under the freedom of information act, the NHSLA database was interrogated for cases of SAH. Data were retrieved from 1995 to 2008.
Results Over this period, 126 cases relating to SAH were reported, 102 of which were closed. Damages were awarded in 64 cases, totalling £13.5 million. Seven claimants, associated with a high cost of continuing care, were awarded more than £0.5 million. The mean damages, awarded were circa £211k. The majority of successful claims related to failure/delay to diagnose or treat.
Conclusion On average, approximately 10 cases of SAH were reported, annually, to the NHSLA. The rate of successful litigation was circa 1:790 cases of SAH. Using lessons learnt from litigation, to manage risk, requires good quality supporting data. The clinical content of the database is limited. A previous study of the database found only 82% data reliability. We also found inconsistencies in our sample and in the output received as a result of our data requests. It would be beneficial if more accurate, detailed clinical information were recorded in the NHSLA database, especially root-cause information, as this could be used by clinicians to inform risk management. The initial concept of the NHSLA database as a claims management tool perhaps represents a lost opportunity.