Duty of care: hospital not liable for non-clinical staff giving incorrect A&E waiting time
Darnley v Croydon Health Services NHS Trust
Andrew Cousins and Tracy Sell-Peters review this interesting decision limiting the expansion of duties placed on hospitals. In Darnley v Croydon Health Services NHS Trust, the High Court held that the Trust did not have a duty of care to provide accurate waiting times to patients attending A&E.
The Claimant was the victim of an assault and sustained an injury to the head. He was taken to hospital but the judge found he left some 19 minutes after arriving without being seen by a clinician. Having returned home his condition deteriorated and an ambulance took him back to hospital later the same evening. He was found to have suffered an extra-dural haematoma, requiring neurosurgery and he suffered a neurological injury.
The Claimant claimed that during his time at hospital there were breaches of duty by both clinical and non-clinical staff. It was alleged that the reception staff gave inaccurate information about the length of time which he would have to wait, that he was not assessed as a priority triage and that the clinical staff failed to assess him during his time at the hospital.
The Claimant alleged that he was told by the receptionist (incorrectly) that he would have to wait 4 to 5 hours to be seen and that if he had been told that he would actually be assessed by a triage nurse within 30 minutes he would have stayed at the hospital. It was further alleged that the Defendant had failed to comply with the National Institute for Health & Care Excellence (NICE) clinical guidelines which provided that head injury patients should be assessed by a clinician within 15 minutes of arrival at hospital.
HHJ Robinson dismissing the Claimant’s claim:
The Court was only concerned with the issue of liability and the claim was dismissed. As a finding of fact the Court concluded that the Claimant had stayed at the hospital for a maximum of 19 minutes after being told that he would be seen within 4 to 5 hours. However, on the evidence, the Claimant’s condition was not such as to have alerted the non-clinical receptionist to the presence of a serious condition requiring priority attention by a triage nurse.
In relation to the NICE clinical guidelines, the Court did not accept that failing to meet a 15 minute target by 4 minutes constituted a breach of clinical duty. The consensus amongst the experts was that the longest allowable target was 30 minutes. The Claimant not being seen within 19 minutes therefore did not amount to a breach and in any event did not cause a loss.
When considering whether the non-clinical staff had a duty to inform the Claimant if he would be seen within 30 minutes, the Court considered the three stage test from Caparo Industries Plc v Dickman . It was reasonably foreseeable that not treating patients could lead to harm and that a person who was informed that the waiting time would be 4 to 5 hours, rather than 30 minutes, may leave before he could be seen. However A&E receptionists were not under a duty to guard patients against the harm that may result from their decision to leave the hospital even if that harm could be prevented by giving more accurate information about waiting times.
The Court concluded that it would not be fair, just and reasonable to impose a liability on a defendant hospital for the receptionist not giving full and accurate information about waiting times. The receptionist’s task was to complete registration forms and the provision of waiting times was a courtesy. To impose liability in damages for failure to provide the information or for providing inaccurate information would be a step too far and would not be fair, just and reasonable.
The court also found that, had the claimant been told he would be seen within 30 minutes, he would not have left A&E, his brain haemorrhage would have occurred whilst in hospital, he would have received urgent treatment and would not have suffered neurological injury. Ultimately however, the Claimant had chosen to leave the hospital and the Defendant was not liable to compensate him.
For further information please contact Andrew Cousins, Senior Solicitor Advocate, Insurance on +44 (0)161 603 5093
This information is intended as a general discussion surrounding the topics covered and is for guidance purposes only. It does not constitute legal advice and should not be regarded as a substitute for taking legal advice. DWF is not responsible for any activity undertaken based on this information.