Supreme Court Allow Appeal Against NHS Trust For A&E Receptionist’s Breach of Duty re Waiting Times

Earlier this month the UK Supreme Court handed down its judgement in Darnley (Appellant) v Croydon Health Services NHS Trust (Respondent) . https://www.supremecourt.uk/cases/docs/uksc-2017-0070-judgment.pdf

In this case, the appellant, Mr Darnley attended the Accident & Emergency Department of Mayday Hospital in Croydon. On arrival at 8.26pm the appellant advised the receptionist that he believed that he had injured his head and that he was feeling unwell. When he asked how long it would be before he was seen by medical staff he was told by the receptionist that it could be 4-5 hours. The appellant protested and said that he needed assistance and that he felt like he was going to collapse. The receptionist replied that if he collapsed then he would be treated as an emergency. Neither of the two members of staff who were identified as working that evening could remember the particular incident and when asked, both members of staff suggested that their standard response to a question regarding waiting times for someone with a head injury was either ‘you will be seen by a triage nurse within 30 minutes’ or that ‘the triage nurse will be informed and they will see you as soon as possible.’

Mr Darnley left the emergency department after 19 minutes to go to his mother’s house as he felt too unwell to remain since he had been advised that he could have to wait up to 5 hours. The appellant’s condition deteriorated, and an ambulance was called at 9.30pm. Upon admission to Mayday hospital a CT scan was performed and a large extradural haematoma with a marked midline shift was identified. As a result, he was transferred to St George’s Hospital to be operated upon at 1.00am. The surgical intervention was too late, and the appellant suffered permanent brain damage.

A case for damages was brought by Mr Darnley and was dismissed by the High Court. This was appealed and again the case was dismissed by a majority decision of the Court of Appeal. The Court held that neither the receptionist nor the trust owed any duty of care to a patient to advise on waiting times, that the damage was outside the scope of any duty owed and that there was no causal link between any breach of duty and the injury. The appellant appealed to the Supreme Court.

The Supreme Court considered the case and unanimously allowed the appeal and remitted it back to the High Court for damages to be assessed. In delivering the sole judgement Lord Lloyd-Jones found that:

  1. The duty of care upon an A&E Department extended to include a duty to take reasonable care not to provide misleading information which may foreseeably cause physical injury;
  2. The duty of care was owed by the Trust and they could not distinguish between medically qualified and non-medically qualified staff. The receptionist was the first point of contact for anyone attending the A&E Department for medical assistance and as a result they had a responsibility for providing accurate information;
  3. That the majority in the Court of Appeal did not deal with the issue of the existence of a duty of care and the negligent breach of the duty; and
  4. The observation that imposing such a duty would add to the social cost was misplaced as it was not a new head of liability. It did, however, acknowledge that the challenging financial circumstances that face NHS A&E Departments “may well prove highly influential in many cases when assessing whether there had been a negligent breach of duty.”

In this case the receptionists knew the average waiting time and the fact that the appellant in the subject case was told 4-5 hours was incorrect and misleading. It was reasonably foreseeable that a person who believed that they might have to wait 4-5 hours before they would be seen may decide to leave. Had the appellant in this case been told that he might only have had to wait 30 minutes before being seen then it is likely that he would have waited to be seen by a doctor and then admitted or, alternatively, if he had suffered the collapse in the A&E Department he would have undergone surgery earlier and he would have made a nearly full recovery.

We at MTB have a team of expert litigators who are ready to assist anyone who feels like they have sustained a personal injury due to the negligence of another. Whether your injury was caused by a fall, a road traffic collision, an accident at work or as a result of a medical procedure going wrong we can provide you with the advice and assistance you need to pursue your claim. Call us now to arrange a free consultation.