NHS Resolution is the arm's-length body of the Department of Health and Social Care that manages medical negligence and other legal claims for NHS organisations in England.
Its role extends beyond simply defending claims. NHS Resolution describes its purpose as helping the NHS to "advise, resolve and learn" by:
- Providing indemnity cover to NHS bodies;
- Resolving disputes involving primary care and practitioner performance;
- Sharing learning from claims data to improve patient safety; and
- Supporting initiatives aimed at reducing avoidable harm.
In May 2025, NHS Resolution launched its new three-year strategy, "Resolution Through Collaboration", setting out its vision for handling medical negligence claims and improving patient safety across the NHS. It aims to encourage earlier incident investigation, alternative dispute resolution, improved communication with patients, and greater use of claims data to drive patient safety improvements.
One of the strategy's core priorities is fair resolution. This strategy encourages earlier engagement, greater transparency, and avoiding unnecessary litigation. This enables thousands of patients and families to receive answers and compensation more quickly, without the need for court proceedings.
On paper, this benefits all parties in a medical negligence claim: a prompt resolution allows people to receive compensation faster. It allows the Trust to prioritise strengthening its standard of care to prevent additional claims. However, the real measure of its effectiveness will be whether it produces tangible improvements for injured patients seeking answers, accountability, and fair compensation.
On 9 July 2026, NHS Resolution published its annual accounts for 2025/2026, in which it boasts that a record 84% of medical negligence claims were resolved without the need for formal proceedings. This is a minor increase from 83% the year prior, but it gives little indication of whether their new strategy is working effectively.
The percentage of claims being resolved outside of legal proceedings was increasing at a quicker rate before the implementation of the Resolution Through Collaboration strategy.
However, as the percentage of claims settled outside of court approaches 100%, it becomes harder to increase further.
While NHS Resolution's emphasis on collaboration and early dispute resolution is commendable, the latest figures raise questions about the extent of its impact. The number of new medical negligence claims increased from 14,428 in 2024/25 to 15,236 in 2025/26, representing a 5.6% year-on-year increase. Although it is concerning that claims are increasing at this rate, it adds context for why claims settling outside of court are slowing slightly.
The increase in claim volumes also highlights a broader challenge facing the Resolution Through Collaboration strategy. Even if alternative dispute resolution mechanisms are becoming more effective, they must operate within a system that is experiencing a growing number of notifications and claims. A modest increase in early reconciliation may not necessarily indicate that the strategy is underperforming. Instead, it may reflect the reality that NHS Resolution is trying to resolve a larger, more complex caseload with limited resources. Nevertheless, the key question is whether patients are experiencing faster investigations, earlier admissions of liability and more timely access to compensation.
Unless improvements in early resolution outpace the growth in new claims, the benefits of the strategy risk being absorbed by increasing demand rather than felt by those seeking closure after avoidable harm.
“Medical negligence claims resolving earlier allows the NHS to prioritise their focus on providing satisfactory care to its patients. It would be unfair to criticise the effectiveness of the Resolution Through Collaboration strategy after only one year since its inception. Although the number of claims settled outside of court is likely an accurate metric for the past year, the strategy's effectiveness needs to be evaluated alongside the number of new claims brought.
We would not expect to see a potential decrease, or even just a marginal increase, in new claims until the publication of NHS Resolution's 2026/27 accounts. This is because any reduction in the number of new claims will inevitably lag behind improvements in claims handling, as potential claims often take months or years to materialise and enter the litigation process.”
Dominic Allen
Trainee Solicitor - Medical Negligence
This information is for guidance purposes only and does not constitute legal advice. We recommend you seek legal advice before acting on any information given.
