A recent Duty of Care decision could prove to be a game-changer moving forward.
It is the opinion of many that we seem to live in an era where there is, in perception at least, increasing unwillingness by individuals to be held accountable for their own actions. However, the Supreme Court in the ground breaking case of Darnley v Croydon NHS Trust [2018] has ruled that non-clinical hospital staff also owe a duty of care to patients.
In this case, the Claimant was assaulted and struck on the head in May 2010. He subsequently attended an A&E department in order to receive medical attention. Upon arriving at the hospital, the Claimant told the receptionist that he had suffered a head injury and that he felt like he could collapse at any moment. Nevertheless, the Claimant was advised that he would have to wait for up to four or five hours before being attended to. After waiting for just 19 minutes, the Claimant felt so unwell that he decided (on his own accord) to leave the A&E department in order to go home and take some pain relief. The Claimant did not inform the receptionist of his decision to leave the hospital.
However, it later transpired that it was the hospital’s policy that all head injury patients would be seen by the triage nurse within 30 minutes of their arrival at A&E. Therefore, the information that was provided to the Claimant, regarding waiting times was factually incorrect.
Shortly after leaving the hospital, the Claimant’s condition worsened and he was transported back to A&E by ambulance. Sadly, by the time that the Claimant received the medical attention that he required, he had suffered permanent and severe brain damage. It was found that, had the Claimant received the correct information regarding the length of waiting times, then he would have waited at A&E to be seen. Furthermore, the medical evidence in this case also showed that, had the Claimant been at the hospital when his condition deteriorated, he would have been treated much sooner and, he would have almost certainly made almost a full recovery.
In light of the above, the Claimant subsequently commenced a negligence claim against the NHS Trust on the basis that the non-medical reception staff had breached their duty of care towards him (by failing to provide him with the correct information about waiting times).
In the first instance, the trial judge and the Court of Appeal ruled in favour of the NHS Trust. The Claimant’s claim was unsuccessful, as it was held that it would not be “fair just and reasonable” to hold hospitals liable for the harm suffered as a result of reception staff failing to give correct information to patients about waiting times. However, the Court did highlight that it was reasonably foreseeable that an individual who believes that there may be a wait of several hours before they are to be seen would leave the hospital. Notwithstanding this point, the Court ruled that the causal link between the giving of the incorrect information and the harm that the Claimant had suffered was broken (as it had been the Claimant’s own decision to leave the hospital after just 19 minutes).
The Supreme Court, however, upheld the Claimant’s appeal, as it considered that the decision and the approach adopted by the lower Courts, in respect of the doctrine of duty of care, was flawed. The Supreme Court fundamentally disagreed with the trial Judge’s viewpoint that it would be unreasonable to impose a duty on the receptionist to provide correct information about A&E waiting times.
Despite some views to the contrary, the Supreme Court confirmed that this present case has not created innovative principles of law, as it was held that there already exists an inherent duty of care between a hospital and a patient. The Supreme Court clarified that once the Claimant had checked into A&E, the relationship of patient and health care provider was formulated and, therefore, a duty of care arose. Therefore, the receptionist owed the Claimant a duty of care which involved the duty not to give false or misleading information that might cause such an injury. The Supreme Court held that it was negligent for the receptionist to advise the Claimant that he would not be seen for between 4 to 5 hours, when the true position was that he could reasonably have expected that the triage nurse would see him within 30 minutes.
The Supreme Court confirmed that the duty of care owed by the Trust is to be viewed in a holistic manner, and so it is inappropriate to distinguish between clinical and non-clinical staff when considering the duty of care owed.
The Supreme Court also stated that the Court of Appeal had also blundered in its judgment on the point of causation. As outlined above, the Court of Appeal had previously held that the Claimant should take responsibility for his own actions, and, in doing so, had failed to consider the effect that the incorrect waiting time information would have on his decisions. The Supreme Court considered that, as it was reasonably foreseeable that a patient provided with incorrect information regarding waiting times would leave the hospital, and as his decision was formulated on the basis of inaccurate information provided by the NHS Trust, it is not the case that Claimant broke the chain of causation by actually leaving the hospital.
It is the opinion of many that the ruling in this case has now opened the floodgates for future claims, with Claimants now being entitled to claim where they have received inappropriate advice from unqualified staff at GP surgeries and hospitals. However, on the other hand, it could be said that the Supreme Court’s decision does not change anything, as ultimately the Supreme Court applied existing legal principles to a set of rather unique facts.
The decision is, however, an important and significant reminder that all hospital staff must take reasonable steps to ensure that patients are not provided with “inaccurate” information. This significant case raises questions around how far healthcare providers’ duty of care stretches. Both clinical and non-clinical staff should be mindful of the fact that A&E waiting time information provided to patients is not provided as an act of mere courtesy. It is imperative that the information given must be reasonably accurate, and those who fall short may face serious legal consequences, if it is disingenuous.
It therefore remains to be seen how this unique and important judgment may affect clinical negligence claims and other cases involving duty of care issues in the future.
For more information on the topic, please contact Matthew Lavelle.
