Litigation in obstetrics and gynaecology in the UK National Health Service over a 17-year period: An analysis of the trends, costs and causes.

IntroductionObstetrics and Gynaecology (O&G) is one of the most litigious medical specialities. This study aimed to analyse the trends and reasons for litigation claims in O&G within the UK National Health Service (NHS) over a 17-year period.MethodsUsing data requested from NHS Resolution under the Freedom of Information Act 2000, an analysis was carried out which included the total number and rate of litigation claims in O&G, the number of these claims that were successful (settled or closed), the damages paid due to successful claims, and the reasons for successful claims between financial years 2006/07 and 2023/24.Results29,129 litigation claims were made in the speciality of O&G between 2006/07 and 2023/24. 66.0% (19,239/29,129) were in Obstetrics, and 34.0% (9890/29,129) were in Gynaecology. 60.8% (17,698/29,129) of O&G claims were successful. The rate of claims in Obstetrics increased per 1000 births (1.1 in 2006 to 2.5 in 2023/24) from the start to the end of the study period. The primary causes for successful claims in Obstetrics included failure/delay of treatment (16.5%, 1943/11,806), failure/delay in diagnosis (8.8%, 1042/11,806) and failure to make response to abnormal fetal heart rate (7.9%, 931/11,806). For Gynaecology, the primary causes were failure/delay of treatment (15.2%, 898/5892), intra-operative problems (15.1%, 888/5892) and failure/delay in diagnosis (12.5%, 735/5892). Never events accounted for 9.3% (790/17,698) of successful claims in O&G.ConclusionO&G has become an increasingly litigious speciality over the last two decades. Although delay in treatment or diagnosis accounted for the highest proportion of successful claims, never events accounted for just under 10% of cases. More work can be done to reduce the risk of these adverse events.