NHS Receptionists Have a Duty of Care Supreme Court Rules

14 Oct 2018

Eight years ago, Michael Darnley then aged 26, was struck on the head in a random attack by an unknown assailant. His friend drove him to the Croydon University Hospital Accident and Emergency Department. He presented complaining of a head injury causing severe pain but was told by the Accident and Emergency receptionist that he would have a 5-hour wait to be seen by a doctor. So, feeling unwell and in pain, he left before he could be triaged by a nurse, who would have assessed him within 30 minutes of his arrival. He told nobody he was leaving and was discovered missing when the triage nurse came looking for him.

Within an hour of arriving home, he collapsed. An ambulance took him back to the Croydon University Hospital. A CT scan revealed a bleed on his brain. He was transferred to St. George’s Hospital for emergency neurosurgery which saved his life. However, the bleed which caused his collapse, left him with permanent paralysis of his left side.

High Court Judgement

The Supreme Court Judgement lays out the details of the case. Initially, Mr. Darnley brought proceedings against Croydon Health Services NHS Trust, alleging a breach of duty by the reception staff, specifically relating to his projected wait time and the failure to assess his injuries for priority triage.

The case was first heard in the High Court in April 2015, before His Honour Judge Robinson. It was determined that ‘the harm suffered in this case was outside the scope of any duty or obligation owed by the respondent by its reception staff’ and ‘the decision to leave was one that was ultimately the decision of the appellant’. However, Judge Robinson did find that Mr. Darnley would have made a ‘very near full recovery’ had he collapsed while waiting at the hospital.

Court of Appeal

Taken to London’s Court of Appeal in 2017, the case was dismissed by a majority, in that the receptionist owed no duty of care and the appellant should ‘accept responsibility for his own actions’. As reported in the Law Gazette, Lord Justice Jackson said, ‘litigation about who said what to whom in A and E waiting rooms could become a fertile area for claimants and their representatives’. He also expressed concern that hospitals, conscious of potential litigation, would take a defensive stance and tell receptionists to only ask for patient details and provide no additional information to them. Lord Justice Sales commented on waiting times, ‘The fair, just and reasonable view is that such information is provided as a matter of courtesy and out of a general spirit of trying to be helpful. Its provision is not subject to a duty of care’. The dissenting judge in the case, Lord Justice Mc Combe stated that ‘inaccurate and incomplete information had been provided negligently’ and amounted to a breach of duty which was causative of Mr. Darnley’s permanent injuries.

Supreme Court’s Landmark Decision

On 10th October 2018 the Supreme Court unanimously allowed Mr. Darnley’s appeal. Lord Lloyd-Jones delivered the judgment that the majority in the Court of Appeal were flawed in their rulings on duty of care, which is in fact owed by all staff, clinical and non-clinical. Providing misleading information breaches that duty of care. The Trust had charged the receptionist with ‘the role of being the first point of contact […] with the responsibility for providing accurate information’. As reported in the Independent, Lord Lloyd-Jones said, ‘I have no doubt that the provision of […] misleading information by a receptionist as to the time within which medical assistance might be available, was negligent’. He added, ‘The pressures on medical staff are enormous, the demand for attention is constantly fluctuating and priorities are likely to change. However, it is not unreasonable to require receptionists to take reasonable care not to provide misleading information as to the likely availability of medical assistance’.

Response to the Judgement

Mr. Darnley’s solicitor, speaking to the Law Gazette, stated, ‘The standard of care required is that of an averagely competent and well-informed person performing the function of a receptionist in a department providing emergency medical care’ but this expectation need not add excessive, additional burden to NHS staff.
Medical Director for the NHS Trust, Dr. Nnenna Osuji commented, ’We note the judgement of the Supreme Court and will carefully consider its implications for the Trust and our staff’.
The value of the award due to Mr. Darnley will be assessed by the High Court at a later date.

At Osbornes Law we care about how you are treated both by medical professionals at your GP surgery or at hospital and also under the care of private providers of health services. If you think that the care you or a loved one has received fell below the standards expected of a reasonably competent professional, then please do not hesitate to contact Partner and specialist medical negligence lawyer Stephanie Prior on 020 7681 8671. You can also fill out an online enquiry form here.

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