The seriousness of negligence claims brought against nurses has risen dramatically in the UK leading to legal costs trebling in the past five years.
A Nursing in Practice investigation found the cost of legal action brought against the Royal College of Nursing's (RCN) practice nurse members rose by nearly £2m alone last year to reach around £5m.
While the year 2010/2011 saw the biggest hike in legal costs, NiP has learned that the size of claims has been rising at an alarming pace over the past five years.
RCN legal costs have more than doubled since 2007 (£2.15m) and more than trebled since 2006 (£1.48m).
Chris Cox, a Legal Director at the RCN, attributes the rise to an increase in 'significant' claims exceeding a million pounds.
"We saw the first million-pound claim against an RCN member in 2008/2009 and the volume of such significant claims has been rising ever since," he said.
"We had a handful of legal claims exceeding a million pounds during 2010/2011 – the highest number we've ever had.
"This has made a huge difference to the overall figures."
The jump in legal costs has contributed to the RCN's decision to remove its indemnity cover for practice nurses.
From January next year, GP employers will be forced to accept 'vicarious liability' for the actions of nurses, taking legal and financial responsibility for any negligent claims.
As well as the rise in costs, the past decade has also seen an increase in the seriousness of legal claims brought against nurses working in a general practice setting.
"Practice nurses are now more likely to be sued for instances such as late diagnoses of cancer and slow referrals to specialists, rather than those 'less serious' and less costly claims of ten years ago, where the most serious was an injection being given in the wrong place," said Cox.
The RCN has said a 'blurring' of nursing and medical roles, lack of training and nurses working outside of their competency levels are among the reasons why more costly and more serious claims are being brought against practice nurses.
"The changes in the nature of work performed by practice nurses has contributed to the rise in legal claims as they are assuming more of a role in diagnosis and treatment," said Cox.
The Nursing and Midwifery Council (NMC) stressed nurses must assume responsibility for rejecting requests to fulfill tasks they are not trained to do.
"The NMC code makes it clear that nurses must work within the limits of their competence and to effectively manage risk," said a spokesperson from the NMC.
Gail Adams, Head of Nursing at Unison, echoed the NMC's call.
"It is a nurse's responsibility to stand up to GPs that ask them to work outside of their competency level," she said.
"Nurses need to protect their own interests as well as those of their patients."
Adams also attributes the rise in legal claims to a 'culture of litigation' and said the business culture of general practice leaves nurses "vulnerable from a financial management position".
"GPs do not encourage nurses to apologise as freely and as quickly as they should, which leads to patients feeling forced into taking legal action," she said.
The Department of Health refused to comment when contacted by NiP.
Your Comments (terms and conditions apply):
"I would attribute this to the RCN's lack of proactive involvement in the development and monitoring of expanded nursing roles. Like the rest of our profession, the RCN has witnessed the growing data indicating that many nurses feel inadequately trained for the roles expected by their
employers. The NMC rightly urges us to stand up to such employers. However, when I encountered a 'serious incident' while training to work in Out-of-Hours service many years ago, I was pressured by the employer to leave. There was no satisfactory support for me from the RCN, and they seemed uninterested in the reality that future 'serious incidents' were likely to happen, due to a lack of systematic learning by the OOH organisation. The RCN, in failing to support individuals who know when to say 'no' to roles outside their capabilities, should not be surprised with the rise in litigation." - Catherine Gleeson, West Yorkshire
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