> ### CIVIL PROCEDURE PRE-ACTION PROTOCOLS

> ### CLINICAL NEGLIGENCE PROTOCOL

> ### ANNEX D

> ### LORD WOOLF'S RECOMMENDATIONS

> 1. | Lord Woolf in his Access to Justice Report in July 1996, following a detailed review of the problems of medical negligence claims, identified that one of the major sources of costs and delay is at the pre-litigation stage because - Inadequate incident reporting and record keeping in hospitals, and mobility of staff, make it difficult to establish facts, often several years after the event. Claimants must incur the cost of an expert in order to establish whether they have a viable claim. There is often a long delay before a claim is made. Defendants do not have sufficient resources to carry out a full investigation of every incident, and do not consider it worthwhile to start an investigation as soon as they receive a request for records, because many cases do not proceed beyond that stage. Patients often give the Defendant little or no notice of a firm intention to pursue a claim. Consequently, many incidents are not investigated by the defendants until after proceedings have started. Doctors and other clinical staff are traditionally reluctant to admit negligence or apologise to, or negotiate with, claimants for fear of damage to their professional reputations or career prospects.
> 2. | Lord Woolf acknowledged that under the present arrangements healthcare providers, faced with possible medical negligence claims, have a number of practical problems to contend with - Difficulties of finding patients' records and tracing former staff, which can be exacerbated by late notification and be the health care provider's own failure to identify adverse incidents. The healthcare provider may have only treated the patient for a limited time or for a specific complaint: the patient's previous history may be relevant but the records may be in the possession of one of several other healthcare providers. The large number of potential claims do not proceed beyond the stage of a request for medical records, or an explanation , and that is difficult for healthcare providers to investigate fully every case whenever a patient asks to see the records.

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