The reasons behind the most catastrophic blunders in emergency departments have been laid bare in a report highlighting some of the biggest pay outs for NHS A&E errors.

       NHS Resolution conducted a deep dive into compensation claims concerning emergency departments in England, including 16 cases which saw more than ￡1 million handed out after life-changing or deadly errors.

       The average “high-value claim” was ￡2,069,029, with many of them related to spinal cord injuries which, left undetected, can have a life-long impact on patients.

       The report detailed the case of a woman who suffered permanent neurological damage and now has bladder, bowel and sexual dysfunction symptoms, as well as loss of mobility, after a spinal condition was misdiagnosed as sciatica.

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       The report also looked at 86 deaths which resulted in average pay outs of more than ￡45,000.

       The vast majority were blamed on missed diagnoses of illnesses including sepsis or infection, blood clots or heart conditions; falls or medication error.

       The report’s authors also reviewed five potentially preventable suicides, including one inside an A&E department.

       In 2020/21, 11% of clinical negligence claims filed with NHS Resolution concerned errors in emergency departments, the authors said.

       These reports provide analysis of claims of patients who have attended emergency departments in England and highlight important details to support the delivery of holistic care

       Helen Vernon, NHS Resolution

       After reviewing 220 claims between 2014 and 2018, the authors highlighted a number of “common themes”, including:

       – diagnostic errors, including missing signs a patient was deteriorating;– a failure to recognise the significance of repeat attendance at A&E;– delays in care; and– problems with communication, including problems with different hospital departments talking to each other.

       NHS Resolution also examined claims relating to missed broken bones, hospital-acquired pressure ulcers, and falls in separate reports.

       There is a “low” number of compensation claims filed against emergency departments, it was keen to highlight, with one claim for every 17,000 “episodes” of A&E care.

       Helen Vernon, chief executive of NHS Resolution, said: “These reports provide analysis of claims of patients who have attended emergency departments in England and highlight important details to support the delivery of holistic care.

       “The recommendations aim to make it easier for clinicians to do the right thing to support patient healthcare planning, and enhance safer care and patient experience.”

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       Dr Katherine Henderson, president of the Royal College of Emergency Medicine (RCEM), added: “The RCEM welcomes these reports as learning opportunities to reduce the tragedy of preventable harm to individuals and their families as well as the staff involved.

       “As specialty leaders and standard setters, we must use the stories and themes identified in these reports to focus our guidance and teaching and sharpen our advocacy for a better system of care modelled to deliver patient needs.”