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General Orthopaedics

LITIGATION IN FOOT AND ANKLE SURGERY – WHAT LESSONS CAN BE LEARNT?

The South West Orthopaedic Club (SWOC)



Abstract

Foot and ankle surgery is a rapidly evolving specialty. As the number and complexity of cases increases, the number of complaints, litigation and pay-outs has also risen. We aim to assess any learning points discerned from NHS litigation data to allow us help improve patient care.

All claims made to the NHS Litigation Authority between 2007 and 2012 relating to foot and ankle problems were obtained under the Freedom of Information Act. These were reviewed, coded and split into subgroups to allow analysis.

There were 232 successful litigation cases between 2007 and 2012. The total amount paid out was almost £18.5 million (range £112 to £1.6 million). A significant number of successful cases were due to patients not having full, informed consent.

A large amount of money is spent in the NHS is spent on litigation. The amount of litigation and payout in foot and ankle surgery compares favourably with hip and knee surgery.

Lack of informed consent is an easily reversible problem that should be decreasing but is actually on the rise. In our trust, we advocate the use of consent clinics which provide a robust and patient-centred approach to informed consent in foot and ankle surgery.