1. Claims Trends in Obstetrics and Gynaecology Presentation by John Mead Technical Claims Director NHS Litigation Authority 26 th April 2007

2. Clinical Negligence-Numbers of New Claims Reported YearELS/RHACNSTTotal 2002/34715,6146,085 2003/43364,1684,504 2004/53034,3164,619 2005/61614,5164,677

3. Clinical Negligence-Total Payments per Year 2002/3 2003/4 2004/5 2005/6 £446.2M £422.5M £502.9M £560.3M

4. Open Clinical Negligence Claims by Speciality, 31/3/02

5. Open Clinical Negligence Claims by Speciality, 31/3/07

6. Value of Open Clinical Negligence Claims by Speciality, at 31/3/02

7. Value of Open Clinical Negligence Claims by Speciality, at 31/3/07

8. Open Obstetric Claims by Cause, 31/3/07 Cerebral Palsy Other Brain Damage Erb’s Palsy Unnecessary Pain Fatality Additional Operation(s) Stillborn Other % 42.7 11.6 10.3 4.3 4.1 3.9 2.2 20.9

9. Total Value of Open Obstetric Claims, 31/3/07 Cerebral Palsy Other Brain Damage Erb’s Palsy Developmental Delay Wrongful Birth Unnecessary Pain Other £M 3,296 739 83 77 33 29 233 4,490

10. Open Obstetric Claims by Cause, 31/3/07 –Failure to respond to abnormal FHR –Failure to recognise complication –Failure to monitor 1 st stage of labour –Failure to monitor 2 nd stage of labour –Fail/Delayed Treatment –Fail/Delayed Diagnosis –Application of excess force –Other % 20.5 8.4 8.0 7.8 7.7 6.9 5.2 35.5

11. Open Gynaecology Claims by Injury, 31/3/07 –Additional/unnecessary operation –Unnecessary pain –Bowel damage –Bladder damage –Psychiatric/psychological damage –Infertility –Unwanted pregnancy –Cancer –Other % 24.4 13.9 6.8 4.9 4.7 4.3 4.0 32.3

12. Value of Open Gynaecology Claims, 31/3/07 –Brain damage –Additional/unnecessary operation –Bowel damage –Cancer –Unnecessary pain –Fatality –Wrongful birth –Bladder damage % 16.9 16.5 10.0 7.6 7.1 4.4 4.3 3.9 29.3

13. Number of Open Gynaecology Claims, by Cause, at 31/3/07 –Intra-operative problems –Failure/delayed diagnosis –Failure/delayed treatment –Failure to recognise complication –Failed sterilisation –Failure to obtain consent –Inappropriate treatment –Others % 21.6 15.8 13.9 8.1 4.9 4.5 3.0 28.2

14. Number of New Obstetric & Gynaecological claims received by year since 2001/02 NHSLA Notification Year GynaecologyObstetrics 2001/026101,303 2002/035521,148 2003/04391907 2004/05338827 2005/06325801 2006/07274705 Total2,4905,691

15. Amounts paid out on Obstetric & Gynaecological Claims by Year Payment YearTotal Paid on Obstetric Claims £M. Total Paid on Gynaecology Claims £M. 2001/0242932.9 2002/0322612.5 2003/0416316.3 2004/0524314.9 2005/0625913.8 2006/0727215.2 Total1,592105.6