The Supreme Court has today given its judgment in the case of Darnley v. Croydon Health Services NHS Trust (10 October 2018).
Following a head injury, Mr Darnley (the claimant) attended Mayday Hospital, Croydon A&E with a friend. The receptionist advised he would have to wait up to four to five hours to be seen.
Mr Darnley waited 19 minutes before leaving without telling anyone. He was not told he would have been triaged within ~30 minutes. Had he been told this, the trial judge found he would not have left A&E.
Deteriorating shortly after arriving home, Mr Darnley tragically suffered permanent and serious injury, which would have been avoided if he had not left A&E and his treatment delayed as a result.
In finding for the hospital, the original trial judge and then the Court of Appeal adopted a number of arguments, including:
- the Trust was not under a duty to provide accurate information about waiting times
- there was no assumption of legal responsibility for the claimant
- the information was provided as a courtesy by non-medical staff
- the claimant was responsible for his injury because he chose to leave the A&E department, when he had in fact been advised to wait
In overturning the original ruling of the Court of Appeal, the Supreme Court found for the claimant that:
- As soon as the claimant attended seeking medical attention there was a patient hospital relationship (an established category of duty of care)
- There was a duty not to provide misleading information which may foreseeably cause physical injury
- The standard required is that of an averagely competent and well-informed person performing the function of a receptionist at a department providing emergency medical care
- The hospital had been in breach of its duty of care
This is a very sad case because the claimant sadly suffered significant lasting injury. Therefore the decision is an important reminder that hospital staff must take reasonable steps to ensure patients are not provided with “misinformation” including the availability and timing of medical assistance. Both clinical and non-clinical staff must be made aware that A&E waiting time information provided to patients must be reasonably accurate and may have legal consequences if it is misleading.
This case raises issues about the legal liability of non-clinical A&E receptionists when giving advice to patients about waiting times and for which it was important to have a judicial decision. The trust is very sorry that Mr Darnley did not receive accurate information about how long he would have to wait before being assessed for treatment which resulted in his significant injury. In line with the clarity now given on the legal issues by the Supreme Court, we will now work with our lawyers to ensure that Mr Darnley is compensated as swiftly as possible.
This is the first case in England where an A&E receptionist has been found negligent for failing to give accurate information about waiting times to a patient. Trusts therefore need to review their practices straight away, to ensure that visitors to A&E are provided with accurate and not misleading information about waiting times. That might entail, as the court suggested, the use of leaflets or notices. Failure to do so might now incur a legal liability if a patient suffers detriment as a consequence.
A spokesperson for NHS Resolution
You can read the full judgment here: https://www.supremecourt.uk/cases/uksc-2017-0070.html
