NHS compensation: how to claim and what you can expect

Published 18 March 2026

TL;DR

NHS compensation is the financial remedy available when NHS treatment falls below the required standard of care, causes you harm, and that harm is proved on the balance of probabilities
Claims against NHS secondary care providers are managed by NHS Resolution, which handles litigation on behalf of NHS trusts and foundation trusts in England
The legal test is the same whether you are bringing a claim against the NHS or a private provider: Bolam breach plus causation
NHS compensation covers general damages (pain, suffering, loss of amenity) and special damages (financial losses including lost earnings and care costs)
The Pre-Action Protocol for the Resolution of Clinical Disputes governs the process before any proceedings are issued; most claims settle without going to court
The time limit is three years from the date of the negligent treatment or from the date of knowledge

NHS compensation arises from a clinical negligence claim against an NHS trust, foundation trust, or other NHS body. When NHS treatment causes harm that would not have occurred if the standard of care had been met, the patient may be entitled to financial compensation. The claim is brought against the NHS body responsible for the treatment, and in practice NHS Resolution acts on behalf of NHS trusts in England in defending and settling those claims.

This guide explains how NHS compensation claims work, what the process involves, how much compensation you may be entitled to, and how to start a claim.

What is NHS compensation and who handles it?

NHS compensation is the financial settlement paid to a patient or their family following a successful clinical negligence claim against an NHS provider. In England, NHS Resolution (formerly the NHS Litigation Authority) manages clinical negligence claims on behalf of NHS trusts and foundation trusts under the Clinical Negligence Scheme for Trusts (CNST).

When you bring a claim against nhs secondary care, your claim is effectively managed by NHS Resolution's legal team rather than the individual trust's own solicitors. NHS Resolution reported total payments of over £2.8 billion in clinical negligence claims in 2023-24, reflecting the scale of the liability the scheme manages.

In Scotland, claims are managed differently through the Central Legal Office and NHS boards. In Wales, NHS Wales Shared Services Partnership handles litigation. In Northern Ireland, the Health and Social Care bodies handle claims through the Directorate of Legal Services.

For NHS primary care (GP practices, dental practices, and community services) the position is different. These practitioners are not directly employed by the NHS and claims are brought against the practice or individual practitioner rather than a trust; NHS Resolution does not handle these claims in the same way.

How do you bring a claim against the NHS?

A claim against nhs providers follows the same legal framework as any clinical negligence claim. The claimant must prove: that the NHS provider owed a duty of care (established for all NHS patients); that the treatment fell below the Bolam standard; and that the breach caused the harm claimed, assessed on the balance of probabilities.

The process is governed by the Pre-Action Protocol for the Resolution of Clinical Disputes. Before proceedings are issued, you must:

Obtain the medical records. Your solicitor will request these formally and NHS trusts are required to provide them within 40 days.
Obtain a supportive expert report. An independent medical expert in the relevant specialism must confirm that the treatment fell below the Bolam standard and that this caused your harm.
Send a Letter of Claim. This sets out the nature of the negligence, the injuries caused, and the financial losses claimed. It must be sent to the defendant trust.
Await a Letter of Response. The defendant has four months to investigate and respond, either admitting liability, denying it, or requesting more time.

Most claims settle by negotiation during or after this pre-action process. Where liability is disputed and settlement is not reached, proceedings may be issued in the County Court or High Court depending on the value of the claim.

For a step-by-step breakdown of the full process, see the how to claim guide. For an overview of NHS-specific claims, see the NHS claims guide.

What does NHS compensation cover?

NHS compensation covers two categories of loss:

General damages compensate for pain, suffering, and loss of amenity. These are assessed using the Judicial College Guidelines (17th edition, April 2024), which set out brackets for different injury types and severities. General damages are a lump sum assessed at the time of settlement or judgment.

Special damages compensate for actual financial losses. These include: loss of earnings (past and future); the cost of care provided by family members or professionals; aids and equipment; property adaptations; travel to medical appointments; and the cost of private treatment needed as a result of the negligence.

In high-value cases involving catastrophic injury, special damages can exceed general damages many times over. A catastrophic brain injury claim may include decades of professional care costs, lost lifetime earnings, and property adaptation costs totalling millions of pounds.

Vicarious liability means that NHS trusts are liable for the negligence of their employees acting in the course of their employment. You do not need to identify or pursue the individual clinician personally; the claim is against the trust.

How much NHS compensation can you expect?

The amount of NHS compensation depends on the severity of the injury caused by the negligence and the financial losses flowing from it. There is no standard payout and no average that applies across all claim types.

General damages under the JCG range from a few hundred pounds for minor soft tissue injuries with complete recovery to over £350,000 for very severe brain damage. Special damages are calculated on the specific facts and can be very large in catastrophic cases.

NHS Resolution's annual data shows that the average payment per settled claim varies significantly by claim type. Obstetric and birth injury claims have the highest average values; lower-value claims (such as minor medication errors with temporary harm) settle for much smaller sums.

For detailed compensation ranges by injury type, see the compensation guide.

Time limits for NHS compensation claims

The limitation period for an NHS compensation claim is three years from the later of: the date the negligent act occurred, or the date of knowledge. The date of knowledge is the date you first knew (or ought to have known) that you had suffered a significant injury attributable to the treatment and that the NHS body was responsible.

Children have until their 21st birthday to bring a claim (three years after turning 18, when the limitation period begins). People who lack mental capacity do not have a limitation period running while they remain without capacity.

For a full explanation of the limitation rules, including the court's discretion to allow late claims in appropriate cases, see the time limits guide.

Funding an NHS compensation claim

Most clinical negligence solicitors act on a conditional fee basis for NHS compensation claims. Under this arrangement, you pay no legal fees if the claim does not succeed. If it does succeed, fees are recovered from NHS Resolution in most cases, subject to the terms of the agreement.

Legal aid is not generally available for clinical negligence claims. The conditional fee arrangement is the standard funding mechanism used by the vast majority of claimants.

For full details of how conditional fee arrangements work, including the after-the-event insurance that typically accompanies them, see the funding guide.

This page provides legal information, not legal advice. If you believe you may have an NHS compensation claim, speak to a qualified solicitor who specialises in clinical negligence. Time limits apply and early advice is important.