Psychological injury compensation: what you can claim after medical negligence

Published 30 March 2026

TL;DR

Psychological injury compensation is recoverable in a medical negligence claim when a clinician's negligence causes or materially contributes to a psychiatric condition such as PTSD, anxiety, or depression
Psychological injury can be claimed as the primary injury (where the negligence directly caused the psychiatric condition) or as a secondary head of damage alongside a physical injury
The Judicial College Guidelines (17th edition, April 2024) set out four brackets for psychiatric damage, ranging from less severe conditions (£1,540 to £5,860) to severe conditions (£54,830 to £115,730)
Secondary victim claims (where a person suffers psychiatric injury from witnessing negligence to another) are subject to strict legal control under Alcock [1991] and are rarely available in a medical negligence context
A psychiatric expert report is required to establish the diagnosis, its severity, causation, and prognosis; this is the key piece of evidence in any psychological injury compensation claim

Psychological injury compensation covers the losses caused by psychiatric conditions arising from medical negligence. PTSD, clinical depression, generalised anxiety disorder, and adjustment disorder are among the conditions recognised in this context. Where medical negligence causes or substantially contributes to a diagnosable psychiatric condition, the patient may be entitled to compensation for that condition in addition to, or as an alternative to, compensation for any physical harm.

When is psychological injury compensation available?

Psychological injury compensation is available in a medical negligence claim in two main ways.

As the primary injury: where the negligence directly caused the psychiatric condition and there is no separate physical injury being claimed. An example is a patient who develops PTSD following a surgical procedure that was carried out in a negligent way, even if the physical outcome was ultimately acceptable. The psychiatric condition is the injury caused by the negligent experience of treatment.

As a secondary head of damage: where the negligence caused physical harm and the patient has also developed a psychiatric condition as a consequence. In this situation, the psychological injury compensation is claimed alongside the physical injury damages. A person who suffered serious physical harm following a delayed cancer diagnosis, and who developed severe depression as a result of the diagnosis and its treatment, may claim both general damages for the physical harm and psychological injury compensation for the depression.

In both situations, the same fundamental requirements apply: the clinician must have breached the Bolam standard, and that breach must have caused the psychiatric condition claimed.

What are the JCG brackets for psychological injury compensation?

The Judicial College Guidelines (17th edition, April 2024) set out four brackets for general psychiatric damage:

Severe: £54,830 to £115,730. Cases where the person has marked problems with respect to factors such as the ability to cope with life and work, the effect on relationships, the extent to which treatment has been received or is likely to be received, future vulnerability, prognosis, and whether medical help has been sought. The person's ability to function is severely impaired.

Moderately severe: £19,070 to £54,830. Cases where there are significant problems, but where the prognosis is more optimistic. There has been some response to treatment but the condition remains significant at the time of assessment.

Moderate: £5,860 to £19,070. Cases where there has been marked improvement in the person's condition and the prognosis is good. The condition has had a real effect on the person's life but is not permanent.

Less severe: £1,540 to £5,860. Cases where the impact of the condition on daily activities and the period of disability are limited. Full recovery has occurred or is expected within a relatively short period.

These brackets apply to standalone psychiatric damage claims. Where psychiatric injury is claimed alongside physical injury, the brackets are applied to the psychiatric element separately and the award is assessed as a whole, with the court considering whether the total award is proportionate to the combined injury.

Specific conditions with their own JCG sections include PTSD: severe PTSD £59,860 to £100,670; moderately severe PTSD £23,150 to £59,860; moderate PTSD £8,180 to £23,150; less severe PTSD £3,950 to £8,180.

For a full explanation of how compensation is calculated, see the compensation guide.

What evidence is required for a psychological injury compensation claim?

The central piece of evidence is a report from an independent consultant psychiatrist or clinical psychologist. The expert must:

Diagnose the psychiatric condition using recognised diagnostic criteria (ICD-11 or DSM-5)
Assess the severity of the condition and its impact on daily functioning
Address causation: whether the negligence caused or materially contributed to the condition, distinguishing pre-existing vulnerability from the impact of the negligent event
Give a prognosis: whether and to what extent the condition is likely to improve with treatment

Pre-existing mental health conditions complicate the causation analysis. If a claimant had a prior anxiety disorder, the expert must assess the extent to which the negligence made the condition worse beyond what would have happened in any event. This is the "material contribution" analysis: the defendant is liable for the extent to which they materially worsened the claimant's pre-existing condition.

Special damages for psychological injury include the cost of private psychological or psychiatric treatment, medication, and any loss of earnings attributable to the condition.

Secondary victim claims and medical negligence

A secondary victim claim arises when someone suffers psychiatric injury not from negligence to themselves but from witnessing negligence to another person. These claims are tightly controlled by the law following Alcock v Chief Constable of South Yorkshire Police [1992] 1 AC 310.

To succeed as a secondary victim, the claimant must show: a close tie of love and affection to the primary victim; proximity in time and space to the negligent event or its immediate aftermath; and that the psychiatric injury was caused by direct perception of the event, not by being told about it.

In a medical negligence context, secondary victim claims are rare and difficult. The courts have generally held that witnessing the aftermath of negligent medical treatment does not satisfy the proximity requirements, though the law in this area continues to develop. Where secondary victim claims arise, they are technically complex and require specialist advice.

The case of Page v Smith [1996] AC 155 established that a primary victim (who was directly involved in the negligent act) does not need to show that psychiatric injury was foreseeable, only that some personal injury was foreseeable. This distinction is important where a claimant develops psychiatric injury in circumstances where physical injury might also have been expected.

Starting a psychological injury compensation claim

A psychological injury compensation claim follows the same process as any medical negligence claim: records are obtained, a breach expert assesses the clinical care, and a psychiatric expert assesses the psychological condition and causation.

The psychiatric expert report is usually the most significant piece of evidence, and its quality determines the strength of the claim. A report that diagnoses a recognised condition, clearly attributes its onset to the negligent event, and gives a credible prognosis is the foundation of a successful claim.

For a full explanation of medical negligence and the standard of proof required, see the main guide. For the step-by-step claims process, see the how to claim guide. Most solicitors handling psychological injury compensation claims work on a conditional fee basis: see the funding guide.

This page provides legal information, not legal advice. If you believe you have suffered a psychological injury as a result of medical negligence, speak to a qualified solicitor who specialises in clinical negligence.