An Apex Review of Clinical Negligence Trends in 2025

Each year brings new insights into how clinical practice, NHS pressures, regulatory change, and legal expectations shape the landscape of clinical negligence. For those of us who work daily at the intersection of healthcare and law, 2025 was a year of both familiar patterns and emerging challenges.

Across the cases reviewed by our expert witness panel, certain themes recurred with particular clarity. These patterns not only reveal where systems continue to struggle but also highlight opportunities for learning, prevention, and better alignment between healthcare delivery and medico legal processes.

This deep dive explores the most significant clinical negligence trends we observed in 2025 and what they mean for solicitors, expert witnesses, and healthcare organisations moving forward.

1. Documentation Quality Continued to Influence Case Outcomes

One of the most consistent findings throughout 2025 was the decisive role played by documentation. Despite improvements in digital record systems, documentation issues remained a significant contributor to litigation risk.

Common problems included:

• Incomplete risk assessments

• Gaps between paper and electronic notes

• Delayed entries

• Retrospective corrections without clear rationale

• Missing observations or escalation records

In many cases, the care delivered was likely reasonable, but the absence of clear, contemporaneous documentation made it difficult for defendants to demonstrate compliance with national standards. Conversely, claimants often relied on documentation deficiencies as evidence that care fell below expected levels.

The message remains unchanged. In clinical negligence, documentation is not ancillary. It is the evidential foundation of defensible care.

2. Escalation Failures and Recognition of Deterioration Remained High Risk

2025 saw continued scrutiny of escalation pathways, particularly in:

• Early Warning Score responses

• Maternity red flag escalation

• Sepsis protocols

• Post-operative deterioration

• Paediatric and neonatal deterioration

Martha’s Rule, now rolled out in all acute trusts, has heightened expectations around listening to concerns voiced by families and staff. Several cases highlighted missed opportunities where non clinical observations from relatives could have triggered earlier review.

The trend is clear. Courts and investigators increasingly expect organisations to demonstrate a proactive, structured approach to recognising deterioration. A failure to escalate, even within a pressured environment, is unlikely to be excused.

3. Causation Questions Became More Complex and More Common

As the complexity of patient presentations increased, so did complexity in causation analysis. With an ageing population and rising multi morbidity, experts were frequently required to consider:

• Pre-existing conditions

• Natural disease progression

• Delays that may or may not have altered outcome

• Interactions between multiple risk factors

• System-level pressures influencing individual outcomes

2025 highlighted that breach and causation are no longer straightforward in many cases. Even where breach appears clear, determining whether the breach made a material difference requires careful, structured reasoning. Expert analysis was increasingly expected to offer balanced consideration of alternative scenarios and to acknowledge clinical uncertainty where relevant.

For solicitors, this emphasised the importance of early screening reports and early expert instruction, ensuring that causation difficulties are identified before significant cost is incurred.

4. Family Communication and Duty of Candour Featured More Prominently in Claims

Another trend in 2025 was the growing relevance of communication quality in negligence disputes. Families increasingly raised concerns about:

• Being reassured without documented clinical justification

• Receiving partial or conflicting information

• Delayed updates after incidents

• A lack of transparent explanation when things went wrong

The courts continued to recognise that communication is a clinical act in its own right. In several cases, poor communication formed part of the negligence claim, particularly where it contributed to delays in escalation or where it obscured the significance of clinical deterioration.

Duty of Candour compliance also featured more frequently in disclosure reviews. Where organisations failed to follow policy, the credibility of the trust’s evidence was noticeably weakened.

5. Joint Expert Meetings Became a More Strategic Stage in Litigation

In 2025, Joint Expert Meetings (JEMs) played a pivotal role in shaping the trajectory of many cases. With increasing judicial emphasis on cooperation and narrowing of issues, more cases saw early resolution following productive JEMs.

Three observations stood out:

1. When experts were well prepared, JEMs provided significant clarity and reduced unnecessary dispute.

2. When reasoning was weak or inconsistent, JEMs exposed vulnerabilities in expert evidence quickly.

3. The quality of joint statements often influenced whether parties chose to settle or proceed to trial.

   
   

For solicitors, preparing experts for JEMs became even more essential. For expert witnesses, maintaining independence, clarity and balanced reasoning was vital in sustaining credibility.

6. Winter Pressures and System Strain Continued to Feature in Litigation

Although systemic pressures do not lower the legal standard of care, winter 2024 and early 2025 created conditions in which multiple failures were more likely to occur.

Litigation in 2025 increasingly referenced:

• Long emergency department waits

• Staff shortages

• Overcrowded wards

• Delayed treatment or investigations

• Inadequate supervision due to capacity strain

While courts recognised the pressures, they consistently reaffirmed that professional standards cannot be compromised. Individual clinicians must still escalate, monitor, document and prioritise within the realities of their environment. System strain may explain the context but does not excuse unsafe practice.

7. Increased Use of Digital Evidence Created New Considerations

The rise of electronic health records, SMS updates, WhatsApp messages, and digital handover tools meant that more cases relied on digital evidence.

This provided both benefits and challenges:

• Digital timestamps improved clarity of timelines

• Missing digital entries became more obvious

• Mixed paper and digital systems led to contradictory information

• Metadata gained greater relevance in disclosure

2025 reinforced the need for robust digital governance and comprehensive disclosure to avoid evidential gaps.

Final Thoughts on 2025's Clinical Negligence Trends

The clinical negligence landscape of 2025 taught us that although healthcare evolves, certain themes persist. Documentation, escalation, communication, and clarity of reasoning remain central pillars of defensible practice. At the same time, new pressures and new technologies continue to shape how cases are investigated, analysed, and resolved.

At Apex Experts, these lessons guide how we support solicitors, insurers and regulatory bodies. Our expert witness panel has seen these patterns first hand, and we use this insight to provide independent, evidence based reports that help clarify even the most complex cases.

For support with expert evidence, JEM preparation, screening reports or case strategy, get in touch!