East London Foundation Trust: An embedded and sustained “no blame” culture has resulted in marked reductions in the length of time clinical claims take to settle

Changing the culture has helped East London FT settle clinical negligence claims in just over half the time it takes nationally – 2.29 years rather than 4.39 years on average.

Incident investigations are carried out transparently and in a spirit of co-operation with the aim of improving services, and patient and staff experience.

The reduction of time in litigation led the trust to target a reduction in violence across adult mental health services, which was a major cause of litigation. The costs of this were reduced from £31,000 in 2014-15 to £700 in 2015-16 and the downwards trend has continued.   

The focus on transparency has meant problems are addressed before they turn into legal claims, and staff are encouraged to learn from experiences at quality improvement events.

Staff are supported through investigation processes and any further action. The trust’s approach is beginning to influence other organisations.

Read a detailed case study about this project at HSJ Solutions


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  • Gloucestershire Hospitals FT: Investigation, Resolution and Learning through Centralised Investigation
  • Walsall Healthcare Trust: Engagement for Learning