In the recent case of Darnley v Croydon Health Services, the Supreme Court has confirmed the existence of a duty of care to patients at A&E departments claiming illness or injury, even if they are not seen by a medical professional.
The facts of the case
In this case, the claimant, Mr Darnley, arrived at the A&E department of Mayday hospital in Croydon and claimed he had sustained a head injury. The receptionist informed him that he would have to wait 4-5 hours to be examined, despite his protestations that this was not fast enough. He left the department 19 minutes later but was later rushed back when he collapsed, and a CT scan found that he suffered a large bleed on his brain. Although he was then treated, he suffered left side paralysis.
The receptionist confirmed to the court that the standard practice was to inform patients such as Mr Darnley that a triage nurse would see them within 30 minutes if they were complaining of a head injury. The Court upheld the trial judge’s ruling that it was reasonably foreseeable for a person in Mr Darnley’s position to leave the hospital after being told they would have to wait 4-5 hours to be seen by a medical professional.
The Supreme Court found that the Trust was guilty of medical negligence, even though the patient’s only contact had been with non-clinical staff, and Mr Darnley had left the hospital before it could be expected for him to be seen by a triage nurse.
The importance of the ruling
This case confirms that patients are owed a duty of care by a hospital Trust even if they are not seen by a nurse or doctor and that even non-clinical staff, such as receptionists, have a duty not to give negligent advice. The Court did not waste time in confirming this, with Lord Lloyd-Jones saying that the real issue of the case was whether or not there had been a breach of the duty, not the existence of the duty of care itself.
The existence of non-clinical medical negligence might be seen as an unnecessary burden to put on the shoulders of non-clinical staff in hospitals and health centres, but the existence of a duty of care to patients in A&E before they are examined is not new.
As Lord Lloyd-Jones remarks, "the present case falls squarely within an established category of duty of care." The risk of a Trust being sued for negligence if a receptionist gives negligent advice might make receptionists take on a more defensive practice; counterproductively giving out less information to patients.
However, it is difficult to imagine how any hospital department could function effectively if receptionists and other non-clinical staff limited their output in such a way. Instead, it may be that the judgement will encourage better training and clearer standard practice guidance to be produced for non-clinical staff to follow.
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