Should A & E receptionists owe a duty of care to patients?

 

On Wednesday 10th October 2018, the judgement in a case involving a member of the public and an NHS trust, was finally brought to an end in the Supreme Court, with a decision that whilst not a landmark decision, definitely shouts home the important roles every person within the NHS plays.

 

The Facts

In May 2010 the claimant Mr Darnley was involved in an assault which consequently resulted in him sustaining a head injury. Mr Darnley presented himself to A & E staff at the Croydon University Hospital (formally known as the Mayday University Hospital). At check-in stage, Mr Darnley advised reception staff that he had sustained a head injury and enquired about the time he would have to wait before he was seen. He was advised there was a 4-5 hour wait.

Not wanting to wait around, after 19 minutes Mr Darnley left the hospital. In fact had Mr Darnley waited he would have been seen by triage within 30 minutes! They would then have assessed his injuries and made an informed decision as to whether he could wait.

Once home Mr Darnley’s condition deteriorated and later that day he was rushed back to the hospital – this time by ambulance. Mr Darnley had suffered permanent brain damage, an injury when assessed could have been avoided if he had been treated earlier.

Mr Darnley took the NHS trust to court claiming they owed a duty of care to not give misleading information whether this was via medical or non-medical employees.

 

 

 

High Court and Court of Appeal decision

In April 2015 the case was taken to the High Court and in 2017 Mr Darnley appealed to the Court of Appeal. The debate in both courts between the two sides was whether there was a duty owed to the claimant by a non-medial receptionist.

In both instances the judge’s referred to the case of Caparo Industries plc v. Dickman [1990] 2 AC 605 and as a result ruled that the staff’s actions of misleading information was not a breach of duty of care and to find them liable would not be ‘fair, just and reasonable’. They also found that due to Mr Darnley leaving the hospital premises he had broken the chain of causation.  All four judges ruled in favour of the defendant.

Supreme Court Ruling

In June 2018 the case of Darnley v. Croydon Health Services NHS Trust [2.18] UJSC 50 was heard in front of five judges of the Supreme Court lead by Lady Hale.

The judges informed the court that the test in Caparo Industries plc v. Dickman had been wrongly applied as this was an established duty not a novel duty, as when Mr Darnley entered the A & E department a patient/hospital relationship was established.

The judges found that the hospital owed a duty of care to not provide misleading information which may lead to personal injury and directed the respondents in future to provide more accurate information, either by way of orally speaking or in the form of leaflets and notices around the waiting room and reception area.

In a ruling on a majority of 5:0 the Supreme Court ruled in favour of Mr Darnley and have now referred the case back to the Queen’s Bench Division to make a ruling for damages.

 

What this mean’s going forward?

Despite the ruling by the Supreme Court not being a landmark case, it has highlighted that more needs to be done in our NHS to make patients aware of timings so they can make an informed decision themselves.

The NHS is over-stretched already and as advised by the judges in the Supreme Court, it cannot go unnoticed that the receptionists in A & E departments are over worked and sometimes are the target for verbal abuse and their jobs are just as hard as those behind the scenes. This case may open a can of worms with non-medical staff refusing to give information in fear of giving the wrong information which may or may not have been relayed to them.  However, it is down to the trusts to make sure their staff are equipped with the right information going forward to make sure this situation is never repeated.

 

A full report of the case can be found here: https://www.supremecourt.uk/cases/docs/uksc-2017-0070-judgment.pdf

 

By Victoria-Jayne Scholes LLB (Hons)

[1] Illustration thanks to https://www.yourlocalguardian.co.uk/news/13419567.Croydon_University_Hospital_s___1_1m_x-ray_boost/

 

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