• In the case of Darnley v Croydon Health Services NHS Trust 2018 UKSC 50 2019 ac 831, it was held an NHS Trust had a duty of care not to cause physical injury to those who presented themselves at A&E.
  • This duty includes not to give out misleading information about how long patients might wait before been seen by a clinician.

Facts of the Case

  • The appellant appealed against a decision that an NHS Trust’s duty of care did not extend to providing patients with accurate information about waiting times in A&E).
  • The appellant had gone to A&E after sustaining a head injury and told by the receptionist that it would be four to five hours before he would be seen.
  • This was, however, inaccurate; she should have told him that he would be examined by a triage nurse within 30 minutes and that the triage nurse would decide how soon he needed to see a doctor.
  • As the appellant was unaware of this, he went home without alerting anyone.
  • At home, he collapsed and was returned to hospital by ambulance.
  • Although he underwent neurosurgery, he suffered permanent brain damage in the form of a left hemiplegia.
  • As a result, he claimed damages from the trust, alleging that it had breached its duty of care to him when he first presented at A&E by failing to assess him for emergency triage and failing to give an accurate timeframe that he would have been seen by a clinician.
  • The trial judge found in favour of the hospital and the Court of Appeal dismissed the appellant’s appeal, holding by a majority that neither the receptionist nor the trust acting by the receptionist had any duty to advise about waiting times.
  • Alternatively, it found that the appellant had broken the chain of causation by leaving A&E when he did.

Issues in Darnley v Croydon Health Services NHS Trust 2018 UKSC 50 2019 ac 831

  • Was the trust under a duty of care to provide the appellant with accurate wating times
  • Did the appellant satisfy the requirements to break the chain of causation.

Held by Supreme Court

  • Appeal allowed

Lord Lloyd-Jones JSC

  • Here, those running an A&E department owed a duty to take reasonable care not to cause physical injury to those who presented themselves complaining about an injury and that duty existed before the patient was treated.
  • The trust had charged its non-medically qualified staff with being the first point of contact for those seeking medical assistance and, consequently, those members of staff were responsible for providing accurate information about the availability of medical assistance. The trust’s duty of care had to be considered in the round. It had a duty to take care not to provide misinformation and could not avoid that duty simply because the misinformation was given by receptionists rather than clinicians
  • While it was impossible for A&E receptionists to give each patient accurate information as to precisely when they would be seen by a clinician, it was not unreasonable to require them to take reasonable care not to provide misleading information as to the likely availability of medical assistance. 
  • “The appellant had not broken the chain of causation. Three findings made by the trial judge were critical in that regard. First was the finding above. Second was the finding that had the appellant been told that he would be triaged within 30 minutes, he would not have left, his collapse would have occurred within the hospital, he would have undergone surgery sooner than he did, and he would have made an almost complete recovery. Third was the finding that the appellant’s decision to leave had been based at least in part on the information given to him by the receptionist” [28-31]