Darnley v Croydon Health Services NHS Trust [2018] UKSC 50; [2019] AC 831

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.

• 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.

Appeal allowed 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.

An A&E department's existing duty to patients includes reasonable care in information given by reception staff about access to treatment. Misleading waiting-time information can cause actionable injury where it induces departure and delays treatment; exact appointment-time guarantees are not required.

Darnley applies an established clinical duty to the hospital's reception function rather than inventing a separate duty for every administrative interaction. It also illustrates why a patient's decision to leave is not automatically an intervening act: the decision may be the foreseeable consequence of negligent information. The factual findings about remaining for triage and the benefit of earlier surgery were essential. Compare Barnett, where negligent care was established but would not have changed the outcome.