NHS Resolution paid £622.2 million in claimant legal costs on clinical negligence claims in 2025/26, almost exactly the same as the year before. Underneath that flat total, average costs on the lowest-value claims rose 11%, and the fixed costs scheme aimed at those claims is still undecided.
The figures come from NHS Resolution’s Annual Report and Accounts for 2025/26, published on 9 July 2026. They cover the schemes it runs for the NHS in England, so they describe the paying party most claimant clinical negligence firms deal with. This note sets out the figures that bear on costs recovery and what they mean for the bills claimant firms put forward.
What NHS Resolution paid in 2025/26
Payments across NHS Resolution’s clinical schemes, in £ million:
| Payment | 2025/26 | 2024/25 | Change |
|---|---|---|---|
| Damages paid to claimants | 2,427.9 | 2,286.7 | +6.2% |
| Claimant legal costs | 622.2 | 620.9 | +0.2% |
| NHS legal costs | 188.4 | 181.3 | +3.9% |
| Total clinical scheme payments | 3,238.5 | 3,088.9 | +4.8% |
Damages grew faster than costs. Claimant legal costs made up 19% of clinical payments, down from 20% in 2024/25; damages rose from 74% to 75%, and NHS legal costs stayed at 6%. On its non-clinical schemes NHS Resolution paid a further £17.5 million in claimant legal costs, up 21%.
Average claimant costs per claim
The total hides a split by claim value. For clinical claims with damages of up to £25,000, average claimant legal costs paid per claim rose to £30,264, from £27,380 in 2024/25: an increase of 11%. NHS Resolution notes that average costs on these claims again exceeded the highest damages paid in that group. For claims with damages between £25,001 and £100,000, the average fell slightly, to £55,615 from £55,767.
Non-clinical claims, where costs are fixed, show the contrast. Their average claimant legal costs were £6,648 on claims up to £25,000 and £34,159 on claims between £25,001 and £100,000, both up 5%. That gap at the lower end is the background to the proposal to fix costs on lower-value clinical negligence claims.
More claims in, fewer closed
NHS Resolution received 15,236 new clinical negligence claims and reported incidents, up 6% from 14,428, including the largest volume of Clinical Negligence Scheme for Trusts claims it has received. It resolved 11,841 clinical claims, 11% fewer than in 2024/25, and closed 10,047 claims for compensation, 30% fewer. The report links both falls to the move to its new case management system, CaseHub.
Of the claims closed, 5,990 ended with damages and 4,057 without, so 60% closed with a damages payment, up from 54%. If the lower closure figures reflect the system change rather than fewer claims, more files may reach the costs stage in 2026/27.
84% resolved without litigation
84% of clinical claims were resolved without litigation in 2025/26, up from 83%. For claimant firms that usually means damages settle before proceedings are issued, which puts the costs position in the settlement wording. Where liability for costs is agreed but the amount is not, and nothing has been issued, the route is costs-only proceedings under CPR 46.14.
Fixed recoverable costs: still undecided
The Department of Health and Social Care proposed fixed recoverable costs for clinical negligence claims valued between £1,500 and £25,000, together with a streamlined pre-action protocol with fixed timelines. NHS Resolution’s report records that “the current Government has made no announcement on the future of the FRC scheme”, and that the Civil Procedure Rule Committee would be responsible for any rule changes.
The pressure has not gone away. The Public Accounts Committee’s report on the costs of clinical negligence found a 3.7:1 ratio of claimant and NHS legal costs to damages on low-value claims in 2024–25. It also recorded NHS Resolution’s claim to have saved over £138 million in 2024 by challenging the bills presented by claimant lawyers.
What this means for claimant firms
- Low-value bills draw the closest scrutiny. Where average costs exceed damages, the bill has to show why each stage of the work was needed: the records review, the experts instructed and the steps that moved the claim on. A clinical negligence bill of costs in Precedent S that sets out that chronology is easier to defend.
- Budgets set the ceiling early. Where costs budgeting applies, a realistic Precedent H budget for the CCMC protects the recovery that follows.
- Replies have to meet each objection. A paying party that challenges bills as a matter of course is answered item by item, not with a general response: see our guide to Points of Dispute in clinical negligence costs.
- Standard-basis recovery continues for now. Until a decision is made on fixed recoverable costs, the proposed scheme does not apply, and claimant costs on these claims are assessed in the ordinary way.
DMD Costs provides clinical negligence costs drafting for claimant solicitor firms, from Precedent H budgets to the bill, the Replies and negotiation to settlement.
Sources
- NHS Resolution, Annual Report and Accounts 2025/26 (Table 1; “Payments”; “Legal costs”; the note on fixed recoverable costs).
- NHS Resolution, announcement of the 2025/26 report (9 July 2026).
- House of Commons Public Accounts Committee, Costs of clinical negligence (paragraphs 21 and 23).