Every one a published decision of the courts of England and Wales, linked to its source. Seven of the nine did not succeed, and they are the most useful reading.
Claimant succeeded
[2019] EWHC 520 (QB)·2019·Liability decided at trial
Two days after a back injury, Mrs Shaw attended an out-of-hours GP with severe low back pain, numbness and tingling in both legs, difficulty walking and a urinary accident. The judge found these red-flag signs of cauda equina syndrome were present and were missed, so the GP should have sent her straight to hospital.
An out-of-hours GP who fails to pick up cauda equina red flags (bilateral leg symptoms, bladder problems, leg weakness) and does not refer to hospital falls below the standard of a reasonable GP. A doctor's belief that he would not have missed it carries little weight if the records do not support it.
Claimant succeeded
[2011] EWHC 13 (QB)·2011·Liability decided at trial
A fourteen-year-old with days of high fever, vomiting and lethargy was not admitted to hospital by her GP on the Saturday, and the out-of-hours doctor that night managed her by phone instead of visiting; by the time she reached A&E the next morning she deteriorated and suffered irreversible brain damage. The judge found both doctors liable but dismissed the claim against the hospital because it could not be proved when the damage occurred.
A GP who recognises a possible pneumonia in a seriously unwell child but defers investigation for two days, and an out-of-hours doctor who does not visit despite worrying symptoms, can both be held liable when earlier admission would have avoided the injury. A hospital's breach does not lead to liability unless the timing of the damage can be linked to it.
Claim failed
[2015] EWHC 276 (QB)·2015·Liability decided at trial
A four-year-old with fever, headache and vomiting was seen at an out-of-hours walk-in centre on New Year's Day and sent home with advice to return if he did not improve; the next evening he was admitted with meningitis and was left severely disabled. The judge held the GP's management was within the range of acceptable practice and dismissed the claim.
A feverish child sent home with safety-netting advice is not automatically a negligent consultation; the court asks whether a reasonable GP could have acted the same way. Hindsight about a devastating outcome does not prove breach of duty.
Claim failed
[2013] EWCA Civ 547·2013·Appeal decision
A six-week-old premature baby was seen at an out-of-hours clinic, diagnosed with colic and not referred to hospital; he developed bacterial meningitis and was left severely disabled. The trial judge accepted the GP's contemporaneous note over the mother's recollection of symptoms and found no negligence, and the Court of Appeal upheld that decision.
Even where earlier hospital referral would have prevented the injury, the claim fails if the court accepts the GP's record of what the child looked like at the consultation. Contemporaneous clinical notes can outweigh a parent's later recollection.
Claim failed
[2023] EWHC 156 (KB)·2023·Liability decided at trial
A three-year-old was diagnosed with tonsillitis by a GP registrar, deteriorated over the next two days and was then referred to hospital, where meningococcal meningitis was diagnosed. The court found no causative breach of duty and dismissed the claim.
Meningitis claims against GPs often fail because early symptoms genuinely resemble common childhood infections; the claimant must show both that the GP fell below a reasonable standard and that earlier referral would have changed the outcome.
Claim failed
[2020] EWHC 3445 (QB)·2020·Liability decided at trial
A two-and-a-half-year-old girl seen at a Badger out-of-hours centre was diagnosed with a sore throat and sent home; two days later scans showed hydrocephalus and brain abnormalities needing emergency neurosurgery, leaving her profoundly disabled. This judgment decided only whether the NHS commissioning body was legally responsible for the nurse practitioner's alleged negligence, and held it was not.
When an NHS body contracts an outside provider to run out-of-hours services, the NHS body does not automatically carry a non-delegable duty for that provider's clinicians. Claims must be brought against the clinician and the out-of-hours provider themselves.
Claim failed
[2006] EWCA Civ 1028·2006·Appeal decision
A five-year-old whose overnight glucose pump failed had a hypoglycaemic fit; the GP who came to the house gave suppositories rather than the intravenous glucose he was carrying, and the boy suffered fatal brain damage. The trial judge found the GP negligent but not that IV glucose would have saved him, and the Court of Appeal upheld that decision and refused to admit new evidence.
Proving a doctor was negligent is not enough; the claimant must also prove that correct treatment would have changed the outcome. The court also held that an expert's undisclosed link to the defendant's medical defence organisation did not by itself make his evidence inadmissible.
Mixed outcome
[2018] EWHC 2715 (QB)·2018·Appeal decision
A man with a disc problem developed cauda equina symptoms and the out-of-hours GP told him to go to A&E rather than arranging direct orthopaedic assessment; surgery came many hours later and he was left with permanent bowel and bladder problems. A Master had struck out the claim against the GP by summary judgment, but the High Court allowed the claimant's appeal so the claim against the GP could go to a full trial.
Clinical negligence claims should rarely be disposed of by summary judgment before the expert evidence has been exchanged. The ruling did not decide whether the out-of-hours GP was negligent, only that the question had to be tried.
Claim failed
[2018] EWHC 1345 (QB)·2018·Liability decided at trial
A man with back pain and new groin numbness phoned his GP, who told him to go to A&E rather than ringing the hospital orthopaedic team directly. Master Cook found the GP had credible expert support for that approach and struck out the claim against him.
Sending a suspected cauda equina patient to A&E by ambulance can be a defensible GP response. A GP claim will fail at an early stage if a responsible body of GPs would have done the same.