Darnley v Croydon Health Services NHS Trust [2018] UKSC 50

Facts

• Mr. Darnley attended the accident and emergency (A&E) department of Croydon Health Services NHS Trust after sustaining a head injury.
• Upon arrival, a hospital receptionist informed Mr. Darnley that he would have to wait four to five hours to see a doctor.
• Relying on this information, Mr. Darnley left the hospital without receiving medical attention.
• Later, his condition deteriorated, and he was transported back to the hospital by ambulance.
• As a result of the delay in receiving treatment, Mr. Darnley suffered permanent brain damage, which would have been avoided had he stayed at the hospital initially.
• Mr. Darnley sued the Trust, alleging a breach of duty of care due to the receptionist’s misinformation.
• The claim and subsequent appeal were initially dismissed by the trial judge and the Court of Appeal, who found no duty to advise on waiting times and held that leaving the A&E broke the chain of causation.

Issues

1. Whether a hospital receptionist owes a duty of care to provide accurate information to patients about likely waiting times.
2. Whether the misinformation about waiting times given by the receptionist constituted a breach of duty.
3. What standard of care applies to administrative staff in an A&E context.
4. Whether Mr. Darnley’s decision to leave the hospital, having received misleading information, broke the chain of causation and absolved the Trust from liability.

Decision

• The Supreme Court overturned the lower courts’ judgments, finding in favour of Mr. Darnley.
• It was held that the hospital’s duty of care to patients presenting at an A&E department extends to the provision of accurate information about waiting times, applying to all staff including administrative personnel.
• The standard of care for receptionists is that of an averagely competent and well-informed person performing that role in an emergency department.
• The receptionist’s misleading statement regarding waiting times amounted to a negligent breach of duty.
• Mr. Darnley’s decision to leave the hospital, given the misinformation, was foreseeable and did not break the chain of causation.
• The Trust was held liable for the injuries suffered by Mr. Darnley as a result of the delay in treatment.

Legal Principles

• Hospitals owe a duty of care to all patients presenting at A&E, including in the information provided by administrative staff.
• The standard for breach is that of an averagely competent and well-informed person in the relevant administrative role.
• There is no distinction between medically qualified and administrative staff in determining the existence of a duty of care, though the required competencies differ.
• The Caparo test is not required where a duty of care is already established in the hospital-patient relationship.
• A patient’s foreseeable reaction to negligent misinformation does not necessarily break the chain of causation.

Conclusion

The Supreme Court established that NHS Trusts owe a duty of care encompassing the actions and statements of both medical and administrative staff, requiring accurate communication to patients in A&E. Misleading information by a receptionist about waiting times constituted a negligent breach that resulted in liability for consequent harm, and a patient’s foreseeable decision to leave based on such information does not sever causation.