Is a hospital liable for an A&E receptionist providing erroneous waiting time information?
I have recently written for Lexis Nexis on the case of Darnley v Croydon Health Services NHS Trust [2015] EWHC 2301 (QB).
The case is a very interesting case because it concerned allegations against both non-clinical and clinical A&E staff, but it is most important for the decision relating to the duty of non-clinical receptionists in A&E (and, by extrapolation, other non-clinical staff). In short, the judge concluded that such staff were not to held to be liable for a head-injured claimant leaving A&E and going home after only 19 minutes, even though it was after, and as a result of, the receptionist telling him incorrectly that he had a 4 to 5 hour wait before being seen. The judge found that this was the only information that the reception staff gave to Mr Darnley and he had not been told about being seen earlier by a triage nurse. The judge also determined that, had the claimant been told he would have been seen within 30 minutes, he would not have left the A&E, his brain haemorrhage would have occurred whilst in hospital such that he would have received urgent treatment and he would not have suffered neurological injury.
In considering whether the reception staff should have told the claimant he would be seen in 30 minutes rather than 4 to 5 hours, the judge concluded that, whilst it was reasonably foreseeable that a patient might leave A&E in the belief that he would not be seen for 4-5 hours rather than 30 minutes and that harm could result, receptionists were not under a duty to guard against harm coming to patients caused by the failure to wait to be seen in A&E and it would not be fair, just and reasonable to impose liability on the receptionist for harm arising in this case as a result of the failure to inform the claimant of the likely waiting time to be seen by a triage nurse. The judge stated that he reached this conclusion on the basis that (a) the duty of civilian receptionists was to complete relevant registration forms competently; (b) provision of (accurate) waiting time information was a courtesy, and not mandatory; and (c) the imposition of liability on reception staff may result in that courtesy (and possibly other courtesies) being removed, which ultimately would be detrimental.
The Judge also concluded that non-clinical staff were not to be the subject of the same legal test as that of clinical staff and were assessed against “the standard of a member of the public exercising common sense” rather than the traditional Bolam test, based on medical expert peer review, used when assessing clinical staff.
In essence, the key take-home point is that any case against non-clinical hospital staff is very unlikely to succeed unless it can be shown that the member of staff under scrutiny fell below the standard of the reasonable person and that it would be appropriate public policy to hold that staff member (and ultimately the hospital employer) liable in the particular circumstances of the case.