Patients owed a duty of care by non-medical Emergency Department staff

The Supreme Court in Darnley v Croydon Health Services NHS Trust has unanimously decided that patients attending an Emergency Department are owed a duty of care not just by medical staff but also administrative staff such as receptionists.

Briefly, in May 2010, Mr Darnley was assaulted and struck on the head.  He complained of a worsening headache to his friend who took him to the Emergency Department of the Mayday Hospital in Croydon where he was booked in at 8:26pm.  He was told by the receptionist that he would have to wait between 4 and 5 hours to be seen.  19 minutes later at 8:45pm, feeling worse and wanting to go home to bed, Mr Darnley left the Emergency Department without informing anyone.  At home, he collapsed and an ambulance brought him back to hospital at 10:38pm.  He underwent emergency surgery but has been left with permanent brain damage.

The claim arose out of the information given by the receptionist as it was alleged the advice he would have to wait between 4 and 5 hours was inaccurate and misleading as he should have been told he would be seen by a triage nurse within 30 minutes.  At first instance, the Judge accepted the following:

  • Mr Darnley would have remained at the hospital had been told that he would be seen within 30 minutes of arrival.
  • Following triage, he would have either been admitted or told to wait and if he was told to wait, he would have waited.
  • If he had waited, his collapse would have happened in a hospital setting and he would have had earlier surgery and a near full recovery.
  • Mr Darnley’s decision to leave was based partly on the inaccurate that he was given by the receptionist about waiting times.
  • It was reasonably foreseeable that a person told he would have to wait for 4 to 5 hours might leave without treatment and then might go on to suffer physical harm as a result.

The claim however failed as the Judge held that there was no duty of care owed by the receptionist to patients attending the Emergency Department.  This was upheld by the Court of Appeal.

However, the Supreme Court has taken a different view and has held that the question is not whether a receptionist owes a duty of care to a patient, it is the hospital that owes the duty of care and this duty is well established.  As soon as a patient arrives at the Emergency Department and is booked in, the hospital owes that patient a duty of care which includes a duty to ensure a patient is not provided with inaccurate and misleading information.  As it is the hospital that owes the duty of care, there is no distinction between advice given by clinical and administrative staff.

Although this case relates to the advice given by a receptionist at an Emergency Department, the same principle can apply to advice given by clerical staff in any healthcare setting such as at GP surgeries or transport services.  It is important to remember that whilst a number of claims for injuries are the result of treatment provided by doctors, dentists and nurses, this is not always the case.

Kathryn Watson, December 2019