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

A&E receptionist found negligent due to misleading information on waiting times

Mr Darnley went to A&E with a head injury following an assault. After being booked in by a receptionist he was told that he would have to wait up to five hours to be seen. Receptionists given evidence confirmed that this information was not correct: patients with head injuries could expect to be seen by a triage nurse within half an hour.

Mr Darnley went home about twenty minutes later as he felt too unwell to stay. His condition got worse and he was rushed back to hospital in an ambulance about an hour later for the evacuation of a haematoma. He was left with severe and disabling brain damage.

It was accepted that if given correct information about waiting times Mr Darnley would have stayed at A&E, would have been there when his condition worsened and would have made a near full recovery.

Reversing the decision of the Court of Appeal, the Supreme Court ruled that the reception staff owed Mr Darnley a duty of care at least to not give him misleading information about waiting times. Where that misinformation resulted in reasonably foreseeable harm, as had happened here, the hospital would be responsible.

The Court of Appeal had placed a lot of weight on the receptionists being non-clinical staff, but the Supreme Court disagreed. As the hospital had decided to give information about waiting times through non-clinical staff it was up to them to ensure that it was done correctly:

‘…a receptionist in an A & E department cannot, of course, be expected to give medical advice or information but he or she can be expected to take reasonable care not to provide misleading advice as to the availability of medical assistance. The standard required is that of an averagely competent and well-informed person performing the function of a receptionist at a department providing emergency medical care.’

 

Comment

The briefest search will return a number stories about people being turned away from A&E, and we regularly hear from people with mental health problems being unable to access support this way. In times of crisis, including mental health crisis, A&E may be an appropriate last port of call, and it needs to be open for all types of urgent care.

In some cases people are turned away following an assessment by a mental health professional. This can be difficult enough but some people struggle to get that far, being told that they can only access urgent support through their CMHT. Some people we have heard from have it expressly written in their care plan that they cannot attend A&E.

This decision has important implications for people who only come into contact with frontline non-clinical staff. It could apply to information beyond waiting times. It might be that anyone who is known to a CMHT cannot be seen at A&E. It is not unforeseeable that a person turned away from A&E in a mental health crisis could come to serious harm, or worse.

We hope that this decision will lead to hospitals taking a close look at the information people are being given in their first point of contact and ensuring that this is correct.

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