Bolam test meaning

McCulloch and others v Forth Valley Health Board (Scotland) [2023] UKSC 26 What are the practical implications of this case? In Montgomery v Lanarkshire Health Board [2015] AC 1430, the Supreme Court confirmed that doctors must take reasonable care to make sure patients are told about any material risks of a recommended treatment, as well as any reasonable alternative or variant treatments. It explained that the materiality of a risk is assessed, among other things, by asking whether a reasonable patient would attach importance to it. In McCulloch the Supreme Court clarifies that deciding whether an alternative is a ‘reasonable’ option lies within professional medical judgment, and is therefore determined by the Bolam approach—namely the test in Hunter v Hanley 1955 SC 200 and Bolam v Friern Hospital Management Committee [1957] 1 WLR 582. The result is that patient choice has suffered. To show that not disclosing an alternative was reasonable, a doctor need only point to a reasonable body of...

Original news Halsall & Ors v Champion Consulting Ltd & Ors [2017] EWHC 1079 (QB) What should dispute resolution lawyers take note of? Dispute resolution lawyers should note: the potentially broad consequences of the court’s conclusion that the defendants gave affirmative advice rather than merely passing on information (SAAMCO). Absent a limitation defence, they would have faced liability for all losses the claimants suffered by entering the schemes professional advisers cannot invariably depend on their terms of business (TOB) to restrict the retainer’s scope if those terms conflict with earlier clear representations On breach, the court used the Bolam test as refined by Bolitho. Yet Montgomery v Lanarkshire Health Board was not referred to, leaving uncertainty as to whether that approach still holds for negligence based on failing to warn of risks. The notion that the court need consider the claimant’s counterfactual conduct only where the negligence is a failure to advise is doubtful. The claimant must in every case...

Conway (by his father and litigation friend Luke Conway) v Yeovil District Hospital NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust [2025] EWHC 2488 (KB) What are the practical implications of this case? Conway stands as a clear illustration of a court working through the Supreme Court’s principles in Meadows v Khan [2022] AC 852, though in a distinct context. In Meadows, the claimant underwent blood tests to check if she carried the haemophilia gene. She was told by doctors she was not a carrier and that any child she conceived would not have haemophilia. Her son was born with both haemophilia and autism. Had she known she was a carrier through genetic testing, rather than blood tests alone, she would not have proceeded to have a child. The issue was whether she could also recover wrongful birth damages for the costs associated with her son’s autism, a condition independent of his haemophilia. The Supreme Court held she could not, as that loss fell outside...

This Practice Note addresses the principle of self-determination, valid consent, implied consent, provision of sufficient information in line with Montgomery, and causation. A doctor may lawfully treat a patient only where consent has first been obtained. This applies whether the intervention is a straightforward test or an invasive procedure. In reality, consent disputes usually emerge after more serious, higher-risk care such as surgery. Any adult who has the mental capacity to make their own treatment choices may accept or decline care, even where refusal could result in permanent harm or death to them or to their unborn child. Nor can such treatment be justified by detaining the person as a mental patient. For additional issues on consent—emergency treatment, withdrawal, capacity, professional guidance, battery, and Human Rights Act 1998 claims—see Practice Note: Consent in clinical negligence claims—capacity and other issues. The principle of self-determination The principle of self-determination sits at the heart of medical law and consent disputes in clinical negligence. See Airedale NHS Trust v Bland...

ARCHIVED: This archived Practice Note sets out key dispute resolution (DR) appeals or notable appellate court rulings in the sphere of general civil litigation in England and Wales from 2023 to the present, and highlights significant pending appeal matters (to support horizon scanning) alongside reported decisions handed down by the Supreme Court, Court of Appeal, Competition Appeal Tribunal, Judicial Committee of the Privy Council (the Privy Council), Court of Justice of the European Union (Court of Justice) and the European Court of Human Rights (ECtHR). Links are provided to each judgment and any bespoke News Analysis to aid comprehension of the principles addressed in the decisions and the impact of those rulings. This Practice Note comprises two elements designed to help dispute resolution practitioners stay current with developments in case law that affect their practice area, or that bear upon civil litigation procedure more generally: selected forthcoming appeals to the Supreme Court are listed below; see Dispute resolution: key appeal cases—2023—Key forthcoming appeals to the Supreme...

The duty of care Healthcare practitioners owe their patients a duty of care. That obligation, arising in the course of their care, requires the exercise of reasonable care to: obtain a full and adequate medical history thoroughly explore the patient’s symptoms and concerns formulate appropriate and reasonable differential diagnoses arrange referrals to relevant specialists where required take action to pursue all reasonable measures to safeguard the patient’s health deliver a reasonable and proportionate course of treatment follow up with the patient afterwards where that is reasonably necessary For guidance on identifying the proper defendant in a clinical negligence claim, see Practice Note: Identifying the correct defendant in clinical negligence claims. The duty is not confined to medical practitioners alone; it may extend further. Non-clinical staff Employees within a healthcare organisation or facility may owe a direct duty to patients. In Darnley v Croydon Health Services NHS Trust, the claimant attended A&E with a head injury...