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United Kingdom

Responding to clinical negligence letters of claim in England and Wales: protocol compliance, preservation, investigation, privilege, experts, admissions, limitation, ADR and early case management

Practice notes
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Overview

This Practice Note offers high-level guidance on replying to a letter of claim in clinical negligence matters in England and Wales. A letter of response is the formal pre-action document issued under the Pre-Action Protocol for the Resolution of Clinical Disputes (the Protocol). In clinical negligence litigation, the letter of response:

  • sets out the defendant’s reasoned stance on breach of duty and causation
  • identifies which issues are admitted and which are contested
  • clarifies the expert disciplines to be relied upon
  • assists in narrowing the issues before proceedings commence

The defendant should acknowledge the letter of claim within 14 days and indicate who will manage the matter. The letter of response must be served within four months of receipt of the letter of claim. See Practice Note: The Pre-Action Protocol for the Resolution of Clinical Disputes—6 April 2015 onwards.

Initial considerations

On receiving a letter of claim, practitioners should consider:

  • whether the allegations disclose a viable claim
  • whether any obvious defence arises, including limitation
  • the seriousness and value of the alleged injury
  • whether urgent issues arise
  • who must be notified, including insurers or indemnifiers
  • which individuals within the...
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Web page updated on 21/05/2026

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