Use of guidelines in clinical negligence cases

O'Brien (Administratrix of the Estate of Mr Berry (Deceased)) v Guy's & St Thomas' NHS Trust [2022] EWHC 2735 (KB)

For many years, reference has been made during clinical negligence litigation to guidelines from various authoritative organisations, and much has been written on the subject. Guidelines can be particularly useful when the key focus is on the alleged failure of a clinician to meet the required standard of care under the criteria established in Bolam v Friern Hospital Management Committee [1957] 1 WLR 583,as modified by the House of Lords in Bolitho v City and Hackney Health Authority [1998] AC 232. However, in some instances, there might be more than one set of guidelines covering the same procedure, and this situation can result in confusion for clinicians, who are obliged to follow reasonable instructions from their employer but are also aware of those issued by the GMC, the Royal Colleges, NICE and other respected organisations. In a recent case, the court considered the significance of a Trust's guidelines issued in respect of ICU care, where the local guidelines were not in every respect aligned with national clinical guidelines.