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  • Graham Balmforth

"Understanding the Implications of Paul & Another v Royal Wolverhampton NHS Trust [2024] UKSC 1"

Updated: Feb 25

Paul & Another v Royal Wolverhampton NHS Trust - Blog Article - A simple approach to the new positon
Paul & Another v Royal Wolverhampton NHS Trust

Navigating the intricate realm of clinical negligence claims, particularly regarding compensation for secondary victims, poses significant challenges due to the complex legal tests involved. Shedding light on these complexities is the English case of Paul & Another v Royal Wolverhampton NHS Trust [2024] UKSC 1, offering valuable insights for individuals considering such legal action.

Initial Points on Secondary Victim Claims

Secondary victims, within the context of clinical negligence, are individuals who suffer psychological harm from witnessing the injury or death of a loved one due to medical negligence. Unlike primary victims who directly experience the harm, secondary victims encounter additional legal obstacles in substantiating their claims.

The Significance of Paul v Wolverhampton NHS Trust

The Paul case serves as a pivotal judgment, setting essential precedents for secondary victim claims. It underscores the necessity for meeting clear and specific criteria when seeking compensation in such instances and establishes that clinicians do not bear a specific duty to shield families from witnessing their loved one's injury or demise due to treatment.

Key Elements for Proof

  • Proximity to the Incident

Central to a secondary victim claim is the proximity of the individual to the event. The closer the relationship with the primary victim and the incident itself, the stronger the case. In Paul v Royal Wolverhampton NHS Trust, the court considered the close family member’s proximity to the traumatic effects of previous medical negligence.

  • Direct Witnessing or Immediate Aftermath

Success in a secondary victim claim hinges on the direct witnessing of the incident or its immediate aftermath akin to witnessing an ‘accident’. The court in Paul emphasized the visual and contemporaneous perception of the shocking event, linking the psychological harm to the observed negligence. Any delay between the initial event and the resulting injury or death weakens the case.

  • Establishing Recognisable Psychiatric Injury

Claimants must furnish evidence of a recognisable psychiatric injury stemming from the witnessed incident. This often entails obtaining expert medical testimony to establish a clear link between the event and the psychological harm endured.

  • Foreseeability of Harm

A successful secondary victim claim necessitates demonstrating the foreseeability of the suffered harm. In Paul, the court scrutinised whether a reasonable person could have anticipated the psychological repercussions for the mother witnessing the negligent medical procedures.

  • Emotional Impact on Secondary Victims

The emotional toll on secondary victims is substantial, prompting the legal system to acknowledge the imperative of accountability in clinical negligence cases. Nevertheless, the stringent criteria aim to ensure the validity of claims, averting frivolous litigation while affording justice to genuinely affected individuals.


The Paul v Royal Wolverhampton NHS Trust case provides valuable insights into the formidable challenges faced by secondary victims in clinical negligence claims. While the legal terrain is intricate, comprehending the crucial elements for proof, including proximity, direct witnessing, recognisable psychiatric injury, and foreseeability of harm, is paramount. Seeking legal representation is instrumental in constructing a robust case and pursuing rightful compensation for the psychological harm endured as a secondary victim.

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