Darnley v Croydon Health Services NHS Trust – Case Summary

Darnley v Croydon Health Services NHS Trust

Supreme Court

Citations: [2018] UKSC 50; [2019] AC 831; [2018] 3 WLR 1153; [2019] 1 All ER 27; [2019] PIQR P4; [2018] Med LR 595.


The claimant attended A&E after suffering a blow to the head. He had severe headaches which were getting worse. The receptionist informed him that there was a waiting time of four to five hours. In reality, the hospital’s policy was that he would be seen in half an hour, at which point a triage nurse could better advise him (depending on his symptoms). After 19 minutes, the claimant left as he felt too ill to stay. He did not inform staff that he was leaving. The claimant later collapsed and suffered brain damage. He sued the hospital for negligence.

  1. Did the A&E receptionist and hospital owe the claimant a duty to provide him with accurate information?
  2. If there is a duty, what standard of care is owed?
  3. Did the claimant’s decision to leave break the chain of causation?

The Supreme Court held in favour of the claimant.

  • This case was not a novel situation. It was sufficiently analogous to the many cases stating that A&E medical staff owe a duty of care to patients. The defendant’s duty was to take reasonable steps not to cause foreseeable injury to patients: these facts fell within that duty. The fact that the duty was delegated to non-medical staff instead of medical staff was irrelevant.
  • The receptionist had not acted as a reasonable A&E receptionist ought to have done, as she did not follow the known and established policy.
  • Since the claimant would have remained in the hospital if he had known the truth and it was reasonably foreseeable that he might leave if provided incorrect information, causation was unbroken.

The defendant was therefore liable in negligence.

This Case is Authority For…

There is no need to consider the test in Caparo v Dickman [1990] UKHL 2 to hold that there is a duty of care where the facts of the case are sufficiently analogous to existing, non-novel cases. Where the precise facts are unusual but the overall issue essentially falls within an existing category of duty of care, a duty exists.

A medical receptionist owes patients a duty to take reasonable steps not to provide misleading information as to the availability of medical care. The standard of care is that of an averagely competent and well-informed A&E receptionist.

A claimant’s decision-making process cannot be assessed in isolation from the breach. Where a claimant’s decision is influenced by the breach, it is less likely to break the chain of causation.