When defence deadlines lose their meaning in clinical negligence claims

Clinical negligence claims are rarely straightforward and often take years to resolve. The complexity of these cases, involving expert evidence, detailed medical records and questions of causation, means that lengthy cases are often unavoidable. 

If you have been involved with this type of claim as a professional or had the misfortune to be involved as a patient or a loved one, you will understand the huge emotional labour and trauma at the heart of these legal cases. Sadly, however, that trauma is getting worse, as the length of time defendants now take to file a defence once proceedings have been served is becoming increasingly difficult to justify.  

Delays are developing as rising costs across the clinical negligence system reach record levels. NHS Resolution figures show claimant legal costs exceeded £600 million last year for the first time on record, while the average time from notification of a claim to settlement remains around 1.7 years. 

Under the Civil Procedure Rules, a defendant has 14 days to acknowledge service of a claim and a further 14 days to file a defence. CPR 15.5 allows the parties to agree to an additional 28 days without requiring court permission.  

The rules are designed to ensure that once proceedings are issued, the case begins to move forward. 

How defence extensions now operate in practice 

Defences are rarely filed within that timeframe in medical negligence claims. 

Instead, claimant solicitors are routinely asked to agree to extensions. CPR 15.5 allows the parties to agree a further 28 days for the defence to be served, and this agreement is usually provided out of professional courtesy. 

However, what I am increasingly seeing is that instead of asking for a 28-day extension, defendants will almost always request a two or three-month extension, usually without providing any reason at all. 

Claimant solicitors will frequently agree to these requests to be less adversarial and more accommodating from the start. Early procedural disputes rarely move a claim forward and can simply increase costs. 

Those costs are already high. According to NHS Resolution, the total cost of clinical negligence claims, including damages and legal costs, exceeded £3 billion last year, underlining the financial pressure already facing the system. 

Now that these longer extensions have become routine, the timetable set out in the rules loses its practical significance. 

By the time proceedings are issued, the defendant’s position is usually already clear in their response to the Letter of Claim. Despite this, it is not unusual for defendants to request further extensions once the initial period has expired. In some cases, where the three-month extension has lapsed, defendants request further extensions ranging from four weeks to a further six months. 

But I’ve had cases where a defence was eventually filed around nine months after proceedings were served. When the defence arrived, it was brief and largely mirrored what had already been stated in the earlier response to the claim. 

Until a defence is served, the claim cannot move to the next stage. The court cannot issue case management directions or set the timetable that will ultimately take the case to trial.  

Instead, the claim effectively stalls. 

For claimants who may already have been waiting years since the incident occurred, that delay can be extremely frustrating and difficult to understand. 

The practical difficulty of opposing extensions 

Of course, claimant solicitors could just refuse those requests and insist that defendants comply with the timetable set out in the rules. Unfortunately, the position is a little more complicated than that.  

If a claimant does not consent to an extension request and the defendant makes an application to the court, the matter may proceed to a hearing. If the extension is granted, the claimant can be ordered to pay the costs of the application. 

But what makes it even more complicated for claimants is that in many cases, judges grant extension applications without listing a hearing at all. The claimant is simply notified of the decision in writing, which discourages challenges to extension requests. 

Applications relating to extensions are therefore being considered within a system that is already managing a high caseload. 

Even where a claimant successfully opposes an application, the result is often limited to recovering the costs of that application. It rarely moves the claim forward in any meaningful way. 

If a defence is not filed by an agreed date, the claimant is technically entitled to seek judgment in default, but this rarely happens in clinical negligence claims.  

Where the defendant can demonstrate that they have a valid defence to the claim, the court will generally set aside the judgment once an application is made. 

Delays and their impact on claimants 

These delays matter because clinical negligence claims already place significant demands on claimants. 

Individuals bringing these claims have experienced serious injury, life-changing medical complications, the loss of a loved one, psychological distress and PTSD. Adding prolonged litigation does anything but help their cause.  

For some, the continuation of litigation can also prolong the psychological impact of the original incident, particularly where proceedings remain unresolved for extended periods. 

When procedural delays occur at the defence stage, they add further time to an already lengthy process. 

The wider system is also under increasing pressure. Clinical negligence payments, including damages and legal costs, exceeded £3 billion last year, and overall NHS negligence liabilities exceeded £60 billion for the first time. 

At the same time, more claims are being notified each year than are being resolved, as NHS Resolution recorded 14,428 clinical negligence claims notified in 2025 compared with 13,329 settlements. Delays at any stage of litigation therefore risk adding further pressure to an already stretched system.  

The consequences are felt most by the claimants bringing these cases. Prolonged delays extend uncertainty for claimants and can exacerbate the emotional and financial strain many already face while pursuing a claim. 

For claimants who may be unable to work or who have been left out of pocket following negligent treatment, delays in progressing a claim can also delay access to compensation that may be urgently needed to return to some sort of normality before the negligence. 

Restoring scrutiny to defence deadlines 

There will always be cases where defendants require additional time, especially when clinical negligence claims often involve complex medical evidence and detailed factual investigation. 

However, extensions should not become routine, particularly where no clear explanation is provided for why additional time is required. 

Greater scrutiny of extension requests, particularly where they are prolonged or repeated without clear justification, would help ensure that the timetable set out in the rules retains practical meaning. 

A more disciplined approach to defence deadlines would also allow claims to progress to the case management stage more quickly, enabling courts to set directions and establish a clear timetable to trial. 

Without stronger oversight of repeated extension requests, there is a real risk that these delays will continue and that claimants will remain stuck waiting for their cases to progress. 

For claimant-side solicitors, the priority remains ensuring that cases progress so that clients can obtain answers and move forward with their lives.  

When defence extensions become routine rather than exceptional, it is the claimants themselves who ultimately pay the price in time, uncertainty and delayed justice.