Compensation figures can seem baffling. A news report may say that someone received £2 million but rarely explains where the figure came from. It can sound as though a lawyer or judge simply plucked a number from the air.

In reality, substantial awards are calculated very carefully. In most high-value personal injury claims, the largest part is not compensation for the injury itself, but money to meet financial losses and additional costs that may continue for years, sometimes decades.

I have found that clients understand the purpose of compensation. However, eyes can glaze over when “multiplicand”, “multiplier” and “discount rate” enter the conversation. The calculation can sound like a dark art. It isn’t—but it does need translating into ordinary language.

Recurring future losses are usually calculated separately. The claimant’s annual loss or expense—for example, lost earnings, care costs or therapy fees—is the multiplicand. It is multiplied by a figure drawn from actuarial tables, called the multiplier. The result is the present value of the future loss—broadly, the lump sum needed now to meet it.

The purpose of damages is, so far as money can, to place an injured person in the financial position they would probably have occupied had the accident or negligence not happened. Compensation is not a prize or windfall—it meets losses and additional needs caused by the injury.

In a personal injury or medical negligence claim, those losses may continue long after the case ends, sometimes for life. They may include loss of earnings and pension benefits, paid care, case management, treatment, therapy, specialist equipment, adapted transport and help with everyday tasks.

Each item is considered separately. A wheelchair may need replacing every five years, physiotherapy may be required for three years, and care may be needed for life. No single calculation could sensibly cover everything.

A compensation award is therefore made up of many separate “heads of loss”. Compensation for pain, suffering and loss of amenity is only one part. Past losses are calculated up to settlement or trial; future losses look ahead.

That inevitably involves some crystal-ball gazing. Nobody can know exactly what will happen in 10, 20 or 40 years. The aim is a fair assessment based on the evidence. This is why a large award is not money without a purpose. Much of it already has a job: paying carers in 20 years’ time, replacing equipment or making up earnings and pension that will never be received.

The standard calculation is:

Annual loss or expense × multiplier = capital value of the future loss

The annual loss or expense is the multiplicand. The multiplier converts that recurring figure into a lump sum payable now.

An example makes this clearer. Imagine a 40-year-old whose injuries have left them unable to work. Their likely net annual earnings loss, after tax and other relevant deductions, is assessed at £15,000.

The calculation does not simply multiply £15,000 by the number of years until retirement. Instead, lawyers use the Ogden Tables to identify a starting multiplier and then consider any appropriate adjustments. If the resulting multiplier were 18, the calculation would be:

£15,000 × 18 = £270,000

That does not mean the person is expected to lose exactly £15,000 a year for 18 years. The multiplier is not simply a count of the years remaining. It converts the expected stream of future losses into a lump sum payable now, taking account of matters such as the duration of the loss, mortality and the ordinary uncertainties of working life.

It also allows for what lawyers call accelerated receipt. Without the settlement, the lost income would have been received gradually, perhaps over several decades. The claimant instead receives money now for losses that will arise in the future. The law assumes that the part not yet needed can be invested and earn a return. A discount is therefore applied so that, in principle, the lump sum and the assumed return generated from it should together meet the losses as they arise — no more and no less.

The assumed return is reflected in the personal injury discount rate. It is not based on an expectation that an injured person will make risky investments or achieve unusually high returns. The rate is intended to reflect the return available from a suitably cautious and diversified approach, after allowing for matters such as inflation, tax and investment-management costs.

The multiplicand is often where much of the real work lies. For loss of earnings, the starting point is usually what the claimant would probably have taken home had they not been injured. From that, any income they are still realistically expected to earn is deducted.

The two figures may need to be calculated separately because different multipliers and adjustments can apply to the earnings the claimant has lost and to what they may still be able to earn. In each case, the calculation is based on net income, after tax, National Insurance and any other appropriate deductions.

The evidence may also cover promotions, bonuses, pension contributions or self-employed profits. For a child or young adult with little earnings history, education, aptitude, family background and labour-market evidence may help establish the path they were likely to follow.

For care, the multiplicand is likely to be the reasonable annual cost of support recommended by medical and care experts. The same approach applies to case management, therapy, domestic help and equipment. The claimant must show that the need arises from the injury and that the cost is reasonable.

Lawyers use the Ogden Tables to find the starting multiplier. Published by the Government Actuary’s Department, the tables use actuarial and financial data to help value future losses in personal injury and fatal accident claims.

The appropriate table and multiplier depend on factors including the claimant’s age, how long the loss will continue, projected mortality and the personal injury discount rate.

The discount rate needs a little explanation. Compensation for future losses is usually paid now, sometimes decades before the money will be needed. The law assumes the lump sum will be invested and earn a return. The rate reflects the assumed net return after inflation, tax and investment costs, so that the money should meet the losses as they arise.

At the time of writing, the personal injury discount rate in England and Wales is 0.5%, effective from 11 January 2025. The Government’s website gives the latest figure. Broadly, a higher rate means a lower multiplier and lump sum; a lower rate means a higher one.

For future earnings, the basic multiplier will usually be adjusted for “contingencies other than mortality”. In ordinary language, this recognises that even without the injury, a working life might include periods of unemployment, illness, caring responsibilities or time outside the labour market. The Ogden reduction factors take account of age, sex, employment status, disability status and educational attainment, although they may be adjusted where the claimant’s individual circumstances justify it.

This is not a judgment about the person’s worth or potential. It simply recognises that few working lives follow a perfectly straight line.

Serious injury calculations are built from evidence, not guesswork. Medical experts address prognosis and, where relevant, life expectancy. Employment or accountancy experts may consider earning capacity and pension loss. Care, occupational therapy, accommodation, transport and equipment experts assess practical needs and costs.

This is one reason we favour building a team around the client. We spend considerable time identifying the right experts for each individual case rather than relying on a standard panel or a one-size-fits-all approach. We also meet with experts as the claim develops, bringing different disciplines together to explore further questions, test assumptions and consider how the client’s needs may change.

That work matters. The time spent selecting the right experts and working closely with them to understand what the future is likely to hold enables us to build a case around the individual, rather than attempting to fit the individual into a familiar template.

A figure in a spreadsheet is meaningless unless it reflects how the person actually lives, what their family can reasonably provide and how their needs may change. In every serious injury claim, the eventual valuation depends heavily on the expert evidence. Sometimes it takes years before the medical position becomes sufficiently clear for experts to give a reliable prognosis and for the claim to be valued properly. Settling too early, before that picture has emerged, can risk compensation being based on needs that later prove to have been underestimated.

Our guides to bringing a brain injury claim and spinal cord injury compensation show how rehabilitation, care, equipment and long-term financial security can all form part of the same claim.

The law does not expect certainty. It asks the court to make the best assessment it can from the available evidence.

Future losses can be calculated in separate periods if earnings or care needs are expected to change. If the evidence does not support a reliable annual figure and multiplier, the court may instead make a broader lump-sum award for the likely financial disadvantage.

A claimant cannot recover losses that could reasonably have been avoided. This is known as the duty to mitigate loss. In an earnings claim, the calculation therefore takes account of any income the claimant can realistically still earn, because the court will expect them to take reasonable steps to reduce their financial loss where they are able to do so.

That does not mean pretending that determination alone can return a seriously injured person to their former life. Nor does it require them to pursue work that is unrealistic or medically unsuitable. It means deciding, on the evidence, what is genuinely achievable with appropriate rehabilitation, retraining, adjustments and support.

Future damages are not always paid as a single lump sum. In serious cases, part of the award—often the damages for future care and case-management costs—may instead be paid as regular, secure and index-linked periodical payments, potentially for life. Any remaining damages may be paid as a lump sum.

The court must consider whether periodical payments are appropriate. They can reduce the risk of money for lifelong care running out, while a lump sum may be needed for accommodation, equipment and other capital costs.

After settlement, the award may need careful management and protection. Our compensation protection team advises on personal injury trusts, deputyships and long-term compensation management.

The multiplier and multiplicand are not designed to make compensation obscure. They turn future needs into today’s money as fairly as possible.

Whenever I see a large settlement figure, I look past the headline. Behind it may be decades of care, lost income, replacement equipment and a family trying to create a secure future after life changed suddenly.

The calculation inevitably involves actuarial tables and expert reports, but its purpose is human—to give the injured person the support and financial security they are likely to need, not only at the time of settlement but throughout the years ahead.

The claim was exceptionally complex. Liability remained disputed for several years, five additional motorists were brought into the proceedings, and the medical experts disagreed significantly about how the claimant’s condition was likely to develop as she grew older.

The case was ultimately resolved through mediation, just six weeks before a long-awaited trial on liability.

The claimant had been driving along the A40 in Oxfordshire when she encountered a vehicle straddling both lanes of the road and causing an obstruction.

She stopped and got out of her vehicle. Shortly afterwards, she returned to the driver’s door to retrieve her phone so that she could alert the emergency services. At that point, she was struck by a vehicle driven by the defendant and suffered catastrophic injuries.

These included an incomplete spinal cord injury at T6, classified as AIS-D, together with multiple orthopaedic and internal injuries and a mild traumatic brain injury.

The consequences were profound. The claimant faced not only the immediate effects of her injuries, but considerable uncertainty about her future mobility, independence, care requirements and accommodation needs.

Claims were brought against both the driver of the vehicle which was obstructing the road, and the driver of the vehicle which collided with the claimant. The obstructing vehicle was uninsured and therefore a claim had to be made against the Motor Insurers’ Bureau which further complicated proceedings.

The defendant driver who collided with the claimant denied liability for three years and alleged that the claimant was contributory negligent by returning to her vehicle instead of remaining on the grass verge.

His insurers then brought five other motorists into the proceedings, alleging that their actions had contributed to the accident. Each of those motorists strongly denied the allegation.

This transformed the case into complicated multi-party litigation and significantly increased the procedural burden.

Although the defendant later admitted primary liability for striking the claimant, the claims against the other motorists continued. Ultimately the matter was listed for a trial to determine the preliminary issues of contributory negligence and the other motorists’ liability to indemnify and/or contribute to the claimant’s claim.

There was also a substantial dispute about the claimant’s medical prognosis. The defendant’s expert took a more optimistic view of her future, while the claimant’s expert considered it likely that she would become dependent on a wheelchair by the age of 70.

That disagreement affected almost every aspect of the assessment of her future losses, including the level of care she might require and the provision of suitable aids and equipment.

The defendant’s expert had also calculated a significantly reduced life expectancy on the mistaken assumption that the claimant continued to smoke. In fact, she had stopped smoking at the time of the accident.

There were, however, important areas of agreement. Both experts accepted that the claimant required single-level accommodation. They also agreed that she had a 1% risk of developing post-traumatic syringomyelia—a potentially serious condition that could significantly further impair her function and mobility and substantially increase her future care needs.

Read more about making a spinal cord injury compensation claim.

The claimant and the other parties attended mediation six weeks before the scheduled liability trial.

Mediation was particularly well suited to the unusual circumstances of this claim. The independent mediator was able to identify the central issues, challenge the parties’ positions and help them navigate the competing liability and medical arguments.

The claimant, the defendant’s representatives and the mediator attended in person, while representatives of the other motorists joined remotely. The willingness of the principal participants to meet face to face had a tangible effect and demonstrated a genuine commitment to finding a resolution.

Ian and Ellen considered that the conventional format of a joint settlement meeting would have been unlikely to achieve the same result.

The mediation concluded successfully, securing a settlement of £2.5 million for the claimant, bringing a long and difficult legal process to an end.

Most importantly, the settlement gives our client the financial security needed to plan for suitable accommodation, care, equipment and support as her needs change. After years of uncertainty, she can now begin to look to the future with greater confidence.

Discover more about road traffic accident claims.

Our client was just 16 when she underwent surgery intended to correct scoliosis and address the significant back pain she had begun to experience. By the end of that day, after a second emergency operation, she was unable to move or feel any part of her body below her upper chest.

She was left with permanent paraplegia and is now a full-time wheelchair user. She has no useful movement in her legs and no control of her bladder or bowels.

RWK Goodman secured a lump-sum settlement of £5,628,510, together with annual periodical payments for her care and case management for the rest of her life. The claim settled in January 2024, when she was 26.

Read more about making a claim following negligent scoliosis surgery.

Our client was diagnosed with mild scoliosis in 2012. During the following year, she began to experience significant back pain and was referred to orthopaedic and spinal surgeons, who advised her to consider surgery to correct the curvature of her spine.

She was admitted to Evelina London Children’s Hospital and underwent scoliosis correction surgery on 1 August 2014.

Her blood pressure fell before the operation began and intravenous fluids were administered. Although it initially recovered, her blood pressure remained unstable.

Spinal cord monitoring was carried out during the procedure. The sensory responses were described as well formed, but the motor responses were very small and unreliable.

After the first incision, her blood pressure fell again. She subsequently experienced significant blood loss and periods during which her blood pressure remained below the intended target.

Following surgery, she was transferred to the Paediatric Intensive Care Unit, where there was another episode of hypotension. Her haemoglobin level fell significantly and staff had difficulty waking her.

When she began to regain consciousness, it became apparent that she was not moving her legs. An urgent MRI scan was arranged, which showed anatomical distortion at the T5 and T7 levels of her thoracic spine.

Although the scan did not reveal a clear cause for the neurological loss, emergency surgery was advised to remove the metalwork and release tension within her spine.

She returned to theatre that evening. A cerebrospinal fluid leak was noted during the second operation and the metalwork was removed. There was no improvement in her condition: she remained unable to move or feel any part of her body below her upper chest.

A third operation was carried out on 20 August 2014 to replace the metalwork and stabilise her spine.

Our client was transferred to the Royal National Orthopaedic Hospital for specialist rehabilitation on 8 September 2014.

During rehabilitation, she regained a very small amount of movement in her legs, but not enough to provide any useful or functional movement. She was discharged on 17 December 2014 with T8 incomplete ASIA B paraplegia.

Her physical condition is permanent. She cannot walk or stand and is entirely dependent upon a wheelchair.

She has no control of her bladder or bowels and experiences significant spasms. She also lives with pain affecting her shoulders, neck, back and legs.

The psychological impact has been considerable. Alongside adjusting to a profound and permanent physical disability, she has had to come to terms with the effect of the injury on her independence, education and future plans.

Her absence from college and the consequences of her disability meant that she could not follow her intended career path. She requires help with day-to-day activities, and the level of assistance she needs is expected to increase as she grows older.

The medical evidence also indicated that her injury was likely to reduce her life expectancy.

The claim arose from the care our client received during and immediately after the scoliosis correction procedure. The evidence considered matters including the management of her blood pressure and blood loss and the response when concerns arose about her neurological condition.

A settlement meeting dealing with liability took place on 24 March 2021. Liability was resolved on an 85/15 basis in our client’s favour, and judgment was entered by an order dated 11 August 2021.

Extensive expert evidence was then obtained to assess the many consequences of the injury and the financial support she would require throughout her life.

The case was listed for an eight-day trial on the amount of compensation, beginning on 1 February 2024. A settlement was instead reached at a meeting on 8 January 2024, avoiding the need for the trial.

Our client received a lump sum of £5,628,510.

She will also receive annual periodical payments towards the continuing cost of her care and case management. These are payable at the following rates:

• £23,000 a year until the age of 45;
• £35,000 a year between the ages of 45 and 55;
• £89,000 a year between the ages of 55 and 65; and
• £109,000 a year from the age of 65 for the remainder of her life.

The lump sum included £320,000, including interest, for her pain, suffering and loss of amenity.

The compensation also reflected the extensive financial consequences of her injury. These included the cost of suitable accommodation, assistive technology, specialist equipment, medical treatment, therapy, transport and incontinence products, together with her expected loss of earnings and pension.

Compensation cannot undo what happened or give our client back the opportunities she lost. It can, however, provide lasting financial security and ensure that her accommodation, care, treatment and support can change with her needs throughout her life.

If you or a family member suffered a spinal cord injury following surgery and are concerned that something may have gone wrong, our specialist medical negligence solicitors can help you understand what happened and whether you may be entitled to compensation.

RWK Goodman’s Head of Medical Negligence Simon Elliman secured a £400,000 lump-sum settlement for a man left with permanent neurological damage after developing cauda equina syndrome.

Our client was in his mid-50s when the claim settled. He now lives with loss of bladder and bowel control, loss of sexual function and the knowledge that he will never be able to return to the work he did before his injury.

The claim concerned an allegation that, when he attended his GP surgery during a flare-up of sciatica, he was not given clear advice about the warning signs that should prompt him to seek immediate medical attention.

Our client developed shoulder and neck pain after playing tennis. At the same time, he was experiencing a flare-up of the episodic sciatica from which he had suffered previously.

When the pain continued for several days, he made an appointment at his GP surgery. The GP diagnosed tendonitis and advised him about pain relief and exercise.

The claim was not that cauda equina syndrome should necessarily have been diagnosed during that appointment. It was that our client should have been told about the symptoms that could indicate developing cauda equina syndrome and advised to attend hospital urgently if any of them appeared.

Later that evening, he noticed altered sensation while passing urine. Because he had recently started taking Naproxen, he assumed that it might be a side effect of the medication rather than a warning of something more serious.

During the following day, he began to find it difficult to start urinating and noticed that his urine flow had reduced. He also developed altered sensation in his buttocks.

In the early hours of the next morning, he lost sensation around his anus. Within a few hours, the numbness had spread across his buttocks and penis.

It was his wife who recognised how serious the symptoms might be. She searched online and discovered that they were warning signs of cauda equina syndrome. Our client telephoned NHS 111 and was told to attend hospital immediately.

He arrived at the Emergency Department later that morning. While waiting to see a doctor, he lost control of his bladder twice.

A doctor examined him around midday, suspected cauda equina syndrome and arranged an MRI scan. The scan revealed that a large central disc extrusion at L5/S1 was compressing the nerves in his spinal canal.

He was transferred to a specialist spinal unit later that afternoon and underwent a discectomy that evening. Further imaging showed that disc material remained in the spinal canal, and a second operation was carried out the following day. He required a third operation a couple of days later after another scan showed continuing disc extrusion.

Despite three operations, the damage to our client’s nerves could not be reversed. Many of the consequences are intensely personal and affect almost every part of his daily life.

He must insert a catheter three or four times each day to empty his bladder. He continues to experience urinary incontinence and remains at risk of recurrent urinary tract infections.

He has no control over his bowel function, including flatus, and must evacuate his bowel manually. He has also lost sexual function.

Living with such intimate disabilities has taken a considerable emotional toll. Our client suffered a recognised psychiatric injury while adjusting to what had happened, although those symptoms have now largely resolved.

He has been unable to return to the job he did before his injury. He already requires some assistance with daily life and is expected to need increasing support as he grows older.

Discover more about rehabilitation after cauda equina syndrome.

The claim was brought on the basis that the GP should have given our client clear red-flag safety-netting advice.

His case was that, had he received that advice, he would have recognised the significance of the altered urinary sensation that developed later that day and sought emergency medical treatment at that point. It was also alleged that earlier diagnosis and surgery would probably have prevented, or substantially reduced, his permanent neurological injuries.

No amount of compensation can restore the independence, employment and intimate aspects of life that our client has lost. The settlement does, however, recognise the profound consequences of his injury and will help provide financial security and meet his continuing needs.

Cauda equina syndrome requires urgent investigation and treatment. If you believe its warning signs were missed, or that you were not advised to seek immediate help when new symptoms developed, our specialist medical negligence team can help you understand whether you may have a claim.

Read more about making a cauda equina compensation claim.

If you’ve been injured in an accident, an allegation that you might be partly to blame is, understandably, worrying. Over the years, I’ve met many clients who initially believed that when an insurer raised the issue of contributory negligence, it meant their claim was dead in the water. Fortunately, that’s rarely the case.

In England and Wales, being partly to blame does not, by itself, prevent you bringing a personal injury claim. If the defendant proves that you failed to take reasonable care for your own safety and that something you did or didn’t do contributed to the accident or your injuries, the court may reduce your compensation to reflect your share of responsibility.

This principle, established by the Law Reform (Contributory Negligence) Act 1945, reflects the reality that accidents are not always clear cut. Rather than preventing a claim altogether, the law allows responsibility to be shared where that is fair. Understanding how this works removes much of the uncertainty surrounding these allegations and helps explain why insurers raise them—and why they are not always justified.

Contributory negligence is a legal defence allowing a defendant to argue that you failed to take reasonable care for your own safety, meaning you should share responsibility for your injuries.

Crucially, in most cases, it’s about sharing responsibility, not taking all the blame. Importantly, you don’t have to cause the accident itself—your actions may simply have contributed to the extent of your injuries.

As the Court of Appeal explained in the landmark case of Jones v Livox Quarries [1952], the law expects people to take reasonable care for their own safety—not to behave perfectly. In other words, contributory negligence arises where someone fails to act as a reasonably prudent person would in the circumstances, and that failure contributes to their injuries.

Yes, absolutely. If proved, contributory negligence affects the amount of compensation you receive, not your right to bring a claim.

For example, if your claim is valued at £40,000 but the court finds you were 25% responsible, your compensation would be reduced to £30,000. That’s why an allegation of shared fault is not the same as a denial of liability. A defendant will often accept primary responsibility for the accident whilst arguing that your own actions also contributed to your injuries.

Unless admitted or agreed, contributory negligence remains an allegation until determined by the court.

The burden of proof rests firmly with the defendant. Whilst you must prove that the defendant’s negligence caused your injuries, the defendant must prove:

• that you failed to take reasonable care for your own safety;
• that your failure contributed to the accident or to the injuries you suffered; and
• that the type of injury resulting from your lack of reasonable care was reasonably foreseeable.

Like all issues in civil litigation, this is decided on the balance of probabilities. In other words, the defendant must show that it’s more likely than not that your own lack of reasonable care contributed to the accident or your injuries.

The strongest way to defeat these allegations is through compelling evidence, such as CCTV footage, witness statements, accident reports and expert medical opinion. The defendant cannot simply assert that you should have been more careful; they must produce evidence to support that allegation.

There is no fixed formula for deciding whether contributory negligence applies or, if it does, what reduction should be made. Judges assess the unique facts of each case by considering two key factors:

1. Causative Potency: How much your actions actually contributed to the accident or your injuries.
2. Blameworthiness: The extent to which your conduct fell short of what a reasonable person would have done in the circumstances.

The judge’s task is to reach a fair and proportionate outcome by weighing both factors together rather than applying a strict mathematical formula.

This is one of the most common areas where contributory negligence arises. Under guidelines established in the case of Froom v Butcher [1975], if another driver causes a collision but you were not wearing a seatbelt, your damages may be reduced by:

• 25% if wearing a seatbelt would have prevented your injuries altogether;
• 15% if it would have reduced the severity of your injuries; or
• no reduction if wearing a seatbelt would have made no difference to the injuries suffered.

This approach was highlighted in the case of Pearson v Anwar [2015], where a taxi passenger suffered tetraplegia after failing to wear a seatbelt.  Whilst the claimant argued for a 15% reduction because he would have suffered a minor whiplash anyway, the court applied a 25% deduction because a seatbelt would have prevented the paralysing impact entirely. In refusing permission to appeal, the Court of Appeal confirmed that the Froom v Butcher guidelines are not to be treated as a rigid principle in every case.

For an excellent analysis of how and when contributory negligence applies in cycling accidents, read:

Why cyclists and motorists should know the law on contributory negligence.

An employer may fail to provide a safe system of work, but an employee might also take an unnecessary risk—for example, standing on a clearly unstable chair for a task instead of using a stepladder. The employee may still succeed in their claim, but their compensation is likely to be reduced to reflect their own contribution to the risk.

There are countless examples of accidents in public places where the claimant might be found partly to blame. For example, a supermarket might leave a spill unattended, but if you ignore a clearly visible warning sign placed over or next to the spill, blame may be shared.

The High Court decision in Lee v Khraud & Others [2025] considers this principle. Mr Lee, a plasterer, fell from an unfenced mezzanine. Although the defendants admitted to failing to install guardrails, the court found the risk of a fall was entirely clear and obvious, meaning that, as an experienced tradesman, Mr Lee should have appreciated the danger. His compensation was therefore reduced by one-third—a decision upheld on appeal because it fairly reflected the parties’ respective responsibility.

“I was partly at fault, so I won’t receive anything.” False. In most cases, contributory negligence simply reduces your compensation.

“The insurance company decides how much is deducted.” No. Insurers will often argue for a substantial reduction, but if the parties cannot agree, the court decides.

“Responsibility is always split 50/50.” Not at all. The evidence may support no contributory negligence, and even if it does, reductions vary considerably depending on the facts.

When patients or their families believe that something has gone seriously wrong with their medical care, compensation is rarely the first thing they talk about.

In my experience, they usually want to know what happened, why it happened, and whether anyone will make sure it does not happen to someone else. They may have spent months trying to obtain a clear explanation, often whilst dealing with the practical and emotional consequences of what has gone wrong.

For more than 40 years, Action against Medical Accidents (AvMA) has helped people ask those questions and find a way forward.

Established in 1982 as Action for the Victims of Medical Accidents, AvMA has become a leading voice for patient safety and justice. Through its specialist helpline, written guidance, inquest support and campaigning, the charity helps people navigate healthcare and legal systems that can otherwise feel complex, intimidating and unresponsive.

RWK Goodman has worked closely with AvMA for many years. It is a relationship built on shared values, but it is also a very practical one. We both believe that people affected by avoidable medical harm should be listened to, treated fairly and able to obtain advice from lawyers who properly understand this specialist area.

I’m proud to be a member of AvMA’s Specialist Clinical Negligence Panel, alongside other members of our team. AvMA pioneered specialist accreditation in clinical negligence, and panel membership remains an important indication that a lawyer has the experience and commitment needed to represent injured patients and their families.

That matters because medical negligence cases often involve complex medical and legal issues and life-changing consequences. Families need advisers who understand the technical detail without losing sight of the person at the centre of the case.

Members of our team have also contributed to AvMA conferences, training events and professional publications, and I have always valued that exchange of knowledge. As the law and medical practice develop, none of us should assume that experience removes the need to keep learning.

Our relationship also has a direct impact on families. For example, in 2024, RWK Goodman took on two cases through AvMA’s pro bono inquest service, providing bereaved families with representation at inquests. Inquests can be daunting, particularly for grieving families facing experienced representatives acting for healthcare organisations. Proper representation can help them participate effectively, obtain answers and ensure that important concerns are explored.

A successful legal claim can provide compensation for care, treatment, lost earnings and other needs. That can make an enormous practical difference, but it is only one part of the response to avoidable harm.

Families often also want honesty, an apology and evidence that lessons have been learned. AvMA supports people seeking those outcomes whilst using their experiences to campaign for greater openness, accountability and safer care.

Its work on issues including the statutory duty of candour has helped keep patients and families at the centre of the debate about how healthcare organisations should respond when mistakes are made.

AvMA has recently told its supporters that it is preparing to introduce a refreshed identity. Whilst its purpose and core services are not changing, the charity aims to make its support easier to recognise, understand and access, particularly for people affected by health inequalities or communication barriers.

That is a sensible and important step. Specialist support is only valuable if the people who need it can find it and feel confident accessing it.

Those of us working in medical negligence see how similar failures can arise in different hospitals and at different times. Securing fair redress is essential, but so is learning from what happened. The two should go hand in hand, and AvMA has championed both for more than four decades.

RWK Goodman is proud of its longstanding relationship with the charity, and I look forward to continuing our work together in support of safer healthcare, greater accountability and justice for those who have been harmed.

Serious hand injuries can instantly alter every aspect of a person’s life. In addition to physical trauma, they often impact confidence, mental health, employment, and independence in less visible ways.

This case demonstrates the importance of early rehabilitation and specialist legal representation following traumatic amputation injuries. The focus extended beyond compensation to ensuring my client received appropriate treatment, support, and rehabilitation from the outset, providing the best opportunity to rebuild his life after a devastating workplace accident.

• The accident: A workplace machinery incident involving a magnetic pillar drill that pulled my client’s dominant left hand into the machine.
• The injuries: Partial amputation of the left thumb, fractures to both bones in the wrist, extensive soft tissue damage, Post-Traumatic Stress Disorder (PTSD), and ongoing psychological symptoms.
• The outcome: £350,000 settlement (net of contributory negligence), together with extensive rehabilitation funded throughout the claim.

My client was using a magnetic pillar drill at work when it snagged his anti-cut glove, pulling his dominant left hand into the machine. His employer alleged that he was contributorily negligent, contending that, as an experienced engineer, he should have known that wearing gloves while operating such machinery created a foreseeable risk and made him partly responsible for the accident.

The claimant, however, maintained that it was standard practice for operatives to wear anti-cut gloves when using the pillar drill and that he had never been instructed not to do so.

The consequences of the accident were severe. He suffered a partial amputation of his left thumb, fractures to both bones of his wrist, and a significant laceration to his forearm. What followed was a long and demanding course of treatment and rehabilitation, involving multiple operations to repair fractures, relieve pressure in his hand and forearm, and treat extensive soft tissue damage. Surgeons also performed a groin flap procedure, temporarily attaching his injured hand to his groin to restore its blood supply and maximise the prospect of preserving function.

His recovery was complex. He developed an infection requiring antibiotics, needed additional surgery to reshape the amputation stump after wound breakdown exposed bone, and was still awaiting corrective wrist surgery when the claim settled.

Traumatic accidents rarely result in only physical injuries, and this case was no exception.

My client developed Post-Traumatic Stress Disorder, experiencing intrusive flashbacks, disturbed sleep, and overwhelming anxiety about returning to work with machinery. He became reluctant to discuss the accident and increasingly avoided reminders of it.

In addition to PTSD, he experienced periods of low mood, reduced motivation, and difficulty concentrating. These reactions are understandable. In serious injury cases, physical and psychological recovery are closely linked, so should be addressed simultaneously.

Early rehabilitation can have a significant impact on long-term outcomes. In serious injury litigation, our priority is to secure access to rehabilitation as early as possible, rather than waiting for a claim to settle. In this case, under the Rehabilitation Code, we arranged for an experienced case manager to coordinate a comprehensive programme tailored to our client’s individual needs. This included:

• Specialist psychological therapy to help him process the trauma of the accident
• Extensive hand therapy, physiotherapy, and upper limb occupational therapy
• A specialist driving assessment
• A range of aids and equipment to maximise independence during recovery and afterwards

The goal extended beyond physical recovery. It focused on helping him regain confidence, rebuild independence, and adapt to life after such a major injury.

As solicitors, we cannot change what has happened, but we can help ensure clients receive the right support at the right time.

For many, the greatest challenges begin after leaving hospital.

During recovery, my client relied heavily on family and friends for support with daily tasks such as shopping, cooking, cleaning, gardening, and attending appointments. Activities that were once routine became difficult or impossible to manage alone.

He eventually returned to work in the summer of 2025 on a phased basis, initially three mornings per week. However, his long-term employment prospects had changed significantly.

Due to permanent limitations in his dominant hand, he could not return to his previous role or perform regular heavy manual work. He also found cold environments particularly challenging.

Helping clients understand and plan for these long-term consequences is essential to achieving the right outcome.

The claim ultimately settled for £350,000, after a deduction for contributory negligence.

Whilst the financial settlement reflected the seriousness of the injuries and future losses, the most significant outcome was the quantity and quality of rehabilitation we achieved during the claim.

Coordinated support from the case manager, therapists, and clinicians helped my client navigate a difficult period, addressing both physical recovery and psychological trauma whilst restoring as much independence as possible.

Traumatic hand injuries and amputations are never straightforward. These cases often involve multiple surgeries, lengthy rehabilitation, psychological trauma, and significant changes to work and daily life. Understanding the full impact of such injuries and securing early rehabilitation can make a profound difference to a client’s recovery and long-term quality of life.

If you or someone close to you has suffered a traumatic hand injury or amputation at work, early specialist legal advice can help you access the rehabilitation, treatment, and financial support you need.

I’m happy to discuss your circumstances confidentially and at no cost, and to explain how we may be able to help.

E is a 27-year-old male who suffered a brain injury and whose claim settled in March 2021. The settlement consisted of a lump sum and a PPO. A Delegate was appointed for his property and financial affairs but there is no welfare Delegate as E was assessed as having capacity to make health and welfare decisions with the assistance of his case manager. Where he lacked capacity, decisions are made on a best interest basis by his MDT.

E lives in a flat and in 2025 his support was increased to 24/7. The increase was a result of his support team becoming aware that E was using cannabis and had begun exhibiting concerning behavioural changes. The consultant neuropsychiatrist, Dr Martine Stoffells, diagnosed him with cannabis-induced psychosis. At this point the Delegate became concerned about the funds being provided to E and discussed it with the MDT. A view was taken that, while there were serious concerns regarding cannabis use, the negative effect of depriving E of funds outweighed the potential benefits of restricting his ability to obtain cannabis. In March 2025 E’s flat was raided by the police but, following further investigation, no action was taken against E as the police were of the view that drugs were being dealt in the stairwell by two individuals who befriended him. E’s support was therefore increased and the Delegate suspended payments to E until his health and lifestyle improved, at which point it was reinstated at £50 per week in April 2025.

The Delegate made an application to Court requesting authority to continue to pay E his allowance despite the fact it may be spent on alcohol, cannabis or other illegal drugs because depriving E could lead to deterioration in his condition due to the loss of the small amount of independence it affords him. In addition, it could cause him to take detrimental steps such as getting into debt to procure cannabis. In reports for the County by Dr Stoffels and the case manager both felt the risk of stopping the small amount of independence was more detrimental to E.

Prior to the application the Delegate considered many issues including they may be committing a criminal offence by giving E funds knowing he may spend it on cannabis. Advice was sought from English leading Counsel, Gideon Cammerman KC, as there were no obvious precedents in Jersey. Counsel did not believe an offence was being committed as the Delegate was not condoning the drug use. It was also considered whether the Delegate was potentially liable for a criminal offence in connection with money laundering but this would not gain traction in E’s case as the funds that were given to E were not proceeds of crime and he was not being encouraged to use the funds for criminal acts.

The Delegate also sought advice from leading counsel, Victoria Butler-Cole, who specialises in health and social care as to how the Court of Protection was likely to approach this. Ms Butler-Cole advised the use of drugs and alcohol must be weighed against E disengaging completely and that a more restrictive package would be counter-productive.

The approach of the Official Solicitor was considered, which was that it is not appropriate to assess Ps capacity to do something that is a criminal offence. There can be no best interests decision on an illegal act so there should be no capacity assessment as it serves no purpose. Assessing capacity to consume cannabis could be viewed that one possible outcome is that it is in the individual’s best interest to consume cannabis. The decision based on case law is that a better analysis is that care plans where individuals are at risk of committing an offence may be endorsed by the Court if the overall care arrangements are deemed to be in the individuals best interest. Counsel agreed with this approach. Although cannabis use is a welfare issue, counsel pointed out that it is also an issue in respect of property and financial affairs, since E can only purchase cannabis if the Delegate provides him with funds.

In making the decision the Court had to consider Article 3 of the Capacity and Self-Determination Jersey Law 2016, which is similarly set out to the Mental Capacity Act 2005. In the 2016 Act it states a person is not treated as unable to make a decision unless all practicable steps to enable that person to make a decision have been taken without success and any decisions must be made in P’s best interest.

The Delegate’s affidavit to the Court considered a variety of matters for and against the decision to pay E weekly funds but, after consideration with the MDT, the Delegate believed it was in E’s best interest to continue paying his weekly allowance. They genuinely believed that not paying E would cause him more harm both in terms of his own wishes and feelings and also in terms of the risk to him of what he will do instead. Dr Stoffels was also in agreement.

The Court acknowledged that the Delegate was faced with a difficult decision but were impressed with the lengths she went to in identifying the issues and obtaining appropriate advice. Having applied the test from In re S Settlement [2001] JLR Note 37, the Court approved the decision of the Delegate to advance funds to E in the form of a £50 allowance per week as it was in his best interest to do so; however, for the avoidance of doubt to Court pointed out their decision is not to be regarded as them determining that it is in E’s best interest to commit a criminal offence or declaring illegal conduct is lawful.

The role of a financial Deputy, on the face of it, is to make decisions in relation to P’s property and financial affairs. However, it often goes much further than that. The Deputy must work collaboratively with the MDT on a variety of matters to include the impact on P when there is use of illegal substances, alcohol abuse, excessive pornography use and unhealthy relationships to name a few. The Deputy, as set out in the matter of E, cannot ever authorise or justify an illegal act but must always have regard to P’s best interest and consider the wider impact of a decision on them.

As is evident from the matter of E, although our laws vary, the best interest of P is always a crucial consideration.

This is a charity founded by the parents of Horatio Chapple to provide outdoor space at spinal injury rehabilitation units throughout the country. Horatio had the idea when volunteering at his local unit during the school holidays. Tragically, Horatio’s life was cut short in 2011 at just 17, when his camp was attacked by a polar bear whilst on an expedition to Svalbard. There followed an outpouring of love and goodwill, with donations flooding in for his garden to be created. Since then the charity has raised funds to open gardens in eight of the 11 NHS rehab units in the UK. The mission is to open gardens in all 11 NHS centres to ensure that no-one has to go through a life-changing spinal injury and spend months in hospital without having access to such outdoor space and the therapeutic benefits that space will bring.

The challenge was a hike to the top of any of the highest peaks in England, Northern Ireland, Scotland or Wales. We chose to climb Yr Wyddfa. It is a peak I have never climbed and as a Welshman it seemed something I needed to rectify. Soon we had a team consisting of Joy Davies, Louise Nettle, Beth Evans, Cameron Findley-Smith; Jess Bonniger and Morgan Edwards from RWK Goodman. And as if that was not enough a good friend Amanda Harris, herself living with spinal cord injury and a supporter of Horatio’s Garden and a trustee of the Rookwood SpUR charity, let it be known that she, too, wanted to get to the top despite being wheelchair dependent. She was gathering her own group to support her in the ascent and asked if we would join in. Challenge accepted.

Sunday 19th of April dawned with a blanket of mist draped over the grey mountains surrounding Beddgelert where our CPU team had lodged the night before. The drive to our meeting point in Llanberis was one of the most magical I can recall as the mist burned off revealing Arthurian lakes and towering mountains all around. In all some 20 of us set off taking it in turns to get Amanda and her chair to the top of the mountain. Six people would take their places around the chair and support Amanda who had to do her role all by herself. We would tag in and out at rest breaks to keep the whole thing moving. It may not surprise you that it is not a nice, smooth, paved pathway to the top of Yr Wyddfa. There are boulders and streams and long sets of steps hewn from the rock to navigate. It was hard going in the blazing sunshine but we reached the halfway point where the train reaches middle station and we stopped for a while to recover and meet with supporters who took the leisurely way up.

The second part of the walk was more climbs and rocks and crevices, particularly when you near the end and there are jagged outcrops to navigate to the short steps up to the triangulation point at the summit. Waiting to reach the top was a long queue of all the hikers who had passed us on the way up as they waited to get to the top for that selfie moment. However in one of the most charitable gestures I have seen in a long time, we were able to queue jump to reach the small plateau just below the trig point and were clapped all the way. A moment that would make even the toughest person’s top lip wobble. Amanda had done it and we were all delighted to be there with her as the Horatio’s Garden flag was raised over the mountain.

Now for the small matter of getting back down again and a beer to celebrate. In all an eight hour climb but what a wonderful day. A not insignificant amount of money was raised for Horatio’s Garden. Now Joy, about that dragon boat race….