Beyond Doctors and Nurses: How an A&E Receptionist’s Words Led to a Landmark Negligence Case
Negligence is a cornerstone of tort law, shaping legal responsibility in cases where harm results from careless actions. The Supreme Court’s decision in Darnley v Croydon Health Services NHS Trust provides valuable insight into how this principle applies beyond medical professionals to non-clinical staff. At its core, a claim for negligence requires proof of three key elements:
1. Duty of Care – Did the defendant owe a duty to take reasonable care to avoid harm?
2. Breach of Duty – Did the defendant fail to meet the required standard of care?
3. Causation – Did this failure directly cause the claimant’s injury?
Background of the Case
In May 2010, Michael Darnley attended A&E at Mayday Hospital, Croydon, after sustaining a head injury. He informed the A&E hospital receptionist that he was feeling very unwell. A receptionist incorrectly told him he would have to wait four to five hours to see a doctor.
Unaware that head injury patients were meant to be triaged within 30 minutes, he left the hospital after 19 minutes. That evening, he collapsed at home from a large extradural Haematoma (brain bleed). Despite undergoing emergency surgery after being rushed back to the hospital, he suffered permanent brain damage.
Darnley sued the NHS Trust, arguing that the incorrect advice given by the receptionist led him to leave the hospital, which delayed his treatment and resulted in catastrophic injury.
How the Supreme Court Differed from the Court of Appeal
(1) Duty of Care
The Supreme Court ruled that a hospital’s duty of care begins the moment a patient is ‘booked in’ at A&E. This duty extends to non-medical staff, including receptionists, who provide information that may influence a patient’s decision to stay or leave.
The Court of Appeal dismissed the claim, ruling that receptionists were not responsible for clinical decisions. The Supreme Court disagreed, finding that misleading information about waiting times could foreseeably cause harm, extending the duty of care beyond clinical staff to hospital administration.
(2) Breach of Duty
The receptionists knew that head injury patients should typically be seen by a triage nurse within 30 minutes. However, they provided misleading information that led Darnley to leave.
The Supreme Court held that an A&E receptionist, acting with the competence expected in their role, must take reasonable care to provide accurate information about waiting times.
(3) Causation
The misleading information directly contributed to the harm suffered. Had Darnley been accurately informed that he would be seen within 30 minutes, it is reasonably foreseeable that he would have remained at the hospital, received timely treatment, and avoided permanent injury.
The trial judge had already found that had he remained in hospital, his brain injury would have been diagnosed and treated in time, preventing permanent damage. The Supreme Court agreed that his departure was a direct consequence of the misinformation, thereby establishing causation.
Judgment
The Supreme Court unanimously allowed the appeal, ruling in Darnley’s favour. The case was remitted to the Queen’s Bench Division to assess damages.
Key Takeaways for Negligence Law
1. Duty of care is not limited to medical staff – A&E receptionists have a responsibility to provide accurate information that may impact a patient’s decision to stay or leave.
2. Hospitals must train all staff to prevent misinformation—administrative errors can have life-altering consequences.
3. A hospital’s duty extends beyond direct medical treatment. Providing misleading information—even about waiting times—can amount to negligence if it foreseeably results in harm.
This case is a landmark decision, reaffirming that hospitals must take reasonable steps to prevent harm from the moment a patient seeks medical help—including ensuring that non-medical staff provide accurate and reliable information.
For legal professionals, Darnley v Croydon Health Services NHS Trust is a critical reminder that negligence is not just about direct treatment but also about the broader system of care.
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Disclaimer
This article is for informational and educational purposes only and does not constitute legal advice. While I am a Barrister*, the discussion here is general in nature and should not be relied upon as specific legal guidance. If you require legal advice on negligence claims or any other legal matter, you should consult a qualified solicitor or barrister who can assess your individual circumstances.
Nothing in this article creates a solicitor-client relationship, and I disclaim any liability for reliance on the information provided. Laws and legal interpretations may change over time, so always seek professional advice tailored to your case.
*Authorised to conduct unreserved legal services. No Rights of Audience.