Create professional bundles for clinical negligence claims, from pre-action protocol through to trial and inquest. Aligned with the Clinical Disputes Protocol.
Every stop on the journey explains the step, with a template, official form or hearing bundle wherever one is needed
What documents do I need for a clinical negligence claim?
A clinical negligence claim requires complete medical records, independent expert reports on breach and causation, a treatment chronology, schedule of loss, and pre-action protocol correspondence. BundleCreator organises these into a structured bundle designed to follow CPR r.39.5 and PD 32 para 27.
Each stop is a step in the journey. Large rings are hearings where you build a court bundle; small grey dots are steps you file or take, hollow dots are deadlines or events, and diamonds are forms. The key below the map explains every symbol. Click any stop to see what it involves.
Stops:Bundle hearing — a court bundle is built hereDecision hearing — the court or tribunal decides the case here; bundle requiredOptional hearing — dashed ring: only held in some casesProcess step — something you file or do, no bundleMilestone — a deadline or event; nothing to prepareOptional step — dashed: not always applicable (e.g. only if needed or agreed)Mediation step — mediation, a MIAM or early conciliation happens here
Reading:Blog Insight — purple book icons link to a related article (opens in a new tab)
Timing:⚠ 14 daysstatutory — miss this and lose4 weeksrequired noticetyp. 8motypical wait
Laws:This journey summarises the procedure under Pre-Action Protocol for the Resolution of Clinical Disputes, Civil Procedure Rules Parts 7, 21, 25, 35, 36, 44 (esp. r.44.13–17 QOCS) and 52, CPR rule 39.5 and Practice Direction 32 para 27.7 (trial bundle owned by claimant), Civil Procedure Rules r.26.9(10)(b) — a claim that includes clinical negligence must be allocated to the multi-track unless it would normally be allocated to the intermediate track (over £25,000 and up to £100,000), the defendant admitted liability in full in its Letter of Response, and no Limitation Act 1980 defence has been raised; only then may it go to the intermediate track and its fixed recoverable costs. There is no fast-track route: a claim worth £25,000 or less cannot meet the first condition and must be allocated to the multi-track. No fixed recoverable costs scheme for lower-value clinical negligence claims is in force at 27 September 2026, and CPR Part 45 contains no clinical-negligence section, Limitation Act 1980 ss.11 (3 years personal injury), 14 (date of knowledge — critical in clin neg / latent injury / birth injury), 28 (limitation runs from 18th birthday for children — protects birth-injury claims), 33 (court's discretion to disapply), Montgomery v Lanarkshire Health Board [2015] UKSC 11 (consent / disclosure of material risks), McCulloch v Forth Valley Health Board [2023] UKSC 26 (Bolam applies to choice of treatment; Montgomery applies to disclosure of material risks), Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 (standard of care), Bolitho v City and Hackney HA [1998] AC 232 (Bolam test logical-coherence overlay), Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, reg.20 (statutory duty of candour), Health and Social Care (Quality and Engagement) (Wales) Act 2020 s.3 (duty of candour for NHS bodies in Wales, from 1 April 2023), Damages Act 1996 s.A1 and the Damages (Personal Injury) (England and Wales) Order 2024 (SI 2024/1261): discount rate +0.5% from 11 January 2025; periodical payments under s.2, Mental Capacity Act 2005 (litigation friend / protected party) and Criminal Justice and Courts Act 2015 s.57 (claim dismissed for fundamental dishonesty unless substantial injustice); CPR 44.16 (QOCS enforcement permitted on a finding of fundamental dishonesty). General information only — not legal advice.
Clinical negligence claims follow the Pre-Action Protocol for the Resolution of Clinical Disputes. Before proceedings, the claimant should: (1) obtain the health records (the Protocol expects copies within 40 days of a request on the Annex B form), (2) commission expert evidence on breach of duty and causation, and (3) send a letter of claim to the defendant (usually an NHS Trust or private healthcare provider) setting out the facts, the alleged breaches, the injuries, and the financial losses. The defendant should acknowledge it within 14 days and send a reasoned Letter of Response within four months of the Letter of Claim. In Wales, NHS bodies also operate the 'Putting Things Right' concerns and redress arrangements (National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011, SI 2011/704).
Expert evidence is the backbone of clinical negligence claims. The claimant typically needs: a condition and prognosis expert (to describe the injuries), a breach of duty expert (to explain what a competent practitioner would have done), and a causation expert (to link the breach to the injury). Additional experts may be needed for quantum: care, accommodation, occupational therapy, employment, and forensic accountancy.
The Bolam test (Bolam v Friern Hospital [1957]) sets the standard of care: a doctor is not negligent if they acted in line with a responsible body of medical opinion. This is qualified by Bolitho v City and Hackney HA [1998]: the court can reject a body of opinion if it is not logically defensible. Causation must be proved on the balance of probabilities — the 'but for' test, qualified by material contribution in some cases.
QOCS (Qualified One-Way Costs Shifting) applies to clinical negligence claims — the claimant is generally protected from paying the defendant's costs if they lose, unless the claim is struck out (for example as disclosing no reasonable grounds or as an abuse of process) or found fundamentally dishonest.
Settlement is common: Part 36 offers carry significant costs consequences, and round-table meetings or mediations often resolve cases before trial.
Important: This journey map shows the typical stages of the relevant court or tribunal proceedings. It is general information, not legal advice. Every case is different. For advice about your specific situation, consult a solicitor or instruct a barrister directly.
The law, court fees and time limits can change. We work hard to keep this map accurate, but it may contain errors or become out of date, so please check anything important against the official source — for example legislation.gov.uk or GOV.UK. To the fullest extent permitted by law, Steleo Publishing Limited does not accept liability for any loss arising from reliance on this map. Each stop represents a stage where a separate bundle may be required; BundleCreator handles the formatting — it does not replace professional legal advice.
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A clinical negligence bundle typically includes medical records, expert reports on breach of duty and causation under the Bolam/Bolitho test, witness statements, a treatment chronology, and quantum evidence. BundleCreator is online court bundle software that organises these into clearly indexed sections under CPR Part 35.
Last reviewed: 27 September 2026 by Stevie Hayes
Medical Negligence Court Bundle UK: In Brief
A clinical negligence claim bundle is filed at the County Court or High Court (King's Bench Division) for damages arising from medical treatment that fell below the standard of a reasonably competent practitioner. Proceedings run under CPR Part 16 and the Pre-Action Protocol for the Resolution of Clinical Disputes. The bundle includes the medical records, expert reports on breach and causation, witness statements, and a Schedule of Loss.
Key rules
CPR Part 16 (statements of case), Part 35 (experts), Part 41 (Periodical Payments), Pre-Action Protocol for the Resolution of Clinical Disputes
Time limits
3 years from the date the cause of action accrued or, if later, the date of knowledge (Limitation Act 1980 ss.11(4), 14); for children, 3 years from the 18th birthday (s.28(1), (6)); for a person who lacked capacity to conduct proceedings when the cause of action accrued, time runs from when capacity is regained (ss.28, 38(2)); court discretion to disapply under s.33
Expert evidence
Breach-of-duty and causation experts (typically separate); both must follow CPR Part 35 and the Guidance for the Instruction of Experts in Civil Claims 2014 (PD 35 para 3.2(9))
Jurisdiction
County Court; High Court (King's Bench Division) only if the claim is worth £50,000 or more (PD 7A para 2.2)
Bundle size
Clinical negligence bundles routinely run long — medical records, imaging, expert reports; up to 1,000 pages supported
NHS Resolution received 15,236 new clinical negligence claims and reported incidents in 2025/26 (England).
Source: NHS Resolution Annual Report and Accounts 2025/26 (9 July 2026)
3 years
Clinical negligence limitation
Claims in respect of personal injury caused by negligence must generally be brought within three years of the date the cause of action accrued or, if later, the date of knowledge (Limitation Act 1980 s.11(4)).
Source: Limitation Act 1980, section 11
Pre-Action Protocol
Clinical Disputes Protocol
The Pre-Action Protocol for the Resolution of Clinical Disputes governs letters of claim, responses, and disclosure before proceedings are issued.
Source: Civil Procedure Rules, Pre-Action Protocol for the Resolution of Clinical Disputes
Built for Clinical Negligence
Features designed for medical negligence practitioners
Designed around the Clinical Disputes Protocol
Templates aligned with the Pre-Action Protocol for the Resolution of Clinical Disputes.
Treatment Chronology Builder
Create detailed treatment chronologies from medical records with date-ordered entries.
Breach Analysis Template
Structured templates for analysing breach of duty against the Bolam/Bolitho standard.
Causation Framework
Guided framework for establishing causation, including 'but for' test analysis.
Expert Instruction Letters
Template letter of instruction for medical experts (CPR Part 35).
Inquest Bundle Support
Specialist templates for coronial inquest bundles following a death in clinical care.
Understanding Clinical Negligence Bundles
Everything you need to know about medical negligence case bundles
Clinical Negligence Claims in England and Wales
Clinical negligence (also called medical negligence) arises when a healthcare professional provides treatment that falls below the standard expected of a reasonably competent practitioner, causing injury to the patient.
The claimant must prove three elements: a duty of care existed, that duty was breached (the Bolam test), and the breach caused the injury complained of (causation).
The Pre-Action Protocol for Clinical Disputes
Before issuing proceedings, parties should follow the Pre-Action Protocol for the Resolution of Clinical Disputes. The Protocol expects a records request on the Annex B form, an optional Letter of Notification, a Letter of Claim and a four-month period for the Letter of Response.
The protocol aims to encourage early settlement and ensure both parties have sufficient information to assess the merits of the claim.
What Goes in a Clinical Negligence Bundle?
A clinical negligence bundle should contain all documents relevant to the claim, organised chronologically within each section.
Complete medical records from all relevant providers
Expert reports on breach of duty and causation
Condition and prognosis reports
Treatment chronology
Schedule of loss and quantum evidence
Pre-action protocol correspondence
Clinical Negligence Templates
Choose the template for your claim stage
Pre-Action Bundle
4 sections -- Letter of Notification; Letter of Claim; Medical Records; Response
CMC Bundle
4 sections -- Pleadings; Case Management; Expert Evidence; Costs
Trial Bundle
7 sections -- Pleadings; Case Management; Expert Evidence; Medical Records; Quantum; Witness Evidence; Legal Submissions
Inquest Bundle
5 sections -- Inquest Documents; Medical Records; Expert Evidence; Witness Evidence; Interested Person Submissions
Quantum Bundle
4 sections -- Agreed Liability; Schedule of Loss; Medical Evidence; Financial Evidence
BundleCreator's Medical Negligence template handles trial bundles up to 1,000 pages per bundle — for very large medical-records sets, split across multiple bundles by issue or section. Upload medical records by source (GP, A&E, consultant, theatre, anaesthetic, drug charts); the tool sequences them chronologically inside the Medical Records section, applies OCR throughout for keyword search, paginates continuously, and bookmarks each treating clinician. Breach, causation and condition-and-prognosis reports sit in the Expert Evidence section, with a slot for the joint statement. Output: one PDF, ready for trial in the County Court or the King's Bench Division.
BundleCreator orders medical records chronologically across all sources into the Medical Records section of the trial bundle. Upload GP records, hospital admissions, consultant letters, theatre notes, drug charts, and imaging reports as you obtain them — the tool merges them by date, applies OCR so the trial judge and counsel can keyword-search across the lot, and bookmarks each treating clinician for navigation. No manual rebuilds when late records arrive; the tool re-paginates and re-bookmarks automatically. Bundle limit is 1,000 pages per bundle, so very large records sets are split across multiple bundles by date range or issue.
The Pre-Action Protocol for the Resolution of Clinical Disputes requires a Letter of Claim with a clear summary of facts, allegations of negligence, alleged injury, causation case, and quantum indication. BundleCreator's Medical Negligence template produces a Protocol-stage bundle: Letter of Claim, supporting medical records (chronologically arranged), expert support letter on breach and causation, draft witness statements, and any relevant consent forms. See [Pre-Action Protocol for Clinical Negligence: Letter of Claim Walkthrough](/blog/clinical-negligence-pre-action-protocol-letter-of-claim).
Most clinical negligence cases need separate experts on breach of duty (the Bolam-Bolitho test for clinical practice generally — a responsible body of medical opinion that withstands logical analysis; with Montgomery v Lanarkshire applying the patient-centred test for consent and risk-disclosure cases) and on causation (but-for or material contribution). BundleCreator's Medical Negligence trial template has an Expert Evidence section for the claimant's and defendant's breach of duty reports, the claimant's and defendant's causation reports, the condition and prognosis report, and the joint statement. Joint statements are bookmarked for fast navigation, and the hyperlinked index lets the trial judge jump from one expert's view on an issue to the opposing view. See [Clinical Negligence Expert Evidence: Breach of Duty vs Causation Reports](/blog/clinical-negligence-expert-evidence-breach-causation).
BundleCreator runs on Google Cloud's London region (europe-west2) — primary storage, backups, and processing all in the UK. AES-256 at rest, TLS 1.3 in transit. Patient medical records, expert reports, and witness statements stay within UK borders, removing UK GDPR Article 44 international-transfer concerns.
BundleCreator's Essential tier is £19.99 a month with no per-bundle fee — well-suited to sole practitioners running clinical negligence claims on Conditional Fee Agreements. It produces a Pre-Action Protocol bundle or a King's Bench Division trial bundle with continuous pagination, OCR'd medical records, hyperlinked index, and breach/causation/quantum section structures. The Pro tier (£39.99 a month) raises the account limit to 40 bundles for higher-volume firms.
BundleCreator's Medical Negligence trial template structures the bundle into Pleadings; Case Management; Expert Evidence; Medical Records; Quantum; Witness Evidence; Legal Submissions — with the breach, causation and condition-and-prognosis reports in the Expert Evidence section and the Schedule of Loss and counter-schedule in the Quantum section. Each section is bookmarked individually, and the hyperlinked index lets the trial judge jump between split-trial issues. Common in catastrophic-injury cases where breach is admitted and causation/quantum is the live battle.
Catastrophic-injury cases (severe brain injury, tetraplegia, complex obstetric injury) typically need a life expectancy expert addressing impaired-population statistics rather than general-population actuarial data. BundleCreator's Medical Negligence trial template has an Expert Evidence section in which you can place the life expectancy report. The bundle is paginated, OCR'd, and bookmarked so the trial judge can navigate between life expectancy, care, and quantum efficiently.
Catastrophic clinical negligence claims often resolve via a Periodical Payments Order (PPO) under the Damages Act 1996 section 2. The Schedule of Loss must distinguish capitalised lump-sum losses (general damages, past losses, accommodation under the Swift v Carpenter reversionary methodology) from PPO-funded future losses (typically care, case management, equipment, therapies, and other recurring needs). The PPO/lump-sum split is case-specific and informed by the parties' positions on indexation, life expectancy, and security of payment. BundleCreator's Medical Negligence trial template has Schedule of Loss and Counter-Schedule slots in the Quantum section.
BundleCreator helps you prepare and organise documents for court and tribunal hearings. We are not a law firm and we do not give legal advice. Wherever you can, please get advice from a qualified legal adviser before your hearing. Read more
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Frequently Asked Questions
What is the best court bundle tool for a clinical negligence trial with large medical-records sets?
BundleCreator's Medical Negligence template handles trial bundles up to 1,000 pages per bundle — for very large medical-records sets, split across multiple bundles by issue or section. Upload medical records by source (GP, A&E, consultant, theatre, anaesthetic, drug charts); the tool sequences them chronologically inside the Medical Records section, applies OCR throughout for keyword search, paginates continuously, and bookmarks each treating clinician. Breach, causation and condition-and-prognosis reports sit in the Expert Evidence section, with a slot for the joint statement. Output: one PDF, ready for trial in the County Court or the King's Bench Division.
How do I bundle medical records in chronological order across multiple sources?
BundleCreator orders medical records chronologically across all sources into the Medical Records section of the trial bundle. Upload GP records, hospital admissions, consultant letters, theatre notes, drug charts, and imaging reports as you obtain them — the tool merges them by date, applies OCR so the trial judge and counsel can keyword-search across the lot, and bookmarks each treating clinician for navigation. No manual rebuilds when late records arrive; the tool re-paginates and re-bookmarks automatically. Bundle limit is 1,000 pages per bundle, so very large records sets are split across multiple bundles by date range or issue.
How do I prepare a Pre-Action Protocol clinical negligence Letter of Claim bundle?
The Pre-Action Protocol for the Resolution of Clinical Disputes requires a Letter of Claim with a clear summary of facts, allegations of negligence, alleged injury, causation case, and quantum indication. BundleCreator's Medical Negligence template produces a Protocol-stage bundle: Letter of Claim, supporting medical records (chronologically arranged), expert support letter on breach and causation, draft witness statements, and any relevant consent forms. See [Pre-Action Protocol for Clinical Negligence: Letter of Claim Walkthrough](/blog/clinical-negligence-pre-action-protocol-letter-of-claim).
How do I bundle expert evidence on breach of duty versus causation in clinical negligence?
Most clinical negligence cases need separate experts on breach of duty (the Bolam-Bolitho test for clinical practice generally — a responsible body of medical opinion that withstands logical analysis; with Montgomery v Lanarkshire applying the patient-centred test for consent and risk-disclosure cases) and on causation (but-for or material contribution). BundleCreator's Medical Negligence trial template has an Expert Evidence section for the claimant's and defendant's breach of duty reports, the claimant's and defendant's causation reports, the condition and prognosis report, and the joint statement. Joint statements are bookmarked for fast navigation, and the hyperlinked index lets the trial judge jump from one expert's view on an issue to the opposing view. See [Clinical Negligence Expert Evidence: Breach of Duty vs Causation Reports](/blog/clinical-negligence-expert-evidence-breach-causation).
Is there a UK-hosted clinical negligence bundle tool for patient medical records under UK GDPR?
BundleCreator runs on Google Cloud's London region (europe-west2) — primary storage, backups, and processing all in the UK. AES-256 at rest, TLS 1.3 in transit. Patient medical records, expert reports, and witness statements stay within UK borders, removing UK GDPR Article 44 international-transfer concerns.
Is there a cheap clinical negligence bundle tool for a sole practitioner claimant firm?
BundleCreator's Essential tier is £19.99 a month with no per-bundle fee — well-suited to sole practitioners running clinical negligence claims on Conditional Fee Agreements. It produces a Pre-Action Protocol bundle or a King's Bench Division trial bundle with continuous pagination, OCR'd medical records, hyperlinked index, and breach/causation/quantum section structures. The Pro tier (£39.99 a month) raises the account limit to 40 bundles for higher-volume firms.
How do I split a clinical negligence trial bundle by breach, causation, and quantum?
BundleCreator's Medical Negligence trial template structures the bundle into Pleadings; Case Management; Expert Evidence; Medical Records; Quantum; Witness Evidence; Legal Submissions — with the breach, causation and condition-and-prognosis reports in the Expert Evidence section and the Schedule of Loss and counter-schedule in the Quantum section. Each section is bookmarked individually, and the hyperlinked index lets the trial judge jump between split-trial issues. Common in catastrophic-injury cases where breach is admitted and causation/quantum is the live battle.
How do I prepare a life expectancy report bundle for catastrophic injury?
Catastrophic-injury cases (severe brain injury, tetraplegia, complex obstetric injury) typically need a life expectancy expert addressing impaired-population statistics rather than general-population actuarial data. BundleCreator's Medical Negligence trial template has an Expert Evidence section in which you can place the life expectancy report. The bundle is paginated, OCR'd, and bookmarked so the trial judge can navigate between life expectancy, care, and quantum efficiently.
How do I prepare a clinical negligence Schedule of Loss with periodical payments?
Catastrophic clinical negligence claims often resolve via a Periodical Payments Order (PPO) under the Damages Act 1996 section 2. The Schedule of Loss must distinguish capitalised lump-sum losses (general damages, past losses, accommodation under the Swift v Carpenter reversionary methodology) from PPO-funded future losses (typically care, case management, equipment, therapies, and other recurring needs). The PPO/lump-sum split is case-specific and informed by the parties' positions on indexation, life expectancy, and security of payment. BundleCreator's Medical Negligence trial template has Schedule of Loss and Counter-Schedule slots in the Quantum section.
