Secondary Victim Claims After Paul v Royal Wolverhampton NHS Trust [2024] UKSC 1

When someone witnesses the injury or death of a loved one caused by another’s negligence, they may suffer severe psychiatric harm even though they were not physically harmed themselves. In legal terms, such individuals are known as secondary victims.

For many years, the law allowed secondary victims to bring claims under specific, tightly controlled circumstances — but a landmark 2024 Supreme Court decision has significantly narrowed these rights, particularly in the area of clinical negligence.

The Traditional Test for Secondary Victim Claims

Before 2024, the rules governing secondary victim claims were established by the case of Alcock v Chief Constable of South Yorkshire Police [1991] — the case arising from the Hillsborough disaster.

For a secondary victim to bring a successful claim, the claimant needed to satisfy the following five criteria:

1. Close tie of love and affection with the primary victim (for example, a parent, spouse, or child).

2. Proximity in time and space to the incident or its immediate aftermath.

3. Direct perception of the event or aftermath (not through television or hearsay).

4. The event must have been sudden and shocking, rather than a gradual process.

5. The claimant must have suffered a recognised psychiatric illness, such as PTSD, rather than mere grief or emotional distress.

   
   

These strict criteria meant that even before 2024, secondary victim claims were complex and often challenging to establish.

The Impact of Paul v Royal Wolverhampton NHS Trust [2024] UKSC 1

In 2024, the Supreme Court revisited this area of law in the case of Paul v Royal Wolverhampton NHS Trust. This case involved family members who suffered psychiatric injury after witnessing a loved one’s death from a medical condition that had not been properly diagnosed or treated.

The Court’s decision fundamentally changed how the law views secondary victim claims in a medical context.

The Supreme Court held that:

• No direct comparison can be made between accident cases and cases involving medical crises resulting from untreated illness.

• Medical professionals owe a duty of care only to their patients, not to family members who witness distressing medical events.

• Witnessing a medical emergency, such as a heart attack or sudden deterioration, does not qualify as witnessing an “accident.”

What Counts as an “Accident”?

The Supreme Court defined an accident as:

“An unexpected and unintended event which causes injury (or a risk of injury) to a victim by violent external means.”

In other words, events such as road traffic collisions or workplace accidents may qualify, but the gradual effects of a medical condition, even if negligently untreated, do not.

What This Means for Future Claims

Following Paul, most secondary victim claims arising from clinical negligence will no longer succeed. Because medical crises typically result from underlying illnesses rather than “accidents” in the legal sense, these situations now fall outside the scope of secondary victim liability.

While this ruling may seem harsh, it represents a significant clarification of the limits of a healthcare provider’s duty of care.

However, secondary victim claims can still succeed in other contexts — for example, where a claimant witnesses a loved one injured or killed in a road traffic accident, workplace accident, or public disaster.

Final Thoughts

The decision in Paul v Royal Wolverhampton NHS Trust has closed the door on most secondary victim claims in the context of medical negligence, even in tragic circumstances where family members have directly witnessed a loved one’s suffering or death.

If you believe you may have a claim as a primary or secondary victim, it is crucial to seek specialist legal advice as early as possible. Our experienced clinical negligence and personal injury solicitors can help you understand your options and guide you through the claims process with sensitivity and expertise. Don't hesitate to contact Graystons for advice and support on 0151 645 0055 or by email at enquiries@graystons.co.uk.