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Six years ago, there were approximately 90 firms defending the NHS against patient claims of clinical negligence. Since the National Health Service Litigation Authority (NHSLA) was created in 1998, this figure has been slashed to just 14, as the authority centralised control of the previously fragmented claims management system. Uniquely in the litigation world, firms sitting on the NHSLA panel have only one choice of client – and if the constant screwing down on costs makes partner profits suffer, they have to like it or lump it.

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