In case of Darnley v Croydon health services, Mr Darnley was unlawfully attacked and struck on the head by unknown assailants in May 2010. After a time, he began to feel unwell and was persuaded by his friend to go to the accident and emergency department of Mayday University Hospital.  He was booked in at reception at 20:26 and left at 20:45 without having been seen by a clinician because he felt so dreadful, very drowsy and with a severe headache - making it difficult for him to speak. 

When he returned home his condition deteriorated and an ambulance was called at about 21:42. He was taken back to the Mayday Hospital where it was shown that he had an extradural haematoma on the brain.  He was transferred to St George’s Hospital for neurosurgery but suffered damaging brain injury leaving him with left hemiplegia and wheelchair dependant. It was agreed that had he been treated sooner he would have made a complete recovery.

Mr Darnley argued  that he  should not have been told by the receptionist that he would have to wait up to four hours before being seen and should have been told that he would be seen by a triage nurse within 30 minutes. If he had been told this he would have waited in reception.  Instead he left after 19 minutes because he felt so unwell at the time.

The evidence from the receptionist was that their usual practice was to tell patients that they would be seen by a triage nurse either within 30 minutes or as soon as possible. It was accepted that they did not follow their usual practice in Mr Darnley’s case. The issue that arose was whether the “usual practice” was equivalent to the status of a duty to follow such practice. 

Mr Darnley argued that he is owed a duty of care by the A&E department and that the reception staff were there to facilitate the A&E assessment of patients for the purposes of treatment and management. Once Mr Darnley entered into the A&E department and registered with them they owed him a duty of care. The reception staff are part of the A&E department; it depends upon them and cannot function without them and patients presenting at A&E are seeking medical treatment and there is a duty to take reasonable care to give the correct information.

The Judge found that whilst it was reasonably foreseeable that some patients might leave A&E departments without being seen or treated and that in such cases harm may result, the receptionists in A&E departments are not under a duty to guard patients against harm caused by failure to wait to be seen and therefore  it was not reasonable to impose a liability on the receptionist. He stated that the primary duty of receptionists in an A&E department is to complete registration forms so that clinical decisions can be taken by healthcare professionals. The information concerning waiting times was a courtesy and not a duty which would impose liability in damages for their failure to provide such information.

The case  is to be an appealed in February 2017.

Deborah Blythe, partner and head of the clinical negligence and personal injury team, and who acted for Mr Darnley, comments "The extent of the duty owed by a receptionist in an A&E setting in respect of the provision of information is of considerable public importance. This is the first occasion on which the issue as to the role of A& E reception staff has been judicially tested and the outcome of the Appeal will be important both for patients attending A&E and A&E departments.”