What is the Bolam Test?

When something goes wrong in a medical setting it can often have a long-lasting negative impact on people’s lives. If this is the case, sometimes patients can make a claim for medical negligence. This results in them getting compensation if it can be proven that there was medical negligence.

In the UK, establishing culpability in a medical setting can be complicated, and this is why the Bolam test is used, enabling medics to be assessed for breach of duty.

Bolam Test History 

The Bolam Test was first implemented following the 1957 case of Bolam vs Friern Hospital Management Committee. The case was related to an incident at the hospital whereby the patient – Mr. Bolam – received Electro Convulsive Therapy (ECT) which caused him serious fractures.

Mr. Bolam argued that his doctor has been negligent for the following three reasons:

1.Muscle relaxation had not been administered before the procedure began.

2.Mr. Bolam had not been restrained during the procedure.

3.Mr. Bolam had not been warned of the potential risks of the procedure.

The result of the case was that it failed as it was deemed that the doctor had followed the medical protocol at the time, and patients were also not routinely advised of all of the small risks that could occur as a result of the procedure. This led to the legal system developing and implementing the Bolam Test as a way to measure medical negligence.

The Bolam Test is based on the premise of determining whether the actions of the medic are in line with the actions of other medics who are in their position – this means that it can sometimes change according to their degree of experience, for example.

Although this happened in 1957, the basics of the Bolam Test remain key, but it has been adapted to fit with the ever-evolving medical profession.

The case of Bolitho vs Hackney Health Authority (1977) found that both the claimant’s and the defendant’s evidence was useful. This case was used to amend the rules around the Bolam Test, with the explanation being, “In cases of diagnosis and treatment there are cases where, despite a body of professional opinion sanctioning the defendant’s conduct, the defendant can properly be held liable for negligence…  In the vast majority of cases, the fact that distinguished experts in the field are of a particular opinion will demonstrate the reasonableness of that opinion… But if, in a rare case, it can be demonstrated that the professional opinion is not capable of withstanding logical analysis, the judge is entitled to hold that the body of opinion is not reasonable or responsible.” (Lord Browne-Wilkinson)

The Chester vs Afshar (2004) and Montgomery v Lanarkshire Health Board (2015) cases helped to refine the law in regard to the failure to warn patients of potential risks to certain procedures. It was argued that the medic’s withholding of information meant that the patient was unable to make an informed decision about the procedure that they were due to have (and, indeed, which caused an injury having had the procedure).

What is a Duty of Care? 

If you work in the medical profession, you have a legal obligation to provide a reasonable standard of care to your patients. This is called a ‘duty of care’.  If this duty of care is breached, it can result in illness or injury to the patient, and this can result in a claim being made against you for medical negligence.

The Bolam test is the standard test that is used to establish whether the duty of care has been breached.

How is the Bolam Test Applied? 

The Bolam test is essentially a test that is judged by the medical professional’s peers. They must be able to show that any medical professional who was in the same position as them would have done the same, giving the same outcome. In those circumstances, a case would fail.

Following Bolam Principles and Guidelines 

Although the Bolam Test is a good way to set out the principles around the idea of a duty of care and the potential existence of medical negligence, it can be a somewhat grey area and sometimes difficult for medical professionals to be certain that what they are doing is correct.

This is why we are seeing more and more bodies such as NICE (National Institute for Health and Care Excellence) publishing extensive sets of guidelines as to best practice and the duty of care, to help to ensure that medical professionals protect themselves and their patients.

How can Waldrons Help?

If you feel that you have suffered illness or injury as a result of medical negligence, our team of expert solicitors is on hand to help you to determine whether you have a case and guide you through the process.


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