The first contact that patients have with medical professionals is commonly online or on the telephone and there remain concerns as to whether such arrangements are adequate from a diagnostic point of view. In a case on point, the family of a woman who suffered a fatal heart attack within hours of making an anxious call to NHS Direct received seven-figure compensation.

The woman, a 32-year-old teacher with a first-class degree, was suffering from an E. coli infection of the kidneys when she made the call. She spoke to a healthcare assistant, then to a nurse, and the call lasted for about 45 minutes. She was not, however, advised to go to hospital or consult her GP and went on to develop bacterial septicaemia. She suffered catastrophic heart failure and died at home about nine hours after first picking up the phone to NHS Direct.

Left to grieve were her husband – who described her as the perfect wife – and her two children, the youngest of whom was only a few months old when their mother died. The children both suffer from moderately severe autism and are likely to always lack capacity to manage their own affairs and to require care and support from others throughout their lives.

The family took action against the NHS trust that took over the liabilities of NHS Direct when it was disbanded. The trust argued that a reference to hospital or a GP would not have saved the woman's life. Following negotiations, however, it agreed to settle the family's clinical negligence claim for £2,250,000, that sum representing 80 per cent of its full value. More than £1.8 million of that total would be set aside to fund the children's future care.