When a patient dies and the police open an investigation, the doctor at the centre of it tends to assume the worst. Yet the published figures on police investigations of doctors point the other way. They are incomplete and nobody collects them every year. But each serious study since 2018 has found that most investigations of healthcare professionals for gross negligence manslaughter end without a charge. The studies also found that a charge often ends without a conviction. This article sets out what those studies found, where their limits lie and what they mean for you.
The Williams review, 2018
Professor Sir Norman Williams led a rapid policy review of gross negligence manslaughter in healthcare for the Secretary of State for Health. It appeared in June 2018. The Crown Prosecution Service gave the review its figures for cases involving a healthcare professional since 2013. The CPS had been involved in 151 such cases. In 85 the police took no further action after early advice from the CPS. In 43 more the CPS decided to take no further action after the police had submitted a full file for a charging decision. Seven cases led to a prosecution, producing four convictions and three acquittals, and 16 were still under consideration.
Of the 135 cases decided by then, 128 ended without a prosecution, about 95 per cent. The review put its conclusion plainly:
Investigations of gross negligence manslaughter in healthcare are unusual, prosecutions are rarer and guilty judgements rarer still.
The review also counted every prosecution of a healthcare professional for gross negligence manslaughter since the House of Lords decided Adomako in 1994. The deaths of 38 patients had led to the prosecution of 47 professionals (37 doctors, nine nurses and one optometrist). Twenty three ended in conviction, and four of those convictions were overturned on appeal. Since 2013, 15 professionals had faced prosecution, with six convictions, two of them later quashed.
The CPS data, 2007 to 2018
In May 2019 two academics reported to the CPS and to the GMC's independent review. They were Danielle Griffiths of the University of Sussex and Oliver Quick of the University of Bristol. Their report covered a table of every known case referred to the CPS Special Crime Unit between 2007 and early 2018. There were 192 cases involving 219 individual suspects and 50 organisations. Twelve led to a prosecution, two of them by guilty plea, which is about 6 per cent. One hundred ended on early investigative advice, 60 ended after the full code test and 15 were still under review. The records gave dates for 44 cases. In those, a decision not to prosecute on early advice took an average of seven months from referral. A full code test decision took an average of 17 months. Those periods run from referral, not from the death.
The GMC's independent review chaired by Leslie Hamilton, published in June 2019, relied on that research. It described investigation and prosecution of doctors for gross negligence manslaughter as extremely rare, at around one prosecution a year.
What the figures leave out
These numbers cover gross negligence manslaughter only, and only cases the police referred to the CPS. Griffiths and Quick said that the number of police investigations which never reach the CPS is unknown, and likely to be larger. I have found no published national figure for police investigations of doctors that end without charge. That gap covers every offence, whether assault, a sexual offence or fraud. So anyone who gives you a single percentage for all criminal allegations against doctors is going beyond the evidence.
Two recent cases
Operation Magenta is the police investigation into deaths at Gosport War Memorial Hospital. On 13 November 2025 it told 101 families that the investigations into their relatives' deaths had not met the evidential test for criminal prosecution. It added that the police would take no further action unless further information came to light. The understanding was that those cases had not gone to the CPS. The investigation has reviewed the records of more than 750 patients. In January 2025 the police said they were interviewing 29 suspects, 24 of them for alleged gross negligence manslaughter, and that they had made no arrests. Other files continue to go to the CPS.
In September 2024 the BBC reported the case of Matthew Charnock. He died in 2016 after Whiston Hospital discharged him with a head injury that another man had inflicted. Cheshire Police had spoken to a nurse practitioner. Prosecutors decided there was not enough evidence for a realistic prospect of conviction against any individual. In September 2024 a coroner at a fresh inquest concluded that his death was an unlawful killing contributed to by neglect. The Nursing and Midwifery Council said it would consider whether the findings called for regulatory action. Since the Supreme Court's decision in Maughan in 2020, the CPS notes, an inquest reaches its conclusions on the balance of probabilities. So an unlawful killing conclusion no longer carries the old expectation that a prosecution will follow.
What this means for you
The odds favour you, but the process is still slow. Most cases close at the early advice stage, before anyone builds a full file. The CPS guidance on gross negligence manslaughter says early advice can bring an investigation to an end where the case cannot meet the evidential test. The same guidance requires medical expert evidence in every medical manslaughter case. It also asks whether the conduct was truly exceptionally bad. A careful account at interview and a properly instructed expert at the early stage are where cases are won.
The figures here concern doctors. If you are a nurse, dentist, pharmacist or other healthcare professional, the police track runs the same way and your regulator's process differs, as our pages for each profession explain.
Your GMC case runs alongside. The GMC may wait for a police investigation to finish before opening its own enquiry, unless the case calls for an interim order. And in 2025 more than 90 per cent of the cases heard by tribunals involved misconduct, criminal convictions or both. Our article on what the GMC figures say about 2025 gives the detail. Eloquia runs both tracks as one strategy. Police interview and pre charge representations, run with our criminal defence partner, cost a fixed £15,000 plus VAT. That fee includes the specialist barrister involved from the outset, and we quote expert fees separately. Our page on criminal allegations against doctors explains how the two tracks fit together. Our fees and funding page lists the fixed fee for each stage, every one stated plus VAT.
Sources
- Gross negligence manslaughter in healthcare: the report of a rapid policy review (Williams review), June 2018
- Williams review, full report (PDF), paragraphs 4.4 to 4.8
- D Griffiths and O Quick, Managing medical manslaughter cases: improving efficiency and transparency?, Bristol Law Research Paper No 7, May 2019
- Independent review of gross negligence manslaughter and culpable homicide (Hamilton review), GMC, June 2019
- Gross negligence manslaughter, CPS prosecution guidance
- Coroners, CPS prosecution guidance (Maughan and unlawful killing conclusions)
- No charges over 101 deaths at scandal-hit hospital, police tell families, The Standard, 13 November 2025
- Five more suspects in Gosport War Memorial Hospital deaths probe, ITV News, 24 January 2025
- Hospital neglect victim's dad calls for charges, BBC News, 21 September 2024
- Professional Standards Authority, Monitoring report: GMC 2024/25 (third party investigation guidance)
- Concerns about fitness to practise: annual statistical report 2025, GMC
