High value clinical negligence litigation is resource-intensive by its nature. Multiple expert disciplines, complex causation issues, significant disclosure, and heavy counsel involvement can produce costs that quickly become a target for challenge. In our experience, the firms that maximise recovery are not simply those who draft a strong Bill at the end. They are the ones who treat costs as a live strategic issue from the first letter of claim through to settlement or detailed assessment.

This guide sets out practical steps that consistently protect recoverability and improve outcomes in high value cases.

1) Start with a recovery strategy, not just a budget

In high value claims, “we’ll sort costs out at the end” is where recoverability is lost. Early on, decide what the recovery story is going to be:

• Why does this case justify the level of work anticipated?
• Which issues will drive complexity (liability, breach, causation, quantum, capacity, future care)?
• Which workstreams will be expert-led and why?
• What is the likely procedural path (interim applications, split trial, ADR, Part 36)?

If you can’t explain the logic of the work at the start, it becomes far harder to justify it later. A coherent strategy also helps you deploy fee earners appropriately and record time in a way that supports recovery.

2) Get costs budgeting right, and keep it alive

Most high value clinical negligence claims are multi-track and budgeting is central. A budget is not a formality; it is a recovery framework. A well-prepared budget does three things:

1. It explains the case: assumptions should connect the work to the issues, evidence, and timetable.
2. It controls the narrative: you frame what is “necessary” before the other side frames it as excessive.
3. It reduces end-stage uncertainty: a well-managed budget can make the subsequent Bill more straightforward to negotiate.

Practical steps that improve recovery:

• Draft phase assumptions with enough detail to show why work is required, but keep them clear and disciplined.
• Ensure the phases reflect the true case plan (experts, conferences, schedule of loss updates, capacity).
• Avoid building “contingency padding” into every phase. Judges spot it quickly and it undermines credibility.

Where the case changes materially, treat budget variation as a protective step, not a last resort.

3) Record time like you expect it to be challenged

High value cases attract scrutiny. The best time narratives are those written for an external reader, not for internal billing.

Time should show:

• What was done (specific activity, not “review documents”)
• Why it was needed (link it to an issue, order, instruction, expert step, or procedural requirement)
• What the output was (advice, draft, instructions, analysis, conference note)

Avoid repeated vague entries, block billing, and generic “attendance to emails” where the real work was strategic. If a costs judge cannot see the necessity from the record, the item becomes vulnerable, even in a genuinely complex claim.

4) Match the work to the right fee earner, and show the delegation

Recoverability in clinical negligence is frequently reduced due to avoidable seniority. The point is not to remove senior input as high value cases require it, but to justify it and show that routine tasks were delegated.

Practical approach:

• Use senior fee earners for strategic decisions, pleadings oversight, key expert analysis, settlement strategy and complex advice.
• Use mid-level and junior fee earners for document management, first-draft tasks, routine correspondence, and organisation of evidence.
• Make delegation visible: if a partner reviews or signs off, time narratives should reflect “supervision / strategic review” rather than implying the partner did the underlying task.

When hourly rates are challenged, an evidence-led explanation of the fee earner’s role and the need for that level of expertise is far more persuasive than asserting the case is “complex”.

5) Treat experts as a recoverability risk area

Experts are essential in clinical negligence claims, but they are also one of the first areas challenged by paying parties. Risk arises from:

• Overlapping disciplines
• Excessive conferences and re-conferences
• Poor articulation of why an expert was needed
• Late changes of expert
• Unclear division between liability/causation and quantum expert work

To strengthen recovery:

• Document why each discipline is required and how it links to pleaded issues.
• Record the purpose and outcome of conferences (e.g., narrowing breach, addressing causation mechanism, preparing joint statement).
• Keep instructions and follow-up work aligned with the timetable and court directions.
• If the defendant’s approach generates extra expert work, record that causal link clearly.

6) Use interim steps to your advantage

High value clinical negligence claims often involve interim hearings, relief, amendments, disclosure disputes, and procedural skirmishes. These can drive costs upward, but they can also support recovery if approached properly.

Maximising recovery depends on showing that:

• The step was necessary to move the case forward; and/or
• The additional work was caused by the opponent’s conduct or position; and/or
• It was proportionate to the issues at stake.

Where you obtain interim costs orders, ensure the resulting costs are captured accurately and that the link between the hearing and the work undertaken is clear. This also helps in negotiations later.

7) Be disciplined with documents and disclosure

Disclosure in clinical negligence can be vast: hospital records, GP records, internal policies, incident reports, imaging, pharmacy records, and third-party material. Electronic document work is frequently challenged as excessive.

To protect recovery:

• Keep document handling processes structured (and record the structure).
• Use sensible workflows and explain them where necessary (particularly if a large disclosure exercise was unavoidable).
• Avoid duplicative review by multiple fee earners without a clear reason.

If you can show the court that your approach was controlled and efficient, the paying party’s “too much document time” argument becomes harder to sustain.

8) Protect proportionality from the beginning, not at the end

Proportionality arguments are common in high value clinical negligence cases even where damages are substantial. Paying parties may still argue that costs are excessive relative to the issues, or that the claim could have been run more cheaply.

The strongest protection is:

• A clear case plan reflected in the budget and time records
• Evidence that the work was driven by the issues and the opponent’s stance
• Sensible delegation and controlled document processes
• Appropriate use of ADR and Part 36

In our experience, the moment you start trying to “explain proportionality” for the first time at the Bill stage is the moment you have already lost leverage.

9) Negotiate costs as the case progresses

Costs negotiation is not just an end-stage exercise. In high value claims, sensible negotiation throughout can limit dispute scope and protect recovery.

Examples:

• Agreeing expert disciplines or narrowing issues can reduce later challenges to scope.
• Meaningful engagement over budgets can reduce judicial intervention and later argument.
• Early discussion on interim costs consequences can prevent tactical disputes.

If the other side refuses to engage, that may itself become useful context at assessment — but only if you have a clear record of your attempts to narrow issues.

10) Draft the Bill of Costs as a recovery case, not a spreadsheet

A high value clinical negligence Bill is not simply itemisation, it is persuasion. The structure and clarity of the Bill matters.

A strong Bill:

• Reflects the case chronology and litigation logic
• Allocates time coherently into phases
• Explains why key workstreams were necessary
• Identifies where additional work was generated by the defendant’s conduct
• Anticipates common paying party challenges (rates, experts, duplication, documents, counsel)

If your Bill reads as a coherent account of what the case required, it is harder to undermine through generic reductions.

11) Prepare for Points of Dispute before they arrive

Paying parties tend to challenge similar areas repeatedly. Preparing in advance improves recovery.

Common targets include:

• Hourly rates and seniority
• Expert evidence and conferences
• Document review and disclosure
• Counsel’s fees
• Duplication and “over-lawyering”
• Proportionality

If your file already contains the justification for these areas, your responses to Points of Dispute can be concise and confident rather than defensive.

How ARC Costs can assist

ARC Costs supports solicitors and litigation teams handling high value clinical negligence claims with practical, evidence-led costs expertise. We help you maximise costs recovery by preparing and negotiating robust costs budgets, drafting and defending Bills of Costs, and advising strategically on proportionality, hourly rates, expert-heavy work and recoverability throughout the life of the claim. Where disputes arise, our team can assist with Points of Dispute and Replies, negotiations, and preparation for detailed assessment.

Maximising costs recovery in high value clinical negligence claims is ultimately about consistency: a clear strategy, defensible recording, sensible delegation, and proactive management of risk areas. When those elements are in place, recovery becomes far less vulnerable, and negotiation outcomes improve accordingly.

To speak to a clinical negligence costs draftsman from our team, contact us today.

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