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Introduction
A blame culture is characterised by an unwillingness to accept responsibility for mistakes due to a fear of criticism or prosecution (Walton, 2006; Harris and White, 2013). Indeed, Furedi and Bristow (2012,p. 14) found, “there are no such things as accidents, it has to be someone’s fault and someone has to pay”. Litigation claims against the National Health Service (NHS) in the UK have increased year on year over the past two decades (Dobbie and Cooke, 2008). Written complaints against ambulance services in England have also risen by 28.5 per cent in 2013/2014 compared to 2012/2013. As of March 2011, the NHS Litigation Authority (NHSLA) estimated its potential liabilities at £16.8 billion, of which £16.6 billion relate to clinical negligence claims (Furedi and Bristow, 2012). Despite annual increases over recent years the 2015/2016 NHSLA annual report revealed that clinical negligence claims had reduced by 4.6 per cent from the previous year. However, damages paid to patients continue to rise with a 23 per cent increase in 2015/2016 from the previous year (National Health Service Litigation Authority, 2016). Indeed, it is reported that there is now a significant “blame culture” in the UK with the public being far less tolerant of mistakes (Dobbie and Cooke, 2008). The general public are exposed to an over-abundance of companies promoting the common “no win no fee” mantra and encouraging members of the public to claim for an accident or even perceived medical negligence (Furedi and Brown, 1999). Waring (2005) identified that the rise in the culture of blame has had a major impact on the medical profession resulting in a significant fear of litigation amongst doctors, affecting their practice, making it defensive and resulting in an under-reporting of clinical incidents due to fear of reprisal. This is further highlighted by Marienisis (2013) who suggested that the fear of litigation in the emergency medical profession leads to defensive practice and possibly influences overcrowding in emergency departments in the USA, thus highlighting the fear of litigation as an international concern amongst the medical professions. This can be damaging to healthcare professionals; “[The fear of litigation] erodes professional autonomy, stifles innovation, leads to defensive practices, and encourages greater bureaucracy. ‘Best practice’ is now defined as having checked all the boxes in...