A pressure sore claim in the UK arises when a patient develops a pressure ulcer (bedsore) because a hospital or care home failed to carry out a proper risk assessment and prevention plan. Most pressure sores are avoidable. NICE Clinical Guideline CG179 sets out the standard of care that hospitals and care homes must follow. Compensation is valued under the Judicial College Guidelines for the injury sustained, plus special damages for treatment, care and other losses. The time limit is generally three years.
Pressure sores — also called pressure ulcers, bedsores or decubitus ulcers — develop when sustained pressure on the skin reduces blood flow to the tissue. They are one of the most common, and most preventable, forms of harm in hospitals and care homes. At their worst, they expose bone and muscle, require months of painful wound care or surgical intervention, cause life-threatening sepsis and leave permanent scarring. This guide explains when a pressure sore amounts to clinical negligence, how compensation is assessed, and what evidence you need. We are an independent information service, not a law firm.
Pressure sore grading system
The internationally recognised classification system (used by NICE, EPUAP and NPUAP) has four categories:
| Category | Description | Claim significance |
|---|---|---|
| Category 1 | Non-blanchable redness of intact skin. The area does not turn white when pressed. | Rarely the subject of a claim on its own, but a Category 1 sore that progresses to a higher grade because of continued neglect strengthens the case. |
| Category 2 | Partial-thickness skin loss. May present as a blister, abrasion or shallow open wound. | Can support a claim if it developed or worsened due to negligent care, but awards are lower because healing is usually possible without surgery. |
| Category 3 | Full-thickness skin loss. Subcutaneous fat may be visible, but bone, tendon and muscle are not exposed. There may be undermining. | A serious injury. Often requires months of wound care. Classified by NHS Improvement as a patient safety incident requiring investigation. |
| Category 4 | Full-thickness tissue loss with exposed bone, tendon or muscle. Undermining and tunnelling are common. | The most severe grade. Often requires surgical debridement, possible skin grafting, extended hospital stays and carries a significant risk of sepsis and death in vulnerable patients. |
When is a pressure sore negligent?
NICE Clinical Guideline CG179 (Pressure ulcers: prevention and management, 2014) sets the standard. A hospital or care home is likely negligent if it:
- Failed to carry out a pressure-ulcer risk assessment on admission (using a validated tool such as the Waterlow or Braden scale).
- Identified the risk but failed to implement a prevention plan: regular repositioning (typically every 2-4 hours), pressure-relieving mattress or cushion, skin inspection, continence management and nutritional support.
- Failed to monitor and escalate: a Category 1 sore that was not identified or acted upon, allowing progression to Category 3 or 4.
- Failed to provide adequate wound care once a pressure sore developed, leading to infection, sepsis or avoidable deterioration.
⏰ NHS Improvement classification
Category 3 and Category 4 pressure ulcers that develop in NHS-funded care are classified as patient safety incidents and must be reported and investigated by the trust. The investigation report can be powerful evidence in your claim.
Who can be liable?
- NHS trusts. Claims are handled by NHS Resolution. The trust is liable for the acts and omissions of its nursing staff, healthcare assistants and medical staff.
- Care homes. Both nursing homes and residential care homes owe a duty of care. Claims are made against the care home operator's insurer. CQC inspection reports may document concerns about pressure-sore prevention.
- Community nursing teams. District nurses visiting patients at home who fail to assess and manage pressure-ulcer risk.
Compensation
Compensation for pressure sore claims covers:
- General damages — pain, suffering and loss of amenity, valued under the Judicial College Guidelines, 17th edition (2024). The JCG does not have a standalone pressure-sore chapter; awards are assessed under the relevant body-area chapter (skin, scarring) and, where applicable, for any secondary injury such as sepsis or surgical complications. The grade, location, duration of treatment and any permanent scarring all affect the value.
- Special damages — additional treatment and wound care costs, extended hospital stays, private nursing, equipment, lost earnings, travel and any home adaptations needed.
Where a pressure sore contributed to the patient's death (for example through sepsis), the estate and dependants can claim under the Fatal Accidents Act 1976.
Evidence for a pressure sore claim
| Evidence | Purpose |
|---|---|
| Nursing records and repositioning charts | Show whether the patient was repositioned at the correct intervals; gaps or absence of charts suggest neglect |
| Pressure-ulcer risk assessment (Waterlow/Braden) | Proves whether risk was identified on admission; its absence is evidence of breach |
| Wound measurement and tissue viability records | Track the progression of the sore and the adequacy of treatment |
| Photographs | Visual evidence of the sore at each stage; families should photograph the wound if possible (with consent) |
| Dietitian and continence records | Malnutrition and incontinence are major risk factors; records show whether they were managed |
| Incident reports and safety investigation | Category 3/4 sores should be reported; the investigation findings can support your claim |
| CQC inspection reports (care homes) | May document systemic concerns about pressure-sore prevention at the home |
Time limits
The standard limit is three years from when you knew or should have known the pressure sore was caused by negligent care (Limitation Act 1980, section 14). For patients who lack mental capacity (common in elderly or cognitively impaired patients), there is no limitation period while the incapacity continues. If the patient has died, the estate has three years from the date of death. See our time limits guide.
Getting help
We are not a law firm. To find a regulated solicitor experienced in pressure-sore and clinical negligence claims, use the Solicitors Regulation Authority register and the Law Society "Find a Solicitor" service. Action against Medical Accidents (AvMA) provides free advice for victims of medical negligence. Tissue Viability Society provides professional guidance on wound care standards.
Frequently asked questions
Can I claim compensation for a pressure sore?
Yes, if the pressure sore developed or worsened because of negligent care. Hospitals and care homes have a duty to assess pressure-ulcer risk, implement a prevention plan (regular repositioning, pressure-relieving mattresses, skin inspection, nutrition support) and monitor the patient. If they failed to take these steps and a pressure sore developed or progressed as a result, that is likely to amount to negligence.
What are the grades of pressure sore?
The internationally recognised classification has four categories. Category 1 is non-blanchable redness of intact skin. Category 2 involves partial-thickness skin loss presenting as a blister or shallow open wound. Category 3 is full-thickness skin loss where fat may be visible but bone, tendon and muscle are not exposed. Category 4 is full-thickness tissue loss with exposed bone, tendon or muscle, often with undermining and tunnelling. Categories 3 and 4 are the most serious and are most commonly the subject of claims.
How much compensation for a pressure sore?
It depends on the category of the sore, the area affected, the treatment required and any lasting consequences. A Category 4 pressure ulcer that requires surgical debridement, skin grafting, months of wound care and leaves permanent scarring will attract significantly higher compensation than a Category 2 sore that heals with conservative treatment. Compensation covers pain and suffering under the Judicial College Guidelines plus special damages for treatment, care and any other financial losses.
Are pressure sores preventable?
In the vast majority of cases, yes. NICE Clinical Guideline CG179 states that most pressure ulcers are avoidable with proper risk assessment and prevention. NHS Improvement has classified Category 3 and Category 4 pressure ulcers that develop in NHS care as patient safety incidents that should be investigated. While some patients with very complex medical conditions may develop pressure damage despite best care, this is the exception.
Can I claim for a pressure sore in a care home?
Yes. Care homes owe the same duty of care as hospitals. They must carry out risk assessments, provide pressure-relieving equipment, ensure regular repositioning, maintain skin hygiene and nutrition, and monitor for early signs. Claims can be made against the care home operator. The Care Quality Commission (CQC) regulates care homes and its inspection reports can be useful evidence.
How long do I have to claim for a pressure sore?
Three years from when you knew or should have known the pressure sore was caused by negligent care, under the Limitation Act 1980. For patients who lack mental capacity (common in elderly care settings), there is no time limit while the incapacity continues. If the patient has died, the estate has three years from the date of death.
What evidence do I need for a pressure sore claim?
Medical and nursing records showing the risk assessment (or its absence), repositioning charts, tissue viability assessments, wound measurement records, photographs of the pressure sore at various stages, dietitian records, and any incident reports. An independent expert in tissue viability nursing or wound care will review these records and advise whether the standard of care was met.
Get help from official, free sources
- Action against Medical Accidents (AvMA) — free advice for medical negligence victims
- Care Quality Commission (CQC) — care home inspection reports
- Solicitors Regulation Authority (SRA) — check a solicitor is regulated
- Citizens Advice — free, impartial guidance
Related guides: medical negligence claims, nursing home negligence claims, sepsis negligence claims, hospital fall claims, and scarring and burns claims.