What Bolam decided
Bolam v Friern Hospital Management Committee [1957] gave English law its test for the standard of care. In the direction that still carries his name, McNair J told the jury that a doctor is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of medical opinion, even if other practitioners would have done it differently. The standard is set by responsible peers, not by the court.
The facts
Mr Bolam was given electro-convulsive therapy without a muscle relaxant and without physical restraint, and he suffered fractures. Some doctors used relaxants at the time; some did not. Because a responsible body of medical opinion supported the approach actually taken, there was no negligence. Peer practice, honestly held, was a defence.
What Bolam still governs, and what it no longer does
Bolam remains the test for the standard of diagnosis and treatment. Was the technique, the dose, the clinical decision one that a responsible body of practitioners would support? That question is still answered the Bolam way. But for consent, the Supreme Court in Montgomery (2015) replaced this doctor-centred approach with a patient-centred one. You can no longer rely on Bolam to decide how much a patient needed to be told about the risks. And even the treatment limb was sharpened: Bolitho (1997) held that the body of opinion you rely on must itself withstand logical analysis.
What it means for your clinic
For aesthetic and ophthalmic practice, Bolam is both a shield and a trap. It protects clinically reasonable technique performed competently. It does nothing for a thin consent record. A perfectly executed treatment with a signed generic form and three lines of notes is a Bolam-compliant procedure wrapped in a Montgomery-failing consent process. The clinical work is judged by one test; the conversation is judged by another, and it is the conversation that most claims turn on.
Where this sits in the story
Consent and negligence law did not arrive fully formed. It climbed, case by case. You can watch the whole arc, and see what each judgment added to the burden your records carry, in the interactive timeline. The related cases are linked below.
Watch the standard rise: 1957 to today →
Related: Bolitho · Sidaway · Montgomery · McCulloch