Lost Years Damages After CCC v Sheffield: Why Nutritional Evidence Now Carries More Weight

For more than forty years, a child whose life expectancy was shortened by an injury at birth could not claim for the earnings they would have made in the years they were expected to lose. On 18 February 2026, in CCC v Sheffield Teaching Hospitals NHS Foundation Trust [2026] UKSC 5, the Supreme Court removed that bar by a majority of four to one. For anyone running a catastrophic paediatric claim, the practical effect is that life expectancy now carries more of the value of the case than it did. In children with severe neurological injury, feeding and nutrition are part of the life expectancy evidence.

What the Supreme Court decided

CCC suffered a hypoxic brain injury at birth. Her life expectancy was agreed at 29 years. Under Croke v Wiseman (1982), a young child could not recover damages for the earnings she would have made between her expected death and normal retirement age, the so-called lost years. The Supreme Court overruled Croke v Wiseman. Lord Reed, Lord Briggs, Lord Burrows and Lord Stephens formed the majority; Lady Rose dissented.

The majority held that the evidential difficulty which justified the old rule has lessened. Courts can assess a child's lost years claim with tools already in use elsewhere: the Ogden tables, statistical evidence of average earnings, evidence about family circumstances and likely educational path, and a conventional, and probably substantial, deduction for living expenses.

Why life expectancy evidence now matters more

Before CCC, a reduced life expectancy mainly shortened the period over which future care and loss were calculated. After CCC, each year of expected life lost before retirement age can also found a lost years claim. The gap between a normal life expectancy and the figure agreed or found by the court now moves damages in two directions at once: fewer years of future care, and more lost years, net of living expenses. The two do not cancel out. That makes the life expectancy figure one of the most closely examined numbers in the case, on both sides.

Life expectancy in these children is usually addressed by a paediatric neurologist or a specialist life expectancy expert, drawing on the published cohort literature. In the widely cited cohort studies of children with cerebral palsy, feeding ability is one of the main predictors of survival, alongside mobility. Whether a child feeds orally or relies on tube feeding is not a detail in these assessments. It is one of the variables the estimate is built on.

Where dietetic evidence comes in

Nutrition is not only a predictor in the statistics. It is something the evidence can describe for the individual child. Within the dietetic field, an expert can address whether nutritional requirements have been met over time, the pattern of growth against the appropriate charts, the adequacy and safety of the feeding route, including gastrostomy feeding and its complications, dietetic aspects of feeding safety, including aspiration risk, and what nutritional care is reasonably required in future to maintain health.

That evidence matters in two ways. First, it gives the life expectancy expert an accurate account of the child's nutritional history and current feeding status, which is part of the clinical picture the estimate rests on. Second, future nutritional care, including feeding equipment, specialist feeds and dietetic review, sits in the schedule of care and loss, and its duration is tied to the same life expectancy figure that now also drives the lost years claim.

The standard of proof, and staying in lane

These are civil claims. Past facts, including the course of a child's nutritional care, are found on the balance of probabilities. Future matters such as life expectancy are not proved as facts. The court makes the best estimate it can on the expert evidence. The dietetic expert's role is to give evidence on the nutritional history and explain its clinical significance within dietetics. It is not to give the life expectancy figure itself, which belongs to the neurologist or life expectancy expert.

What this means when instructing experts

Life expectancy experts can only work from the clinical picture they are given. Where feeding, growth or nutritional care is in issue, instructing dietetic evidence early, alongside the neurology and life expectancy evidence, means the life expectancy expert has evidence on the nutritional history before interpreting it, rather than inferring it from records after the other reports are written.

Where this sits for RMD

This piece extends the brain injury and paediatric malnutrition series on this site. If you are running a catastrophic paediatric claim where feeding, growth or nutritional care is in issue and want to consider whether a dietetic expert report would assist, it is worth a conversation before the life expectancy evidence is finalised rather than after.

Rick Miller BSc., MSc., RD

Consultant Registered Dietitian

HCPC DT25651