A troubled Birmingham hospital trust has shelled out a staggering £22.4 million in damages and costs to patients.

The trust which runs Heartlands, Good Hope and Solihull Hospitals, paid out the amount to 203 patients in incidents and claims in 2015-16 – making it the second highest in the country.

Damages alone amounted to £13.7 million, with the rest being made up of defence and claimant costs.

The incidents themselves could have taken place years beforehand.

The news of the payouts come as it was revealed that Heart of England NHS Foundation Trust (HEFT), is to be run jointly with University Hospital Birmingham NHS Trust.

It follows an investigation into its finances by health watchdog Monitor after it was “badly managed” by former chief executive Mark Newbold and faced a £30 million deficit.

HEFT is also where breast surgeon Ian Paterson worked. He is currently awaiting trial after being charged with 21 counts of unlawfully and maliciously wounding 11 patients between 1997 and 2011.

The figures, from the NHS Litigation Authority (NHSLA), put Imperial College Healthcare NHS Trust, in London, ahead of HEFT, after it paid out a total of £23.7 million.

Lisa Jordan, head of the specialist medical negligence team at Irwin Mitchell in the West Midlands, said: “It’s a sad fact that despite all the great work done in the NHS there are still too many avoidable mistakes occurring, many of which have life-changing consequences for patients.

“It is good to see that the NHSLA is increasing its focus on improving patient safety but much more could and should be done to reduce the number of avoidable errors.

“Those patients who have suffered serious harm as a result of negligent treatment need highly specialised lawyers to fight for fair compensation for them.

“Legal action also inevitably leads to improvements in patient safety to reduce the risk of further mistakes.”

Within the region, Walsall Healthcare NHS Trust follows HEFT, recording a total payout of £15.2 million, whilst Sandwell and West Birmingham Hospitals NHS Trust handed out £14.4 million.

The total cost of pay outs by hospitals across the city and the Black Country amounts to an eye-watering £81.1 million.

In comparison, the same trusts paid out a total of £56.7 million last year.

The NHS LA pointed out that different hospitals perform different operations - as the procedures become more complex, the risks can grow as well.

Whether or not the NHS trust has a labour ward is also a major factor in the total costs because complications during childbirth account for a large proportion of the payouts.

The Mail approached HEFT for comment but nobody was available.

Where does your hospital trust rank?

1. Heart of England NHS Foundation Trust:

2015/16 £22.4m

2014/15 £17.1m

2. Walsall Healthcare NHS Trust:

2015/16 £15.2m

2014/15 £6.1m

3. Sandwell and West Birmingham NHS Trust:

2015/16 £14.4m

2014/15 £4.9m

4. University Hospital Birmingham NHS Trust:

2015/16 £8m

2014/15 £7.1m

5. Birmingham Children's Hospital:

2015/16 £5.7m

2014/15 £1.5m

6. Dudley Group of Hospitals NHS Foundation Trust:

2015/16 £5.5m

2014/15 £8m

7. Birmingham Women’s Hospital:

2015/16 £3.9m

2014/15 £1.9m

8. Royal Orthapaedic Hospital:

2015/16 £3.2m

2014/15 £1.6m

9. Royal Wolverhampton NHS Trust:

2015/16 £3m

2014/15 £8.5m