More established forms of alternative dispute resolution (ADR), such as settlement meetings and mediation, have become increasingly common in clinical negligence claims, a trend which is set to continue given the potential costs savings involved. As ADR becomes generally more widespread, so too is it diversifying. In the clinical negligence space, we have recently seen major ADR providers start to offer early neutral evaluation and this could provide an effective and relatively low cost early intervention to resolve claims. In time, we may see further diversification, for instance with arbitration being used to provide confidential resolution of substantial claims.