NHS Resolution

NHS Resolution logo

NHS Resolution, the operating name of NHS Litigation Authority, is an arm's length body of the Department of Health. It changed its name in April 2017.

The organisation's purpose is to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care.

Services

The main bulk of NHS Resolution's workload is handling negligence claims on behalf of the members of the indemnity schemes: NHS organisations and independent sector providers of NHS care in England.

The four clinical schemes they manage are:

Clinical Negligence Scheme for Trusts (CNST), which covers clinical negligence claims for incidents occurring after 1 April 1995

Existing Liabilities Scheme (ELS) is centrally funded by the Department of Health and covers clinical negligence claims against NHS organisations for incidents occurring before 1 April 1995

Ex-RHA Scheme (Ex-RHAS) is a relatively small scheme, centrally funded by the Department of Health, covering clinical negligence claims against former Regional Health Authorities abolished in 1996

DH clinical covers clinical negligence liabilities that have transferred to Department of Health following the abolition of any relevant health bodies

NHS Resolution also manages two non-clinical schemes under the heading of the Risk Pooling Schemes for Trusts (RPST):

Property Expenses Scheme (PES) which covers 'first party' losses as property damage and theft, for incidents on or after 1 April 1999

Liabilities to Third Parties Scheme (LTPS) which covers non-clinical claims such as public and employers' liability

In addition the one other non clinical scheme is DH non-clinical which covered non-clinical liabilities that have transferred to the Department of Health following the abolition of any relevant health bodies

In addition it:

  • has developed an active risk management programme to raise NHS standards and reduce incidence of negligence
  • monitors human rights case law on behalf of the NHS
  • co-ordinates claims for equal pay in the NHS
  • the Family Health Services Appeal Unit handles disputes between doctors, dentists, opticians and pharmacists and NHS England) since April 2005.
  • runs the National Clinical Assessment Service
  • The overhaul announced by Jeremy Hunt in March 2017 is intended to shift emphasis away from claim management to proactive, earlier interventions to support families, particularly in maternity cases. There will be a specialist early intervention team focussed on brain injuries at birth.

Performance

In 2004-5 the authority dealt with 5,609 claims of clinical negligence and 3,766 of non-clinical negligence. About 38% of claims are abandoned by the claimant, and about 43% are settled out of court. In 2004-5 £502.9 million was paid out in respect of clinical negligence claims, and £25.1 million in respect of non-clinical negligence. By 2015/6 payments (which include defence and claimants' legal costs) had risen to more than £1.4 billion, although new claims in that year fell by 4.6%. It often takes several years to resolve claims.[1] Claims may be submitted many years after the event. The biggest element of compensation is the cost of caring for children who suffer brain injury at birth. There is no time limit on these claims.[2]

It runs the clinical negligence scheme for trusts. All NHS trusts in England are members of the scheme. They paid £968m in contributions in 2013-14 an increase of 38% since 2009. In principle trusts can insure themselves in the commercial market, but none have yet done so, possibly because leaving the scheme would crystallise their outstanding liabilities.[3] The authority altered the scheme in 2014 to give greater weight to trusts claims history when setting contributions.[4]

In 2012/3 charges amounted to £3,778,000. 47.59% related to maternity, 21.45% to surgery, 15.65% to medicine, 7.83% to A&E and 7.48% to all other specialities. Clinical negligence charges amounted to 23% of the cost of maternity services in England.[5]

The Department of Health’s triennial review of the Authority in 2015 reported that it took an average of 2.7 years for claims to be reported and a further 1.31 years for claims to be resolved.[6]

History

It was established in 1995 as a special health authority.[7] Its current duties are established under the National Health Service Act 2006.[8] Since its foundation it has managed about 160,000 clinical negligence claims.

The National Clinical Assessment Service became part of the NHS Litigation Authority on 1 April 2013, taking the headcount of employees at the NHS LA to over 200 people.[9]

Mr Ian Dilks is chair of NHS Resolution, having taken up his appointment on 1 April 2014 for a three-year term of office, which was extended on 1 April 2017 for a further two years till 1 April 2019.[10] He succeeded Dame Joan Higgins who was appointed in 2007.[11]

References

  1. ↑ "NHS negligence claims hit £1.4bn". BBC News. 29 September 2016. Retrieved 1 October 2016.
  2. ↑ "Fear of litigation must never be a roadblock to transparency". Health Service Journal. 5 July 2016. Retrieved 1 October 2016.
  3. ↑ "Trusts threaten to quit negligence scheme". Health Service Journal. 13 July 2015. Retrieved 23 September 2015.
  4. ↑ "Winners and losers from clinical negligence scheme changes". Health Service Journal. 14 September 2015. Retrieved 23 September 2015.
  5. ↑ Yeung, Hoi (22 October 2015). "The cost argument for seven day working". Health Service Journal. Retrieved 29 November 2015.
  6. ↑ "America's risk management approach could help the NHS". Health Service Journal. 21 August 2015. Retrieved 7 October 2015.
  7. ↑ "NHS Litigation Authority: Who we are and what we do" (PDF). NHS Litigation Authority. Retrieved 10 August 2014.
  8. ↑ "NHS Litigation Authority: Report and accounts 2012/13" (PDF). NHS Litigation Authority. 10 July 2013. Retrieved 30 September 2014.
  9. ↑ "National Clinical Assessment Service to become part of the NHS Litigation Authority on 1 April 2013". National Clinical Assessment Service. 22 March 2010. Retrieved 10 August 2014.
  10. ↑ "New Chair appointed to the NHS Litigation Authority (NHS LA) Board" (PDF) (Press release). NHS Litigation Authority. 27 March 2014. Retrieved 21 December 2014.
  11. ↑ "Dame Joan opens the secret door". Daily Telegraph. 11 October 2007.
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