The NHS Litigation Authority has recently launched a programme
of reform for its main indemnity scheme, the Clinical Negligence
Scheme for Trusts (CNST).
Earlier this year, the NHSLA carried out a consultation on
pricing for the CNST. The NHSLA's Clinical Negligence
Scheme for Trusts (CNST) is a not-for-profit membership scheme that
aims to spread and smooth the financial costs of clinical
negligence liabilities over time. It operates on a
pay-as-you-go basis which means that, unlike commercial insurance,
NHS funds are not used to pay up front for claims that will be
settled in the future.
The full report which provides an analysis of the
responses can be accessed here.
There was a lot of consensus in the responses received,
the highlights being:
Continued support for the current concept of "risk
pooling" which protects NHS organisations from rare expensive
incidents and provides stability.
Raising the need to move away from a "one size fits
all" approach and address the individual needs of members such
as ambulance and mental health trusts, without losing the
collective benefits of membership.
Overwhelming support for the NHSLA's activity to
promote learning from incidents in the NHS and for using CNST to
provide financial incentives to improve safety similar to the
recent "Sign Up To Safety" campaign.
Support for a shift in the pricing approach
to rely less on experience of the past and more on indicators of
The report sets out the feedback received, how the NHSLA
intends to use that to improve the CNST, and the steps that will be
taken and when. The NHSLA is accelerating the process for setting
price for 2017/18, progressing immediate work on 'risk
indicators', and plans to increase support to NHS trusts and
families in the rare cases where life-long injuries occur, such as
cerebral palsy at birth. From 1st April 2017, the NHSLA will be
asking trusts not to wait for a high value claim but to contact
them as soon as possible after the event so that help can be
provided and learning shared quickly. It has also made a commitment
to meet the particular needs of members such as Ambulance and
Mental Health trusts who face different risks and
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