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Posted on 3rd December 2018

Financing Medical Negligence Claims Against The NHS

Making a claim against the NHS can feel daunting and brings up questions about who pays for the compensation you receive if you are successful.

Below we hope to help you get a better understanding of how claims are financed and what the cost to the NHS is.

What is the NHS Budget for Negligence Claims?

A separate body to the NHS deals with negligence claims. The NHS Resolution look after the budget for all medical negligence claims. NHS Resolution have estimated that they will need £1.9 billion to cover their costs for this year. £1.8 billion of that will be for medical negligence claims.

Who pays and how?

For most claims against the NHS, NHS Resolution will pay, though it doesn't cover every single practitioner working under the NHS. For example, GPs are generally not covered by the NHS indemnity schemes, but by their own insurance.

Money for NHS Resolution is gathered through indemnity schemes, which are similar to insurance schemes. Each NHS trust or CCG signs up to one of these schemes with NHS Resolution. Individual medical practitioners don't sign up as individuals as long as they fall into one of the categories below. Otherwise they get their own cover.

Members pay into the scheme on a pay-as-you-go basis. The amount paid is figured out by the following three factors:

  • The risk of a negligence claim compared with the likely cost of that claim (so there is more risk for neurosurgery and therefore a higher charge)
  • How much has been paid towards claims in the past
  • The cost of known outstanding claims

Who does NHS Resolution cover?

NHS Resolution covers medical and dental staff employed in Hospital and Community Healthservices, it doesn't cover GPs because GPs are contracted by the NHS, rather than being direct employees. This is the same for some dental practitioners. GPs are responsible for making their own indemnity arrangements.

Specifically NHS Resolution covers:

  • All NHS employees
  • Contracted locums
  • Medical academic staff with honorary contracts
  • Students
  • Those conducting clinical trials
  • Charitable volunteers
  • People undergoing further professional education, training and examinations
  • GPS or dentists directly employed by Health Authorities e.g. Public health doctors (at airports or sea ports)

Indemnity Schemes

NHS Resolution runs what are known as indemnity schemes. These are similar to an insurance policy, and are specifically for the NHS and NHS Foundation Trusts, CCGs and Independent providers of NHS care.

Indemnity - what does it mean?

Indemnity is security or protection against a financial burden. There are several indemnity schemes that cover the NHS including The Clinical Negligence Scheme for Trusts (CNST) and the Risk Pooling Scheme for Trusts (RPST).

How much has NHS Resolution paid into negligence claims in the past?

Year

Total Clinical Negligence Expenditure

2012/13

£1,258,880,000

2013/14

£1,192,538,084

2014/15

£1,169,586,958

Breakdown of claims by speciality, 2014/15:

How much do claims cost compared to the NHS budget?

The budget set aside by the NHS Resolution for negligence claims comes to approximately 1.3% of the total NHS budget which £116.4 billion for 2015/16.

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