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:

  1. Continued support for the current concept of "risk pooling" which protects NHS organisations from rare expensive incidents and provides stability.
  2. 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.
  3. 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.
  4. Support for a shift in the pricing approach to rely less on experience of the past and more on indicators of recent improvement.

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 challenges.