Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the report on the Clinical Negligence Scheme for Trusts consultation by NHS Litigation Authority, published in October 2016, what progress has been made in assessing the methodology used to determine contributions setting to the Clinical Negligence Scheme for Trusts from NHS and non-NHS health providers.

The NHS Litigation Authority (NHS LA), known as NHS Resolution since 1 April 2017, handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.

NHS Resolution has provided the following response.

Following the consultation on the Clinical Negligence Scheme for Trusts (CNST) in 2016, NHS Resolution has begun work on the findings. Two main areas of research have been whether staffing and activity are an appropriate measure of exposure to risk. NHS Resolution found that, amongst other providers of clinical negligence indemnity cover internationally, activity levels are a key feature of quantitative pricing approaches. An assessment of numbers of types of staff and their experience were more likely to be used in a qualitative review to adjust the price charged to providers of clinical care.

NHS Resolution also looked at maternity-related data sets to refine the approach to exposure so that it reflects indicators of safety. Studies of several available data sets were made, but were not found to be reliable indicators of exposure to risk to inform CNST pricing arrangements. An approach focused on incentivising the delivery of actions considered good practice by the NHS England Maternity Champions, other arm’s length bodies and the Royal Colleges, was developed and implemented from December 2017.

Since the consultation, other adjustments have been made to the CNST pricing methodology with respect to experience and exposure factors, the treatment of older and larger liabilities, and the appropriateness of breaking down the risk pool between smaller groups in line with the consultation response. Research to assess the efficacy of excesses has not been progressed.