News Update
Proposed NHSLA Changes
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3 Feb 2012
The Department of Health has provided its response (26 January 2012) to the NHSLA Industry report by Marsh Ltd (April 2011, published January 2012). The DoH has accepted a number of the recommendations which are likely to have far reaching effects not only on the management of claims but also wider financial and risk management implications for NHS and in due course commercial providers of NHS services.
Structural and Strategic
The DoH has confirmed its commitment to dealing with clinical negligence claims centrally through the NHSLA and recognises the need to allow all providers of NHS secondary and tertiary care to be members of the CNST. The changing NHS landscape and Any Qualified Provider agenda suggest that the membership of the Scheme will change significantly.
For non clinical claims Marsh recommended and the DoH has accepted that the NHSLA should explore how commercial involvement could improve non-clinical claims handling where Marsh found that the NHSLA performs worse than corresponding benchmarks for settling claims. The response gives no indication of the level or extent of commercial involvement likely.
While the DoH response rejected Marsh’s recommendation of consideration of a “claims made” scheme (as opposed to the existing “pay as you go”), there was agreement to explore exit barriers and the impact of competition from commercial insurers.
Risk management standards and financial
Marsh suggests that consideration is given to requiring Foundation Trusts to achieve risk management level 2 rather than the present level 1 and the DoH agrees this should be considered together with greater alignment of NHSLA, CQC and Monitor standards.
The DoH has also agreed to consider:
- an additional RM level 4 with a 35% reduction in contributions
- removing the 10% discount for level 1
- reworking the discount formula so that more members achieve adjustments (both up and down)
Marsh also proposed the introduction of specific risk management standards for specialities such as A&E and surgery. The DoH has agreed to consider this but is concerned about the burden or bureaucracy it would entail.
Greater Trust involvement
Marsh Recommends that the delegated authority scheme for Trusts be promoted to encourage more Trusts to take up the option. There are currently only 10 Trusts who have taken up the option. Marsh also identified delays in Trusts reporting claims to the NHSLA and recommended the consideration of financial penalties for late reporting.
Marsh suggests that there should be a closer working relationship between Trusts and the NHSLA. The NHSLA should move away from claims administration and become a more pro-active incident reporting, claims, risk management and educational body.
The DoH recommends:
- that the NHSLA should work with scheme members to understand and to assess the appetite for delegated authority
- that the NHSLA should consider incentives to promote the use of delegated authority by Trusts
- the NHSLA should review the use of levers and incentives within the operation of its schemes to improve performance
- that the NHSLA will look into development of the relationship between the NHSLA and CNST Scheme members.
If you would like further information or if you require advice on any of the above, please contact us on: enquiries@hempsons.co.uk
This news update is made available on the basis that no liability is accepted for any errors of fact or opinions it may contain. Professional advice should be obtained before applying the information to particular circumstances.
© Hempsons 2011
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