Reflection and Review at The National Health Service Litigation Authority (NHS LA)

By John Tingle

The NHS LA is a pivotal organisations in the NHS whose work has a daily impact on the lives of patients and on all those who work in the health service. The NHS LA  have recently published its new five year strategy which reveals some very interesting and informative data, trends, insights into patient safety and regulation, governance and litigation.

NHS LA functions

If you work as a solicitor, lawyer handling  NHS clinical negligence claims, acting either for an injured patient or a hospital  then the NHS LA will be a daily feature of your professional life. They appoint solicitors to act for the hospital or other NHS organisation which is being sued from an approved panel of law firms and manage the claims process.

The NHS LA was established in 1995 as a Special Health Authority and handles clinical and non-clinical negligence claims on behalf of NHS organisations and independent sector providers of NHS care in England who are members of the NHS LA’s indemnity schemes.

The organisation has a wide range of functions and these include assisting the NHS with clinical risk management, sharing lessons from claims and providing important data on claim trends.

The NHS LA aims to:

  • Settle justified claims fairly and quickly
  • Defend unjustified claims robustly, helping to protect NHS resources
  • Help the NHS to resolve disputes and claims fairly and cost effectively
  • Resolve 96% of claims out of court to keep legal costs low

The first point to note about the report is that the NHS LA has had a name change. From April 2017 it’s changing its name to NHS Resolution. At the same time as the name change it has launched the report.

The NHS LA   new approach is to move what it terms, ‘upstream’ to provide support closer to the incident with learning and local resolution. It wishes to keep cases out of court, saving costs and to use more alternative models of dispute resolution. It also intends to dig deeper into what drives the costs of harm and to develop interventions to respond to these in partnership with others. The NHS LA will increase its involvement in cases of brain injury at birth.

Amongst a number of patient safety initiatives over five years, the NHS LA will also publish annually an in-depth analysis of high cost and/or high volume areas of claims, drawing on national data to inform on trends and the  potential for improvement.

Another strategy  concerns the development of a culture shift to ensure a more human centered approach to dealing with cases. It’s important for the lawyers and all those concerned with a case to remember that there are ‘real people’ behind cases. That the litigation negotiation and management does not become a dehumanised and inanimate experience for all concerned:

Make a cultural shift, training and setting standards for our staff and legal panel to ensure a sympathetic, personalised approach and tone is taken with all cases and that we reflect on the use of legal jargon, putting ourselves in the shoes of the injured person. (p.13)

The report is to be welcomed, the NHS LA have put together an ambitious strategy for the next five years.

John Tingle

John Tingle

Global Patient Safety Consultant and Analyst, Formerly Associate Professor at Nottingham Law School, Nottingham Trent University in the UK. I have a fortnightly magazine column in the British Journal of Nursing where I focus on patient safety and the legal aspects of nursing and medicine. I have published over 500 articles and a number of leading texts in patient safety and nursing law .Visiting Professor at Loyola University Chicago, School of Law. I was a Visiting Scholar at Harvard Law School in November 2018.My current research interests are in global patient safety, policy and practice particularly in African health care systems.My most recent publication is: Global Patient-Safety Law Policy and Practice edited by John Tingle, Claytion O'neill and Morgan Shimwell, Routledge 2018.

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