NHS Resolution: Delivering fair and timely resolution

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Helen Vernon is chief executive at NHS Resolution

The aim for NHS Resolution is to be at the forefront of best practice in the management of healthcare complaints, concerns, incidents and claim

NHS Resolution has just published Advise, Resolve and Learn: Our strategy to 2025, its blueprint from April 2022 for the next three years.

One of the four priorities is to deliver the next phase of our strategy to move claims, concerns and disputes into a neutral and less adversarial space. The new strategy builds on the work undertaken since 2017 to focus on early intervention, and avoid unnecessary court action. Learning from claims is also fundamental to our work with the NHS to prevent the same thing happening again.

We have worked hard to dispel the myths of the ‘defend, delay, deny’ mantra, which historically was levelled at the organisation. Much of the work is based on our priority of delivering fair and timely resolution, and wherever possible keeping patients and healthcare staff out of formal processes to minimise distress and cost. We have witnessed a shift in the narrative to one of collaboration, and this is as a result of the excellent work carried out by our staff, in collaboration with claimant solicitors and organisations, along with our own legal panel.

NHS Resolution settled more than 15,500 cases across all its indemnity schemes in 2020/21. We consider all of the evidence presented in the case, which is often contradictory in nature, and seek to find a fair resolution.

In the last financial year (2020/21), we settled 43.8% of claims with no payments made, which is not stated as a target we set ourselves to achieve, but is a reflection on the fact we do receive claims where we go onto find there was no harm caused as a result of negligence.

The majority of the cases that do settle (74%) are resolved pre-litigation. Only a fraction of cases proceed to trial. There are often unavoidable reasons for cases to be litigated such as the need for the court to approve a negotiated settlement—such as in the case of children and/or claimants who lack capacity—or where there is a need for the court to adjudicate on a point of law.

The aim for NHS Resolution is to be at the forefront of best practice in the management of healthcare complaints, concerns, incidents and claim. Through our dispute resolution initiatives, in all their forms, we focus our work on keeping harmed patients and healthcare staff out of court by ensuring that claims only enter litigation after all other avenues to work collaboratively and constructively to resolve the dispute have been exhausted. Ultimately, this will enable fair resolution to be delivered at a reduced cost with the right outcome for patients, which may not always involve financial compensation alone, but rather provide the opportunity to be heard. 

Expanding the range of dispute resolution interventions remains at the centre of our strategy with the next area of focus on early neutral evaluation. These initiatives continue to be supported by high levels of cooperation with claimant representatives. In particular, NHS Resolution has expanded use of resolution (global settlement) meetings, a process that allows the parties to identify and discuss claims where there is limited progress or the claim is about to enter court proceedings. Stock-take is another creative approach which has been adopted to promote claims resolution. The process involves holding meetings with claimant representatives at fixed stages during a claim, such as prior to the service of Court proceedings. These initiatives complement the established claims mediation service, which now includes remote mediation and is designed to support patients, families and NHS staff in working together towards the resolution of incidents, legal claims and costs disputes.

Our aim is to continue to work collaboratively with all parties involved in clinical negligence disputes, recognising the competing interests, but ensuring where possible the claim is managed in a non-adversarial way to reach fair resolution. We recognise we cannot do this alone and acknowledge and appreciate the endeavour and engagement of those working with us to achieve this, for the benefit of NHS patients and those who care for them.

Images: NHS Resolution and Canva
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