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					                            Factsheet 5 - 2009/10 - introduction
The NHS Litigation Authority handles negligence claims on behalf of NHS bodies in England. It operates both
clinical and non-clinical risk-sharing Schemes which NHS Trusts and Primary Care Trusts (PCTs) may choose to
join. These are the Clinical Negligence Scheme for Trusts (CNST), which covers clinical negligence claims in
relation to incidents taking place after 1 April 1995, and the Risk Pooling Schemes for Trusts (RPST), which
cover non-clinical liabilities such as public and employers’ liability claims under the Liabilities to Third Parties
Scheme (LTPS) and "first-party" losses such as property damage and theft under the Property Expenses Scheme
(PES). Since April 2002, the NHSLA has handled, and funded, all CNST claims, regardless of value. However,
RPST claims are subject to excesses and hence trusts handle and fund lower value RPST claims themselves.


In addition to these risk-sharing Schemes, the NHSLA also operates the Existing Liabilities Scheme (ELS) which
covers clinical negligence claims arising from incidents before April 1995 and which is centrally funded by the
Department of Health. Claims under ELS will often be made against NHS bodies which no longer exist because of
subsequent restructuring within the NHS. The legal defendant in such an ELS claim will be the legal “successor
body” to the now-defunct NHS body. This will often be the Strategic Health Authority, as Strategic Health Authorities
inherited the legal liabilities of the former District Health Authorities. However, it may also be a trust if the health
body in question had acquired trust status relatively early in the 1990s.

The following tables set out the number of negligence claims (including potential claims or “incidents”) reported to
the NHSLA in 2009/10 by NHS Trusts and PCTs in England, together with the amounts disbursed by the NHSLA on
behalf of each of these trusts to handle and settle claims during the same period. The Factsheet also includes
details of the contributions paid by each trust in 2009/10 for membership of our Schemes. This year we have also
added information relating to obstetric or 'maternity' claims as a separate category (these claims are included in the
total figures). When using the information, please note:

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                            Factsheet 5 - 2009/10 - introduction
The NHS Litigation Authority handles negligence claims on behalf of NHS bodies in England. It operates both
clinical and non-clinical risk-sharing Schemes which NHS Trusts and Primary Care Trusts (PCTs) may choose to
join. These are the Clinical Negligence Scheme for Trusts (CNST), which covers clinical negligence claims in
relation to incidents taking place after 1 April 1995, and the Risk Pooling Schemes for Trusts (RPST), which
cover non-clinical liabilities such as public and employers’ liability claims under the Liabilities to Third Parties
Scheme (LTPS) and "first-party" losses such as property damage and theft under the Property Expenses Scheme
(PES). Since April 2002, the NHSLA has handled, and funded, all CNST claims, regardless of value. However,
RPST claims are subject to excesses and hence trusts handle and fund lower value RPST claims themselves.


In addition to these risk-sharing Schemes, the NHSLA also operates the Existing Liabilities Scheme (ELS) which
covers clinical negligence claims arising from incidents before April 1995 and which is centrally funded by the
Department of Health. Claims under ELS will often be made against NHS bodies which no longer exist because of
subsequent restructuring within the NHS. The legal defendant in such an ELS claim will be the legal “successor
body” to the now-defunct NHS body. This will often be the Strategic Health Authority, as Strategic Health Authorities
inherited the legal liabilities of the former District Health Authorities. However, it may also be a trust if the health
body in question had acquired trust status relatively early in the 1990s.

The following tables set out the number of negligence claims (including potential claims or “incidents”) reported to
the NHSLA in 2009/10 by NHS Trusts and PCTs in England, together with the amounts disbursed by the NHSLA on
behalf of each of these trusts to handle and settle claims during the same period. The Factsheet also includes
details of the contributions paid by each trust in 2009/10 for membership of our Schemes. This year we have also
added information relating to obstetric or 'maternity' claims as a separate category (these claims are included in the
total figures). When using the information, please note:

      The number of claims/potential claims notified in 2009/10 and the amounts paid out in 2009/10 do not relate
      to the same cohort of claims. Payments made in 2009/10 may relate to claims notified in earlier financial
      years, particularly where claims are large or complex. Similarly, claims and potential claims notified to the
      NHSLA by trusts in 2009/10 may not be settled in that year: indeed in cases where a patient has indicated
      that they may be contemplating a claim and the trust therefore notifies the NHSLA (shown as an “incident” in
      the columns below), a formal claim may only be made many months later. Moreover, many patients do not
      pursue an initial intention to make a claim and hence the “incident” never becomes a “claim”.


      Larger trusts and those which provide more complex treatments are clearly more likely to receive claims than
      smaller trusts or those providing low risk care. The tables therefore give an indication of the size of the trust,
      either through population served for PCTs or by LTPS contribution for NHS Trusts. They also show whether
      or not a trust provides labour ward services, as approximately 20% of all claims (and approximately 60% of
      all payments) relate to claims arising out of birth.

      Claims may be made long after the original incident giving rise to the claim, especially where the patient
      concerned is a child. The tables show when trusts first joined CNST: a trust which joined in 1995 when the
      Scheme was first created is likely to have more CNST claims than a similar trust which only joined three or
      four years later. Where NHS services in an area have been re-organised, the trust legally liable for the claim
      may not in fact have been managing the hospital in question at the time of the incident – for example many
      PCTs “inherited” claims from their predecessor bodies when they were first set up. Where trusts have
      merged, leading to “inherited claims”, we have tried where possible to indicate the date when the
      predecessor trust joined CNST.
The amounts paid out on behalf of trusts are broken down into “damages” (the amounts paid to the patient),
“defendant costs” (the legal costs incurred by the NHSLA in handling the claim) and “claimant costs” (the
legal costs incurred by the patient in bringing the claim, where these are met by the NHSLA). It should be
noted that these 2009/10 figures include repayments from previous years: for example where a payment was
made into court in one financial year and then received back the following year. Occasionally, therefore,
these figures may be less than zero. Moreover, where claims are made by trusts under the Property
Expenses Scheme, for example in respect of stolen medical equipment, the payments made by the NHSLA
are not "damages" payments as such but rather a reimbursement to the trust of its loss.


Until 2002, trusts handled and funded lower-value CNST claims themselves. However, in April 2002 all such
claims were “called-in” to the NHSLA and the NHSLA now handles all CNST claims regardless of value.
Because of this change in the scope of CNST, figures for the years preceding this date are not comparable
with those for successive years and are not given. However, figures in this factsheet for 2009/10 are
presented on a comparable basis with those provided for 2008/09, 2007/08, 2006/07, 2005/06, 2004/05 and
2003/04.

In order to protect the confidentiality of individual patients, we have not given precise figures where the
number of claims/potential claims received in a year was fewer than five or the amounts paid out were lower
than £5,000. Such cases are indicated with an *.

This Factsheet should not be interpreted as a league table. While we have attempted to give some indication
of context in terms of the size of trust/PCT (using LTPS contribution figures for trusts/population figures for
PCTs), inevitably different institutions face different levels of risk because of the variations in the nature and
complexity of the procedures they perform.

Figures for Obstetric claims are given on separate tabs, but these figures are also included within the general claims data.
ed within the general claims data.
                                                                                      Number of claims notified in 2009/10

(a) - 2009 adjusted population figures taken from The Information Centre website - www.ic.nhs.uk More up-to-date information on population may be available from individual PCTs


                                                                                   Original   Trust offers               CNST No.    CNST                     ELS       ELS                    RPST No.
                                                                    Population                               CNST No.                          ELS No.                             RPST No.
           Member Name                Strategic Health Authority                    CNST      labour ward                    of       Total                  No. of     Total                      of
                                                                   (see note a)                              of Claims                         of Claims                           of Claims
                                                                                  Join Date    services ?                Incidents   Matters               Incidents   Matters                 Incidents
 RPST
 Total
Matters
                                                                                                                       Payments made during 2009/10

(a) - 2009 adjusted population figures taken from The Information Centre website - www.ic.nhs.uk More up-to-date information on population may be available from individual PCTs

                                                                                                                                                                                                                                RPST
                                                                                                       Trust offers                        CNST         CNST                                   ELS       ELS
                                                                    Population (see   Original CNST                          CNST                                    CNST            ELS                          ELS Total   Damages/
           Member Name                 Strategic Health Authority                                      labour ward                        Defence      Claimant                              Defence   Claimant
                                                                       note a)          Join Date                           Damages                                Total Paid      Damages                          Paid      payments
                                                                                                        services ?                         Costs        Costs                                 Costs     Costs
                                                                                                                                                                                                                               to trusts
 RPST      RPST
                   RPST Total
Defence   Claimant
                     Paid
 Costs     Costs
                                                                                    Contribution 2009/10

(a) - 2008 adjusted population figures taken from The Information Centre website - www.ic.nhs.uk More up-to-date information on population may be available from individual PC

                                                                                                                     Trust offers
                                                                                    Population      Original CNST
                   Member Name                        Strategic Health Authority                                     labour ward        CNST           LTPS
                                                                                   (see note a)       Join Date
                                                                                                                      services ?
m individual PCTs


      PES           Grand Total
                                Number of claims notified in 2009/10

                                            Original   Trust offers               CNST No.    CNST                     ELS       ELS                  RPST No.
                                                                      CNST No.                          ELS No.                           RPST No.
Member Name   Strategic Health Authority     CNST      labour ward                    of       Total                  No. of     Total                    of
                                                                      of Claims                         of Claims                         of Claims
                                           Join Date    services ?                Incidents   Matters               Incidents   Matters               Incidents
 RPST
 Total
Matters
                                                            Payments made during 2009/10

                                                                                                                                                                RPST
                                            Original   Trust offers              CNST      CNST                               ELS       ELS                               RPST
                                                                       CNST                          CNST Total     ELS                          ELS Total    Damages/
Member Name   Strategic Health Authority     CNST      labour ward              Defence   Claimant                          Defence   Claimant                           Defence
                                                                      Damages                          Paid       Damages                          Paid      payments to
                                           Join Date    services ?               Costs     Costs                             Costs     Costs                              Costs
                                                                                                                                                                trusts
 RPST      RPST
Claimant   Total
 Costs     Paid
                                                                                          Contribution 2009/10
b) the figures in this column may also be used to indicate the comparative size of the organisation


                                                                                                                 Original   Trust offers
                                                                                                                                                     LTPS
                                 Member Name                                       Strategic Health Authority     CNST      labour ward    CNST                  PES
                                                                                                                                                  (see note b)
                                                                                                                Join Date    services ?
Grand Total
              Number of claims notified in 2009/10

                                      ELS No.
                        ELS No. of             ELS Total
Member Name                              of
                          Claims                Matters
                                     Incidents
              Payments made during 2009/10

                          ELS       ELS
                ELS                             ELS
Member Name             Defence   Claimant
              Damages                        Total Paid
                         Costs     Costs
              Number of obstetrics claims notified in 2009/10


                                                                    CNST No.     CNST                    ELS
                                                        CNST No.                          ELS No.
Member Name                Strategic Health Authority                   of       Total                  No. of
                                                        of Claims                         of Claims
                                                                    Incidents   Matters               Incidents
 ELS
 Total
Matters
              Obstetrics payments made during 2009/10


                                                      CNST      CNST                               ELS
                                            CNST                          CNST Total     ELS
Member Name   Strategic Health Authority             Defence   Claimant                          Defence
                                           Damages                          Paid       Damages
                                                      Costs     Costs                             Costs
  ELS
            ELS
Claimant
         Total Paid
 Costs