NHS Resolution

NHS Resolution
Name	NHS Resolution
Formation	1995 (as NHS Litigation Authority); 2017 (renamed)
Status	Special health authority
Purpose	Managing negligence claims and improving patient safety
Headquarters	Westminster, London
Region served	England
Leader title	Chief Executive
Leader name	Judith Hyland
Parent organisation	Department of Health and Social Care

NHS Resolution NHS Resolution is the arm’s-length body responsible for managing legal claims, providing indemnity, and promoting safety and learning within the National Health Service in England. It handles negligence claims, facilitates dispute resolution, and administers schemes that support NHS organisations and staff. The organisation works alongside other bodies involved in patient safety, clinical regulation and health policy.

History

NHS Resolution traces its origins to the establishment of the NHS Litigation Authority in 1995, created to centralise management of clinical negligence claims arising from the NHS in England. During the 2000s and 2010s, it expanded activities in risk management and indemnity while interacting with organisations such as NHS England, Care Quality Commission, Medical Defence Union, Medical Protection Society and professional regulators including the General Medical Council. In 2017 it adopted its current name to reflect a broader remit emphasizing resolution and learning, aligning with initiatives from the Department of Health and Social Care and patient safety programmes influenced by reports such as the Francis Inquiry and the Berwick Report.

Structure and governance

The organisation is a special health authority accountable to the Department of Health and Social Care and subject to oversight by ministers and statutory auditors such as the National Audit Office. Its governance includes a board of non-executive directors and executive leadership reporting to a Chief Executive; stakeholders include NHS Trusts, Foundation Trusts, ambulance trusts, mental health providers and primary care contractors. It engages with external partners such as the Kings Fund, Health Foundation, Royal College of Physicians, Royal College of Nursing and British Medical Association for policy development and professional input. Parliamentary scrutiny occurs via select committees including the House of Commons Health and Social Care Committee.

Functions and responsibilities

NHS Resolution provides indemnity and risk management services, runs claims handling operations, and administers compensation schemes such as the Clinical Negligence Scheme for Trusts and other bespoke arrangements for specialised services. It advises NHS bodies on reducing litigation, supports staff with legal representation arrangements in cases involving clinical practice, and publishes guidance and data used by entities like NHS Improvement and NHS England. It also contributes to national safety initiatives in coordination with the Care Quality Commission, professional regulators like the General Dental Council, and patient advocacy groups including Healthwatch England.

Claims handling and dispute resolution

The organisation operates claims intake, investigation and settlement functions, using alternative dispute resolution methods including mediation and early offers to settle where appropriate. It collaborates with legal firms, medical defence organisations such as the Medical Defence Union and insurers, and court bodies including the Civil Procedure Rules Committee and Royal Courts of Justice to manage litigation. Schemes such as the Clinical Negligence Scheme for Trusts and the Liability to Third Parties Scheme set frameworks for cost-sharing among providers like NHS Trusts and Clinical Commissioning Groups (CCGs). Data published on claims trends informs bodies including the National Audit Office and parliamentary committees.

Patient Safety and Learning

A central remit is to extract learning from incidents and claims to prevent recurrence, working with patient safety organisations such as the Healthcare Safety Investigation Branch, NHS England patient safety teams, and academic partners including Imperial College London, University College London and the Nuffield Trust. Outputs include case reviews, thematic analyses, and actions aimed at reducing risks in specialties represented by the Royal College of Surgeons, Royal College of Obstetricians and Gynaecologists, Royal College of Paediatrics and Child Health and Royal College of Anaesthetists. Collaboration extends to policy initiatives influenced by inquiries like the Francis Inquiry and safety frameworks promoted by the Berwick Report.

Funding and performance

Funding is derived from contributions and levies on NHS bodies, scheme premiums and settlement payments; arrangements interface with financial oversight by the Department of Health and Social Care and external audit by the National Audit Office. Performance metrics include claim volumes, settlement timeliness, legal costs and the effectiveness of preventive interventions, which are scrutinised by bodies such as the Public Accounts Committee and the House of Commons Health and Social Care Committee. Financial pressures from high-value claims have implications for NHS providers and commissioners including NHS Trusts and Clinical Commissioning Groups.

Criticism and controversies

Critics have questioned aspects of indemnity arrangements, settlement practices and transparency, prompting debate among stakeholders including the British Medical Association, Royal Colleges, patient groups like Action against Medical Accidents and parliamentary bodies such as the Public Accounts Committee. Controversies have included discussions about the timeliness and adequacy of compensation, the balance between early settlement and litigation, and the impact of legal costs on NHS finances; these debates intersect with regulatory activity by the Care Quality Commission and professional regulation by the General Medical Council.

Category:Health in England