NHS Resolution (NHSR), the body which represents the NHS in claims made against it, has set out its Corporate Strategy 2022-25 and Business Plan 2022-23.
NHSR's idea seems to be less about changing its direction but instead deepening existing approaches. The organisation's main priorities over the coming years are to:
- Deliver fair resolution;
- Share data and insights as a catalyst for improvement;
- Collaborate to improve maternity outcomes; and
- Invest in people and systems.
This is a sensible list of priorities, with aims of reducing harm to patients, distress for patients and staff alike when concerns arise and the costs required to deliver fair resolution. It also intends to ensure indemnity arrangements drive positive change across the healthcare system.
While three of the priorities are vague, improving maternity outcomes is much more specific. Why is this?
Obstetric claims make up 50 per cent of the value of all clinical negligence claims, mainly due to the severe and lasting impact on quality of life that birth injuries have on those affected.
It's also likely to be a reaction to recent, widely publicised maternity scandals (e.g. that of Shrewsbury and Telford Hospital NHS Trust) and associated investigations which led to the Ockenden Report.
NHSR therefore aims to support the government's longstanding maternity safety ambition to halve the rates of stillbirth, neonatal and maternal death and brain injuries that occur during or shortly after birth by 2025. If successful, this would be a tremendous outcome.
Another NHSR ambition is to remove unnecessarily adversarial processes and resolve disputes via alternative dispute resolution (ADR) models such as early neutral evaluation, resolution summits and case stock-takes. ACSO welcomes this, especially given significant civil court delays at present, and aims to facilitate the uptake of ADR through its ADR Working Group.
ADR can improve access to justice by promoting speedier resolutions to claims, keeping costs down and reducing the already heavy burden on the courts.
Increased reliance on technology, in part contributed to by the pandemic, has also opened up a variety of options when it comes to online ADR. NHSR proposes to innovate further in this area and extend the use of remote mediations, which is also welcomed.
What NHSR offers little commentary on, however, is the legislative backdrop to all this, and specifically where the government's proposals to fix legal costs in lower-value clinical negligence cases will lead. ACSO's longstanding concerns over these proposals and their potentially very damaging impact on access to justice continue.
Author: Jack Normington, Trainee Solicitor at Fletchers Solicitors and ACSO secondee.