Reducing Risk in Mental Health Services: the Work of the NHS Litigation Authority
| DOI | https://doi.org/10.1108/13619322200600008 |
| Pages | 34-37 |
| Date | 01 March 2006 |
| Published date | 01 March 2006 |
| Author | Carole Kaplan |
| Subject Matter | Health & social care |
Reducing Risk in Mental
Health Services: the Work
of the NHS Litigation Authority
Carole A Kaplan
Senior Lecturer and Consultant in Child
and Adolescent Psychiatry
Non-Executive Director – NHS Litigation
Authority
Extra Curriculum
he NHS Litigation Authority
(NHSLA) was established in 1995 as a special health
authority under the provisions of the National Health
Service and Community Care Act 1990. Its two main
responsibilities are:
■to handle claims of clinical negligence in
England by means of the Clinical Negligence
Scheme for Trusts (CNST), a risk pooling
scheme
■to manage and raise the standards of risk
management within the NHS and thus reduce
the number of incidents leading to claims.
In handling claims of clinical negligence the NHSLA
has set up a panel of solicitors who work very closely
with specialist teams within the authority to ensure
that claims aredealt with consistently and with due
regard to the proper interests of the NHS and its
patients. In respect of the second function, the
Authority has established risk standards by which
trusts aremonitored on a regular basis; the greater the
level of compliance, the lower the premium paid by
the trust.
Afurther function of the NHSLA is to assist NHS
bodies to comply with the Human Rights Act by
providing a central source of information on relevant
case-law development.
TThe CNST
During 2004-05 there were 5,609 claims of clinical
negligence with £502.9 million paid out in damages to
patients and legal costs to the NHS. In 2003-04 the
comparable figures were 6,251 claims and £422.5
million in costs. The average length of time to deal
with a claim from time of notification to resolution is
1.44 years. Since 1995:
■38% of claims have been abandoned by
claimants
■43% have been settled out of court
■2% settled in courtin favour of the patient
■0.5% settled in courtin favour of the NHS
■16% remain outstanding at this time.
In Table 1 the specialities are ranked in order of the
frequency and value of claims. From this it can be
seen that psychiatry (including community mental
health) is ranked sixth.
The total number of cases of clinical negligence
involving the mental health services from April 1995
to March 2005 is 806. The data from the CNST show
that within these services the three most frequent
reasons for claims against the NHS are self-harm,
failure to supervise and failure or delay in reaching a
diagnosis (Figure 1).
The database as it now stands is not able to
provide greater examination of these categories.
However,scrutiny of the individual cases reveals that
the self-harmcategoryincludes cases where patients
have injured themselves, either in hospital or out of
hospital, following discharge or after absconding. The
34 The Mental Health Review Volume 11 Issue 1 March 2006 ©Pavilion Publishing (Brighton) 2006
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