Clinical Negligence Scheme for Trusts (CNST) CNST FAQs
The Clinical Negligence Scheme for Trusts handles all clinical negligence claims against member NHS bodies where the incident in question took place on or after 1 April 1995 (or when the body joined the scheme, if that is later). Although membership of the scheme is voluntary, all NHS Trusts (including Foundation Trusts) and Primary Care Trusts (PCTs) in England currently belong to the scheme. While Independent Sector Treatment Centres cannot join the scheme in their own right, they can benefit from cover when treating NHS patients via the membership of their referring PCT.
The costs of the scheme are met by membership contributions. The projected claim costs are assessed in advance each year by professional actuaries. Contributions are then calculated to meet the total forecast expenditure for that year. Individual member contribution levels are influenced by a range of factors, including the type of trust, the specialties it provides and the number of “whole time equivalent” clinical staff it employs. Discounts are available to those trusts which achieve the relevant NHSLA risk management standards and to those with a good claims history.
When a claim is made against a member of CNST, the NHS body remains the legal defendant. However, the NHSLA takes over full responsibility for handling the claim and meeting the associated costs. Until April 2002, trusts handled claims within their chosen excess themselves. Such claims were then “called-in” and all CNST claims are now handled centrally regardless of value. The scope of the scheme is set out in the CNST rules, while our Clinical negligence reporting guidelines and CNST claim report form set out how claims should be reported by trusts to the NHSLA. A Guide to clinicians on how claims are handled is also available.
All acute, specialist and mental health/learning disability trusts, whether or not they have already attained Foundation status or have applied to do so, are asked to print off the letter from our Chief Executive dated 17th July 2006, the CNST Periodical Payments Agreement, Appendix 1 and letter from the Department of Health dated 20th December 2005. The judgments in YM-v-Gloucestershire Hospitals NHS FT and Begum-v-Barnet and Chase Farms Hospital NHST (which concerns ELS) are also available for consideration.
To obtain a printout of existing structured settlements and periodical payment agreements, please contact Sonia Irvin (sonia.irvin@nhsla.com) or on 020 7430 8821.
Trusts are requested to consider these documents, sign one copy of the 17.7.06 letter and return it to Sonia Irvin at NHSLA. Some trusts have already signed, having been sent these documents individually in view of impending court approvals. No further action on their part is necessary.
Should there be any queries, please refer them to the Authority’s Technical Claims Unit.