What about research projects?
Can Independent Sector Treatment Centres be members of the CNST scheme?
No. The current legislative framework does not allow non-NHS bodies to become members of CNST. However, following discussions between the Department of Health and the NHSLA, special arrangements have been made to allow ISTC providers treating NHS patients to benefit from the referring PCTs’ CNST membership. This means that as long as ISTCs are treating NHS patients, the same benefits of CNST coverage for clinical negligence will apply as they do where an NHS patient is treated in an NHS Trust hospital. CNST covers only claims in respect of clinical negligence. ISTC providers must still carry commercial insurance for their other potential liabilities, eg employer’s liability, public liability, damage to the provider’s own buildings etc. For more information about how CNST applies to ISTCs, see our ISTC factsheet.
Are medical students covered by CNST?
Confirmation of cover for medical students is often sought. NHS indemnity extends to provide cover for medical students whether honorary contracts apply or not, but the students must carry out any work under the direct supervision of trust employees.
Some of our staff are seconded to a local hospice to generate income for the trust. Are they covered under CNST whilst giving treatment to hospice patients?
Yes - NHS staff seconded to a hospice or other care establishment are covered under CNST, provided they are acting in accordance with their terms of employment and any income generated from such activity is recycled back into the trust.
One of our consultants undertakes private work using trust facilities and occasionally employees. Would the trust be covered in the event of an incident?
As the consultation and any subsequent treatment is being given on a private basis, that is to say the private patient pays the consultant direct, then the consultant should have his or her own private cover with a defence organisation. Where possible, we suggest that the trust seeks confirmation of such cover before consenting to the use of premises/employees.
The position concerning trust personnel depends on the basis of assistance being given. If the trust expects junior doctors, nurses or other employees to assist whilst working in accordance with their contracted terms of employment, then CNST cover would be available for the specific acts of that individual(s). We anticipate that the trust will be paid by the private consultant in such circumstances to reflect the risk. If however the private consultant asks an employee to assist and pays that employee direct, no cover is available under the scheme.
Finally, a point worth mentioning is that it is up to the trust to make sure that the consultant does not write a report on trust headed paper, either following a private consultation or following an NHS consultation where a report is subsequently requested on a private basis. In the event that such reports are written on trust headed paper this can be seen to be ratification by the trust of the consultant’s actions. No cover will be available under CNST in such circumstances which would result in exposure to the trust direct.
What about training courses?
Training is central to good risk management. Where a course is run under the auspices of the trust, with trust employees, then any adverse outcome falling within the remit of the scheme will be covered. However, if patients are to be involved, the position should be checked with the NHSLA.
What about “Good Samaritan” acts?
There would still appear to be some confusion regarding cover under the scheme for ‘Good Samaritan acts’. Whilst there is no specific mention of these in the scheme Rules, the NHSLA has confirmed that cover will extend to provide indemnity in emergencies, if the act is authorised by the employing trust.
What is the position regarding complementary medicines?
The introduction of complementary medicines is a new initiative being considered by many trusts. Cover is available if provided by trust employees to NHS patients, where the employee is providing the treatment as part of his or her contract of employment with the NHS.