To ask the Scottish Executive, further to the answer to question S2W-9957 by Malcolm Chisholm on 6 September 2004, whether the #9,882,454 cost of negligence claims in 2003-04 was met by NHS boards or by insurers and, if the cost was not met by insurers, how much has been paid in premiums (a) by each NHS board and (b) in total.
In 2003-04 the cost of £9,882,454 for clinical negligence claims was met by theClinical Negligence and Other Risks Indemnity Scheme (CNORIS) and NHS boards.
The cost of clinical negligence claims is generally met from (CNORIS) which is a risk management scheme for NHSScotland that came into operation on 1 April 2000. The scheme was established by the Clinical Negligence and Other Risk Indemnity Scheme (CNORIS) Scotland Regulations 2000, as amended.
Membership of CNORIS is mandatory for all health bodies in Scotland. The arrangements cover both clinical and non-clinical liabilities and are funded by contributions from the members. At the outset there were two aims in establishing the scheme, firstly, to provide cost-effective claims management and financial risk pooling arrangements for all of Scotland's NHS bodies. Secondly, to encourage a rigorous and logical approach to risk management in both the clinical and non-clinical sectors of NHSScotland.
In 2003, the special health board, NHS Quality Improvement Scotland (NHS QIS) was formed and the Health Department decided that the CNORIS risk management standards, should become part of the work of NHS QIS. It was decided to combine the CNORIS standards with the former Clinical Standards Board’s generic standards to form Healthcare Governance standards. The process of establishing the new standards is on-going.
CNORIS operates as a risk pool, meeting the cost of negligence cases arising in any one year (subject to a deductible payable by the member (i.e. NHS body)). The pool operates on a pay-as-you-go basis with members' contributions for any one year based on the expected level of demand on the pool in that year. Further information on the scheme can be found at http://www.cnoris.com/.
In managing the scheme two actuarial reports are commissioned each year. The main report is undertaken in November each year and is used to assess the likely demand on the scheme and determine contribution levels for the coming year. The second report is undertaken each September and assesses the claims to be settled in the remaining six months of the year, the level at which claims have settled in comparison to the amount claimed, the likelihood of new claims and existing funds. This allows the Department to manage the level of funds held centrally and assess if the scheme can return unspent resources in-year.
The scheme actuaries assessed that the potential liability in 2003-04 was £13.68 million. The Department off-set this amount by £4 million, from a carried forward balance leaving £9.68 million to be collected for 2003-04. After the application of risk management discounts £8.49 million was collected. The amounts collected were as follows:
NHS Board | Amount Collected |
Argyll and Clyde | £911,774 |
Ayrshire and Arran | £550,385 |
Borders | £177,734 |
Dumfries and Galloway | £289,903 |
Fife | £513,897 |
Forth Valley | £401,985 |
Grampian | £741,823 |
Greater Glasgow | £1,606,639 |
Highland | £332,781 |
Lanarkshire | £656,578 |
Lothian | £1,171,764 |
Orkney | £30,963 |
Shetland | £36,073 |
Tayside | £740,763 |
Western Isles | £58,096 |
Special Health Boards | £271,827 |
Total | £8,492,985 |
In 2003-04, a further £4.53m was returned to CNORIS members following the in-year review.