PUBLIC TRUST BOARD MEETING 29 th APRIL 2008

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1 PUBLIC TRUST BOARD MEETING 29 th APRIL 2008 SUBJECT: AUTHOR: LEAD DIRECTOR: EXECUTIVE SUMMARY National Health Service Litigation Authority (NHSLA) Clinical Negligence Scheme for Trusts (CNST) Assessment outcomes Sylvia Knight, Chief Nurse Sylvia Knight, Chief Nurse The National Health Service Litigation Authority is a Special Health Authority that administers the Clinical Negligence Scheme for Trusts. Through the CNST scheme, the NHSLA seeks to encourage the effective management of risk. Trusts can participate in the scheme through assessments against a range of standards. The Trust was assessed against the NHSLA standards for general services and maternity services during 2007/08. The outcome of the assessments means that the Trust has maintained its level 2 award for general services and level 1 award for maternity services. The awards mean that the Trust maintains its current level of discount against the NHSLA insurance contributions. TRUST BOARD ACTION For information Page 1 of 7

2 1. PURPOSE OF REPORT 1.1. This report sets out the outcome of the United Lincolnshire Hospitals Trust assessments against the NHSLA CNST standards for both maternity services and general services. 2. ACTION REQUIRED 2.1. The Trust Board are asked to note the outcome of the assessments. 3. BACKGROUND 3.1. The National Health Service Litigation Authority is a Special Health Authority that administers the Clinical Negligence Scheme for Trusts. Trusts that wish to participate in the scheme are able to secure discounts against their NHSLA insurance premiums through a process of rigorous external assessment against a range of standards that relate to the management of risk The NHSLA CNST standards are set at 3 levels for assessment: Level 1 effective risk management systems and processes Level 2 implementation of level 1 systems Level 3 monitoring compliance with systems 3.3 Assessment against the standards is a mandatory requirement for members of the NHSLA scheme and failure to participate in an assessment results in a Trust being deemed to be at level 0 and the NHSLA may refuse to provide indemnity. 3.4 This Trust participated in assessments for both its general services and maternity services in 2007/08 in line with the scheme requirements and confirmation has been received from the NHSLA that the Trust achieved level 2 compliance for general services and level 1 compliance for maternity services which maintains the position from the 2004/05 assessments. 4. ANALYSIS OF KEY ISSUES 4.1. Financial implications Achievement of compliance at level 2 for the general NHSLA standards means that the Trust will continue to receive a discount of 20% against its general NHSLA insurance contributions. Achievement of compliance at level 1 for the maternity standards means that the Trust will continue to receive a discount of 10% against its maternity NHSLA insurance contributions. These discounts will apply until the next scheme assessments General Standards performance The detailed Trust performance against the general standards is shown in the report attached at Appendix A. The Trust achieved the required standard of meeting a minimum of 40 out of 50 standards at level 2. The performance against the standards by group was: Page 2 of 7

3 Governance 6 out of 10 standards met Competent and capable workforce 8 out of 10 standards met Safe environment 8 out of 10 standards met Clinical care 8 out of 10 standards met Learning from experience 10 out of 10 standards met The significant area that affected the Trust s performance against the governance standards was compliance against the Key Lines of Enquiry (KLOE) within the Auditors Local Evaluation (ALE) and the Trust was aware that the related standards would not be met prior to the assessment. The Trust has already made progress against the ALE KLOE It is particularly pleasing to note that the Trust achieved full compliance with the 10 standards the relate to learning from experience and the assessor has commended the robustness of our systems for report, managing and learning from incidents, complaints and claims Maternity Standards performance The detailed performance against the maternity CNST standards is shown at Appendix 2. The Trust achieved the required standard of 90% achievement against the standards required for a level 1 award. The Trust were aiming to achieve a level 2 award but the Trust fell short in 2 standards at level 2 (induction, training and development and health records). The performance against standards by group was: Organisation 100% Learning from experience 90% Communication 90% Clinical care 90% Induction, training and competence 85% Health records 100% Staffing levels 100% 4.6. In addition to the performance at level 1, the maternity services achieved full (100%) compliance with the level 2 standards associated with learning from experience, communication and clinical care and the Trust s performance was commended by the assessor in particular in these areas Relative performance For the general standards, the distribution of NHS organisations that have achieved compliance at each level is as follows: Level 0 1 Level 1 79 Level 2 77 Level 3 12 Page 3 of 7

4 For the maternity standards, the distribution of NHS organisations that have achieved compliance at each level is as follows: Level 0-1 Level 1 45 Level2 72 Level Action Plans Separate action plans for each of the assessments are being developed in response to the detailed feedback to enable the Trust to make progress towards compliance at a higher level Maternity Standards pilot In 2008/09, the NHSLA will be launching a new set of standards for maternity services. United Lincolnshire Hospitals Trust has been accepted as a pilot area for the new standards which will enable the Trust to participate in an assessment against the new standards without prejudice. 5. CONCLUSION 5.1. The Trust has maintained its overall performance in relation to the general and maternity services NHSLA CNST standards. In some areas, the Trust has demonstrated that it has made significant improvement which has enabled fully compliant scores to be awarded. A detailed plan for each of the standards is being developed and will be monitored through the Integrated Governance Committee. 6. PROPOSALS/ RECOMMENDATIONS 6.1. The Trust Board are asked to note the outcome of the NHSLA CNST assessments. 7. REFERENCE/ CONTACTS 7.1. For further information about the NHSLA standards and assessment please contact Rick Dickinson, Risk Manager at rick.dickinson@ulh.nhs.uk Sylvia Knight, Chief Nurse at Sylvia.knight@ulh.nhs.uk For information about the NHSLA please visit Sylvia Knight, Chief Nurse 17/04/2008 Page 4 of 7

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