Common Hospital Negligence Claims
NHS Resolution and the CNST
Claims against NHS hospital trusts are managed by NHS Resolution (formerly the NHSLA) through the Clinical Negligence Scheme for Trusts (CNST). Under the CNST:
- NHS trusts pay annual contributions to NHS Resolution based on their claims experience and risk profile
- NHS Resolution handles the defence of clinical negligence claims on behalf of member trusts
- NHS Resolution employs specialist solicitors and regularly instructs leading clinical negligence barristers — it is a well-resourced and experienced defendant organisation
- Claimants who are not represented by a specialist medical negligence solicitor are at a significant disadvantage when dealing with NHS Resolution's legal team
- Under the Pre-Action Protocol for the Resolution of Clinical Disputes, NHS Resolution has 4 months from the Letter of Claim to respond — during which it instructs its own experts and develops its defence strategy
Frequently Asked Questions
What is the difference between NHS hospital negligence and private hospital negligence?
NHS hospital trusts are vicariously liable for the clinical negligence of their employed clinicians — claims are handled by NHS Resolution under the CNST. Private hospitals may be vicariously liable for employed clinical staff, but consultants who practise privately are typically independent contractors personally insured through a medical defence organisation — the claim may be against the individual consultant, not the hospital. A solicitor identifies all potentially liable defendants, which may include both the private hospital and the individual clinician.
I was asked to sign a Duty of Candour statement by the hospital — what does this mean?
The Duty of Candour (Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014) requires NHS trusts to tell patients when they have been harmed by a safety incident, provide an apology, and explain what happened. A Duty of Candour notification and apology is not a legal admission of liability — it cannot be used as evidence in proceedings — but it is important evidence that the trust acknowledged a notifiable safety incident. A solicitor reviews the Duty of Candour documentation alongside the clinical records.
Can I claim if the hospital has already apologised?
Yes. A hospital apology under the Duty of Candour is not an admission of legal liability and does not affect your right to claim compensation. The Civil Liability Act 1996 provides that apologies made in connection with civil disputes cannot be treated as admissions of liability unless the apology specifically admits fault — institutional apologies typically do not. A specialist solicitor explains how the apology sits within the legal claim.
What is a serious incident investigation, and how does it relate to my claim?
When a significant patient safety event occurs, the NHS trust is required to conduct a Serious Incident (SI) investigation under NHS England's Patient Safety Incident Response Framework (PSIRF). The SI report analyses what went wrong, identifies contributory factors, and makes recommendations to prevent recurrence. SI reports are internally generated documents — the trust is the author and may not provide them voluntarily. A solicitor can request the SI report disclosure through the litigation process or Freedom of Information. The report's findings can be powerful evidence in support of a clinical negligence claim.
Will the hospital know I am making a claim?
Yes — the pre-action protocol requires a Letter of Claim to be sent to the defendant trust before proceedings are issued. NHS Resolution will be notified and instructed to manage the claim. Patients are sometimes concerned about their ongoing treatment when they are claiming against the same trust — in practice, clinical care is managed separately from claims management. A solicitor can assist where a patient has concerns about ongoing care.