Recommendation 92

Financial incentives to achieve risk management standards

The financial incentives at levels below level 3 should be adjusted to maximise the motivation to reach level 3.

From 1 April 2013, the NHS Litigation Authority introduced a revised pricing methodology for the Clinical Negligence Scheme for Trusts.

The new approach means that organisations with a good claims record will see the benefit of this in their Clinical Negligence Scheme for Trusts pricing whereas those organisations with a less favourable claims history will contribute more to the risk pool. These changes were discussed extensively with members of the scheme. The Department of Health and other relevant parties across the system agreed this represents a more equitable way of distributing the costs of the scheme.

The NHS Litigation Authority is also already bringing the focus of NHS organisations onto their claims activity which it is hoped will in turn assist in reducing the costs associated with Clinical Negligence Scheme for trusts and ultimately reduce the level of harm to patients.


In 2013 the NHS Litigation Authority informed the NHS that it would be moving away from the system of risk management discounts on members’ contributions whilst aiming to avoid large swings in price for members who currently receive discounts. The revised pricing methodology, which has been in place since April 2013, financially rewards organisations with fewer, less costly claims and financially incentivises organisations to focus on their claims with a view to reducing them, thereby reducing harm and improving patient and staff safety.

In addition, the NHS Litigation Authority is supporting Sign up to Safety, the campaign launched by the Secretary of State for Health that aims to listen to patients and staff, learn from when things go wrong and act to make care safer. The NHS Litigation Authority will review members’ safety plans and where they aim to reduce claims and are robust, the NHS Litigation Authority will make a payment to support implementation of the safety improvement plan.