Clinical Negligence Scheme for Trusts (CNST)

Clinical negligence claims have been steadily increasing worldwide and these can pose a serious threat to the financial viability of healthcare organizations, threatening their very existence. They may also encourage ‘defensive’ practice, lack of transparency, avoidance of provision of ‘high risk’ services such as obstetrics and orthopaedics, to avoid potential clinical negligence claims. In the U.K., costs of clinical negligence claims have been steadily increasing. Hence, the NHS Litigation Authority (NHSLA) was established in 1995 as a Special Health Authority to administer an ‘insurance policy’ (called Clinical Negligence Scheme for Trusts or CNST) to participating trusts. The aim is to provide a scheme for NHS organizations to fund the cost of clinical negligence claims. Although the participation in this scheme is voluntary, currently all the trusts in England are enrolled in this scheme. As at 31 March 2008, the NHSLA estimates that it has potential liabilities of £12.1 billion, of which £11.9 billion relate to clinical negligence claims.