In March 2022 we reached the end of our five-year strategy, Delivering Fair Resolution and Learning from Harm. This had been refreshed in 2019 to take into account a rapidly changing environment and an extended remit for the organisation into general practice.
The world is shifting yet again. The Covid-19 pandemic continues to have an impact on all of us and, in particular, the healthcare system. There are also planned reforms to the NHS to deliver more integrated health and care. Despite these changes, we remain confident that our strategic focus should be to continue to deepen and improve the work we have been doing since 2017: working upstream to achieve fair resolution without the need for formal processes, and using our data and insights to reduce risk while building up capacity and capability internally and across the healthcare system, such as the way in which concerns are handled locally.
The pressures on NHS staff and our health service partners continue to be immense. Our primary aim is to ensure all that we do supports the delivery of safe healthcare to patients. As it did for many organisations, the Covid-19 pandemic slowed some things down for NHS Resolution but accelerated others. Inevitably, clinical time to investigate and learn from claims has been limited while NHS staff have been engaged in the pandemic response; activity in the courts has also slowed. However, this generated a more collaborative approach to claims resolution, innovation in the legal market and a drop in the number of claims going to court. This shift is directly aligned to our objectives and something we are committed to accelerating in the next three years. It is our strong belief that delivering fair resolution across all of our service areas need not be adversarial or distressing, and that the best outcomes are obtained by stepping away from formal processes.
Covid-19 also brought to the fore the tremendous value of state backed indemnity arrangements. When the pandemic struck in 2020, we were one year into our new scheme for general practice. The seamless indemnity that this created between general practice and secondary care proved to be invaluable as new healthcare arrangements were put in place to respond to the pandemic. This formed the template for the rapid launch of further schemes to address gaps in cover, removing indemnity as a barrier to the provision of services. The strong and constructive partnerships we have built with our sponsoring government department and others over the years, coupled with the expertise of our staff, have enabled us to extend the benefit of our indemnity services to meet the system’s needs. The same can be said for our Practitioner Performance Advice (Advice) service, which dealt sensitively and effectively with a myriad of complex, pandemic-related issues including supporting the return of much needed healthcare professionals to the frontline.
To be fully effective with this approach, we need to do more, both to highlight and share good practice where we find it but also to challenge others to take greater responsibility to put things right outside of the claims, advice and appeals processes. We will work with healthcare providers to ensure that they have regard to information we publish in order to reduce claims risk. Our Primary Care Appeals (Appeals) service will engage with NHS England and NHS Improvement to improve the local decision making around primary care contracting. We will offer interested parties external training and/or access to resources to support early resolution of contracting disputes.
Our analysis across all specialties and service areas will become more rigorous, supported by better tools and greater analytical capability. With the advent of Integrated Care Systems, all of our services will work with systems as well as providers. We will also continue to contribute our data, knowledge and expertise to government across a range of policy areas including any possible changes to the wider legal framework. We will have a greater focus on impact, ensuring that everything we share adds value. This extends to areas where previously we have not looked to collect or analyse data, such as health inequalities.
Successful delivery of this strategy will require significant operational transformation and investment in our people to support them through the changes and make the very most of their expertise. We have two significant change programmes underway. The first is a complete replacement of our core technology systems and the surrounding systems architecture, and the second a change to our claims operating model. Both of these programmes represent a significant undertaking spanning the next three years but will improve our services and will help ensure we continue to deliver best value for money.
There is much to be done in the next three years but, as we approach our 25th birthday, we are well placed to deliver with exceptional, committed staff and close partnerships to call on to help achieve our shared ambitions.
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