Glossary Archive - NHS Resolution

Abdominal aortic aneurysm (AAA)

A bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and tummy.

ALB

Arm’s length body.

AvMA

Action against Medical Accidents: www.avma.org.uk.

Breach of duty

The defendant failed to meet the required standard of care. In order to prove liability in negligence, the claimant must show on the balance of probabilities that the defendant owed a duty of care, breached that duty by failing to meet the standard of care required, and as a result the claimant suffered loss, injury or damage.
To prove negligence, it must be shown that the healthcare provider had a duty to care for the individual, failed to meet the required standard of care, and that this failure directly caused harm, injury, or loss.

Breach of duty of care

For a breach of duty of care the health practitioner must have acted in a way which fell short of acceptable professional standards. Known as the ‘Bolam’ principle, this tests whether the actions of the health professional in question could be supported by a ‘responsible body of clinical opinion’. This test is not about what ‘could have been done’ – that other health professionals might have done something differently, but whether it ‘should have been done’ – would a ‘responsible body’ of health professionals support the action taken?

There is also a further test known as ‘Bolitho’. This means that the court should not accept a defence argument as being ‘reasonable’, ‘respectable’ or ‘responsible’ without first assessing whether such opinion is susceptible to logical analysis.

British Orthopaedic Association (BOA)

The Surgical Specialty Association for Trauma and Orthopaedics in the UK: www.boa.ac.uk

Business Impact Assessment (BIA)

This is a process of collecting necessary information about business systems, processes, functions, resources and people to identify how they may be impacted by an event.

Care Programme Approach (CPA)

A framework for planning and coordinating mental health care for people with severe or complex needs. It involved a written care plan and a named care coordinator to ensure services worked together, risks were managed, and support was regularly reviewed.
Note: CPA was replaced by the Community Mental Health Framework in 2021–2022 as part of NHS England’s transformation of community mental health services.

Causation

What is causation? The harm suffered must be shown, on the balance of probabilities, to be directly linked with the failure of the health professional to meet appropriate standards. If, for example, there was a good chance that the harm would have taken place even if the health professional had acted differently, then a claim is unlikely to succeed. For a successful claim, the claimant needs to establish both a breach of duty of care and causation in order to be entitled to receive compensation.

Cause code

All claims received are categorised against pre-defined cause codes on our database. This will be the main cause(s) of the incident in relation to the claim.

Claim

A claim is a request for compensation made after an incident that causes harm, injury, or damage to property. In healthcare, this may include concerns about the quality of care provided, such as clinical negligence, or any situation that could lead to legal action against the NHS trust.

Claimant

A claimant is any individual – such as a patient, member of the public, or NHS employee – who seeks compensation from the trust. This may be done through legal proceedings or by instructing a solicitor to act on their behalf. In relation to claims associated with suicide this is often the patient’s family or significant other.

Clinical claim

A claim for compensation arising from negligent care or treatment.

Clinical negligence

Clinical negligence refers to a situation where the care provided falls below the standard expected of healthcare professionals. It’s important to note that not every instance of care that doesn’t meet best practice is considered negligent in legal terms.

Clinical Negligence Scheme for Coronavirus (CNSC)

A scheme launched on 3 April 2020 to meet clinical negligence liabilities arising from NHS services provided in response to the coronavirus pandemic where no other indemnity or insurance arrangements are in place already to cover such liabilities.

Clinical Negligence Scheme for General Practice (CNSGP)

A clinical negligence scheme which covers clinical negligence claims for incidents occurring in general practice on or after 1 April 2019

Clinical Negligence Scheme for Trusts (CNST)

A scheme which covers clinical negligence claims for incidents occurring on or after 1 April 1995

Closed claim

A closed claim is one that has been fully resolved. This includes Claims that were settled with damages paid. Claims that were repudiated, withdrawn, or discontinued. Claims that failed to meet the legal threshold for compensation.

Closed claims where damages have been paid

Claims are where there has been a settlement or court order in relation to damages, for either nil or an amount for payment to the claimant.

Closed claims where no damages have been paid

Any claim that does not result in liability being established or damages awarded, either through settlement or court order.

Collaborative Advisory Group (CAG)

The Maternity Incentive Scheme Collaborative Advisory Group (CAG) was established by NHS Resolution to bring together other arm’s length bodies and the royal colleges to support the delivery of the Clinical Negligence Scheme for Trusts Maternity Incentive Scheme and has also advised NHS Resolution on the refined safety actions. Members of the group include:

NHS Resolution
Department of Health and Social Care (DHSC)
NHS England (NHSE)
Royal College of Obstetricians and Gynaecologists (RCOG)
Royal College of Midwives (RCM)
Neonatal Clinical Reference Group (CRG)
Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE)
Royal College of Anaesthetists (RCoA)
Care Quality Commission (CQC)
Maternity and Newborn Safety Investigations (MNSI) programme

Conditional fee arrangement (CFA)

A type of funding agreement between claimant lawyers and their clients.

Consumer Price Index (CPI)

Coronavirus Temporary Indemnity Scheme (CTIS)

A new, but short-term, scheme designed to manage indemnity arrangements for activities carried out in response to the pandemic, such as Designated Settings Indemnity Support for care homes.

Coronial records

Official documentation generated during a coroner’s investigation into a death.

Damages awarded

Damages is the amount of compensation to claimants covering the expected amounts to be paid and actual amounts that have been paid to date.

Damages paid

The amount of compensation paid to date. This may not be the full amount of compensation if further payments are due to be made in the future.

Deep vein thrombosis (DVT)

A condition where blood clots form in a deep vein.

Detained patient

A detained patient is formally held in hospital under a section of the Mental Health Act 1983 (as amended). This means they are not there voluntarily and cannot leave at will. Detention is sometimes called being ‘sectioned’. Mental Health Act – NHS.

Duty of candour

The statutory duty of candour places a requirement on providers of health and adult social care to be open with patients when things go wrong. It means providers must notify the patient about incidents where ‘serious harm’ has occurred and provide an apology and explanation where appropriate

Duty of care

The responsibility of staff to act within the scope of their NHS contract and professional standards to avoid harm.

Emergency Nurse Practitioner (ENP)

A senior nurse practitioner working in the Emergency Department who has been specially trained to treat minor injuries without necessarily having to refer to a doctor.

Ex-Regional Health Authorities Scheme (Ex-RHA)

The Ex-Regional Health Authorities Scheme is funded by DHSC and is a clinical negligence claims scheme that indemnifies the liabilities of former regional health authorities.

Existing Liabilities for General Practice (ELGP)

The Secretary of State has agreed interim arrangements with two Medical Defence Organisations, Medical Protection Society and Medical and Dental Defence Union of Scotland, in relation to NHS historical liabilities arising from general practice incidents that occurred prior to 1 April 2019. NHS Resolution carries out the Secretary of State’s oversight responsibilities under those interim arrangements in relation to the management of claims for the liabilities within scope of the arrangements. The costs are funded out of the budget for the NHS held by NHS England and NHS Improvement, which are transferred to NHS Resolution via financing from DHSC.

Existing Liabilities Scheme (ELS)

The Existing Liabilities Scheme is funded by DHSC and is a clinical negligence claims scheme that indemnifies pre-April 1995 incidents.

Existing Liabilities Scheme for General Practice (ELSGP)

The Existing Liabilities Scheme for General Practice covers NHS historical liability claims of general practice members of medical defence organisations that enter into interim arrangements in respect of such liabilities. Liabilities within scope of the interim arrangements with the Medical Protection Society (MPS) were covered under the ELSGP from 1 April 2021. Those within scope of the arrangements with the Medical and Dental Defence Union of Scotland (MDDUS) were covered under the ELSGP from 6 April 2020.

Extended Scope Practitioner (ESP)

A physiotherapist specialist clinicians who have undertaken additional Orthopaedic training.

Extranet

A secure web portal providing our members and our solicitors with real-time access to their claims data. The data help our members prevent harm to patients and staff, which might otherwise lead to future claims against the NHS.

Family Health Services Appeal Unit (FHSAU)

Family Health Services Appeal Unit, now known as our Primary Care Appeals service.

Getting It Right First Time (GIRFT)

Getting It Right First Time: https://gettingitrightfirsttime.co.uk

Getting it right first time (GIRFT)

National programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. Visit the Getting it right first time website.

Healthcare Professional Alert Notice (HPAN)

Healthcare Professional Alert Notice is an alert system managed nationally by Practitioner Performance Advice to alert employers to the existence of serious grounds for concern about a regulated health practitioner who has departed an organisation and for whom concerns were unresolved. This differs from performers’ list management (restrictions on practice), which are logged centrally by Primary Care Appeals and shared with requesting health bodies

Healthcare Safety Investigation Branch (HSIB)

Healthcare Safety Investigation Branch now known as The Health Services Safety Investigations Body (HSSIB)

hssib.org.uk

HM Treasury discount rates

These discount rates are designed to recognise the value of money over time: £1 now may be worth more or less in the future. Applying a discount rate to the amounts we expect to pay out in the future enables us to put a value on those outgoings at today’s prices. It tells us how much we would need to pay out if we settled all of those future obligations today.

Hospital acquired pressure injury (HAPU)

Pressure ulcers that occur during hospitalisation.

Hypoxic Ischaemic Encephalopathy (HIE)

Hypoxic Ischaemic Encephalopathy (HIE) in the term or near-term infant refers to acute brain dysfunction following critical lack of cerebral blood flow and oxygen delivery.

Incident and investigation reports

NHS documents that record patient safety events and analyse their causes. An incident report captures what happened and immediate actions, while an investigation report examines why it occurred, identifies contributory factors, and recommends improvements to prevent recurrence.

Incident date/year

Date/year that an alleged incident took place. If the allegations span a period of time then the earliest date in the period is used.

Incident description field

A free text field used to record a brief summary of the circumstances leading to a claim.

Incurred but not reported (IBNR)

Incurred but not reported claims: claims that may be brought in the future

Informal patient

An informal patient (also called a voluntary patient) is someone who agrees to be admitted to hospital for mental health assessment or treatment voluntarily. They are not detained under the Mental Health Act 1983.

Injury codes

All claims received are categorised against pre-defined injury codes on our database. These will be the main injuries suffered by the claimant as a result of the incident.

Intentional Rounding (IR)

Structure process whereby nurses in hospital carry out regular checks of patients.

Legal Aid, Sentencing and Punishment of Offenders Act (LASPO)

Legal Aid, Sentencing and Punishment of Offenders Act. Legal reforms that came into force on 1 April 2013. The reforms changed, among other matters, the amount
that claimant solicitors could recover from the defendant under conditional fee agreements and limit after-the-event insurance.

Letters of claim

Formal written notice sent by a claimant to a defendant, stating the intention to initiate legal proceedings.

Liabilities to Third Parties Scheme (LTPS)

The Liabilities to Third Parties Scheme indemnifies the NHS for employers’ liability, public liability and professional indemnity claims made against the NHS

Liability

Liability means legal responsibility. In clinical negligence, liability is established where a duty of care exists between the claimant and healthcare provider and treatment provided falls below a reasonable standard, resulting in an injury which would more likely than not have been avoided (or less severe) with appropriate care.

Location

When used in the context of our Claims Management System data. This refers to the location of the incident. For example, inside or outside a building, a specific clinical area or site, non-clinical offices, car park, or other public area

Maternity and Newborn Safety Investigations (MNSI)

The Maternity and Newborn Safety Investigations programme is part of a national strategy to improve maternity safety across the NHS in England. The programme was established in 2018 as part of the Healthcare Safety Investigation Branch and is now hosted by the Care Quality Commission. As of 1 October 2023, the Maternity and Newborn Safety Investigations (MNSI) programme is hosted by CQC. The arrangement with CQC ensures the continuation of the maternity programme and will maintain the independence of maternity investigations within the NHS.

The purpose of MNSI remains the same:

– to provide independent, standardised and family focused investigations of maternity cases for families;

– to provide learning to the health system via reports at local, regional and national level;

– to analyse data to identify key trends and provide system wide learning; be a system expert in standards for maternity investigations;

– and to collaborate with system partners to escalate safety concerns.

Medical and Dental Defence Union of Scotland (MDDUS)

The Medical and Dental Defence Union of Scotland (MDDUS) is a medical defence organisation: www.mddus.com

Medical Defence Union (MDU)

The Medical Defence Union (MDU) is a medical defence organisation: www.themdu.com

Medical Protection Society (MPS)

The Medical Protection Society (MPS) is a medical defence organisation: www.medicalprotection.org

Mental Health Act (1983)

The Mental Health Act 1983 (as amended in 2007) is the main legislation in England and Wales governing:
• Assessment, treatment, and rights of people with mental health disorders.
• Circumstances under which individuals can be detained (sectioned) and treated without consent.
Safeguards to protect patient rights and ensure care is lawful and proportionate.

Multidisciplinary Team (MDT)

A team of health and care professionals work together to support people with complex care needs.

National Clinical Assessment Service (NCAS)

The National Clinical Assessment Service (NCAS), now known as our Practitioner Performance Advice service.

National Early Warning Score (NEWS)

A tool developed to improve detection and response to clinical deterioration in adult patients.

National Institute for Health and Care Excellence (NICE)

Provide national guidance and advice to improve health and social care.

NHS England

The national body responsible for overseeing the delivery of healthcare services in England, setting priorities, allocating resources, and ensuring high-quality care across the NHS.

NHS indemnity

NHS indemnity protects patients by covering claims of clinical negligence made against NHS staff while they are carrying out their official duties. It does not cover the personal interests of staff, which is why many healthcare professionals also have personal cover through medical defence organisations or professional bodies.

NHS Legal costs

Amounts paid out by NHS Resolution in legal costs for claims resolved: including NHS legal and claimant costs, this can include expert and counsel’s fees as well as court costs.

NHS Litigation Authority (NHSLA)

The NHS Litigation Authority is the legal name of NHS Resolution.

Non-clinical claim

A claim for compensation arising from negligence other than clinical negligence, typically employers’ and public liability claims.

Notification date/year

Date/year in which NHS Resolution is notified of the claim.

Office for Budget Responsibility (OBR)

Office for Budget Responsibility (OBR): https://obr.uk

Open claim

An open claim is one that is still ongoing and has not yet reached a final resolution. This means the legal process is active, and the outcome is not yet determined. The costs and damages are subject to change. The claim may be in pre-action, litigation, or awaiting settlement.

Outstanding damages

Damages attributed to a claim but not yet paid. For Periodical Payment Orders this is the total damages value of the periodical payment element of the future losses.

Periodical Payment Order (PPO)

A Court order, usually reflecting an agreement between the parties, to pay an initial lump sum and regular future payments covering the injured party’s ongoing care needs, usually for life. The amount reserved against the claim will include an estimate of the capitalised
value of future payments based on the injured party’s life expectancy as at the date of settlement.

Personal injury discount rate (PIDR)

Property Expenses Scheme (PES)

The Property Expenses Scheme (PES) indemnifies NHS members for property claims.

Provision

The provision is the best estimate of the expenditure required to settle the present obligation at the balance sheet date or transfer to a third party (for claims
made and predicated to be made, so called ‘incurred but not reported claims’). The figure is updated annually and is an informed estimate that depends on
assumptions about future developments and therefore lies within a range of possible results. When considering the provision, it is important to note that if
there is a value allocated to a future periodical payment order this will change in response to changing needs and the lifespan of the claimant concerned.

PSIRF – Patient Safety Incident Response Framework

The NHS’s national approach to responding to patient safety incidents, replacing the previous Serious Incident Framework (SIF). Introduced formally in August 2022 and mandated for NHS trusts from Autumn 2023, PSIRF represents a fundamental shift in how incidents are investigated and learned from.

Pulmonary embolism (PE)

A condition where a blood clot gets lodged in the an artery in the lung.

Royal College of Emergency Medicine (RCEM)

Sets and monitors standards of care in emergency departments and provides expert guidance and advice on policy to relevant bodies on matters relating to Emergency Medicine.

Royal College of Nursing (RCN)

Nursing union and professional body, representing more than 465,000 nurses, student nurses, midwives and nursing support workers in the UK and internationally.

Royal College of Radiologists (RCR)

Leads, educates and supports doctors who are training and working in the specialties of clinical oncology and clinical radiology.

Situation Background Assessment Recommendation (SBAR)

A framework for communication between members of the health care team about a patient’s condition.

Society of Radiographers (SOR)

The trade union and UK professional body for the diagnostic imaging and radiotherapy workforce.

Specialty

The branch of clinical practice relating to the allegations of negligence.

The Health Services Safety Investigations Body (HSSIB)

The Health Services Safety Investigations Body (HSSIB) undertakes healthcare safety investigations. They investigate patient safety concerns across England to improve NHS care at a national level. Through their education programme they help embed professional safety investigation expertise in healthcare organisations. HSSIB investigations do not find blame or liability with individuals or organisations. Information shared with them is confidential and protected by law. They are a fully independent arm’s length body of the Department of Health and Social Care.