Newly appointed NHS Litigation Authority (NHSLA) chief executive Catherine Dixon’s priority will be getting value for money and using law firms to engage with NHS trusts as she prepares for a legal panel review later this year.
Dixon joined the NHSLA in April from the NSPCC where she was general counsel and company secretary. She was previously head of legal at Bupa and in private practice at Eversheds. She replaces outgoing NHSLA chief executive Steve Walker.
‘We are undertaking a panel review over the course of this year, with a view to the new panel being in place on 1 April next year,’ said Dixon. ‘We will be working with government procurement processes and the key thing is that we are able to deliver value for money. Procuring legal services is always a sophisticated purchase. It has to be the right price but it’s key that it’s the right quality.’
‘Procuring legal services is always a sophisticated purchase. It has to be the right price but it’s key that it’s the right quality.’
Catherine Dixon, NHSLA
The NHSLA, which is responsible for negligence claims and improving risk management in the NHS, has seen its legal spend increase dramatically in recent years. According to its most recent accounts, in 2010/11 its total legal spend stood at £257m, up from £163m in 2009/10 and marking a 57% increase.
The body currently has two panels in place, a clinical negligence panel and a non-clinical panel, that were last reviewed in 2008 and 2009 respectively. The clinical negligence panel features Clyde & Co, DAC Beachcroft, Bevan Brittan, Browne Jacobson, Capsticks, Hill Dickinson, Kennedys, Ward Hadaway, Hempsons and Weightmans. The non-clinical panel consists of Clyde & Co, Weightmans, Browne Jacobson, Hill Dickinson, Kennedys, Veitch Penny and Ward Hadaway.
Around £57m of the 2010/11 legal spend went to panel firms. Beachcroft and Bevan Brittan were the biggest beneficiaries, receiving £8.7m and £6.2m respectively, according to the government data website, data.gov.uk.
Of the 11 panel firms, Barlow Lyde & Gilbert (now Clyde & Co) received the smallest amount, pocketing just £368,000 from the NHSLA in fees during the 2010/11 financial year.
The remaining £200m in legal costs, or 76% of the NHSLA’s legal expenditure, was paid out to claimants’ lawyers, with Irwin Mitchell and Leigh Day & Co receiving £16m and £5.5m respectively in the 2010/11 financial year.
In its most recent accounts, the NHSLA blamed the use of conditional fee agreements for its rising legal bill, claiming ‘their use by claimants in clinical negligence claims has also meant that claimants’ costs are almost invariably disproportionate’.
Dixon will also be responsible for non-legal matters, including reforming risk management and communications, as the NHSLA comes under increasing pressure to cut its spend and deliver value for money for health bodies. In April Lancashire Care NHS Foundation Trust became the first mental health trust to give notice that it was leaving the NHSLA scheme. Separately, the trade magazine Health Service Journal reported in April that a quarter of NHS trusts were considering leaving the NHSLA, with 72 NHS organisations in ‘active discussions’ with insurance brokers about leaving the clinical negligence scheme.
In January a report by insurance broker Marsh, commissioned by the Department of Health, said that the NHSLA had to do more to share information between trusts to help drive improvements. For panel firms, this may mean more sharing of information with the authority.
‘We had a review by Marsh and received a largely positive endorsement of the value we deliver,’ said Dixon. ‘But we really want to engage with [NHS trusts] regarding patient safety and I think our solicitors and claims handlers are critical to that going forward. The other key is that opportunity around education and knowledge-building for trusts. There is a huge opportunity in sharing lessons learnt.’
As well as seeing an increase in its legal spend, the NHSLA also saw an increase in claims across its schemes in 2010/11. According to NHSLA accounts, claims in 2010/11 rose by 9% on the previous year to 22,364 claims.