Digest News


NHS litigation costs continue to rise


THE cost of medical negligence claims to the NHS in England continues to rise despite a reduction in formal litigation as more claims are mediated. NHS Resolution reports that the number of new clinical negligence claims in 2017/18 fell by 0.12 per cent (13 claims) but that the NHS paid out more than £1.63 billion in damages to claimants, an increase from £1.08 billion in 2016/17. Over £400 million of the increase was due to the change in the personal injury discount rate (PIDR) from 2.5 to minus 0.75 per cent.


Legal costs fell (by £31.8 million) for the


first time in many years as NHS Resolution implemented the first year of its five-year strategy. Helen Vernon, NHS Resolution chief


executive, said: “The growing interest both from our NHS members and those who act for injured patients in working together to resolve claims for compensation without going to court has been very encouraging and we hope to build on this so that mediation is no longer seen as novel in healthcare. “However, the cost of clinical negligence is at an all-time high. The total provisions for all of our indemnity schemes continue to rise from £65 billion last year to £77 billion as of 31 March 2018 which brings a renewed urgency to efforts across government to tackle the drivers of that cost.”


Dental prevention pilot proves successful


A SCHEME for prevention-focused dental care piloted in 73 practices in England has led to “reduced or maintained levels” of tooth decay in 90 per cent of patients, according to a government evaluation. The new system incentivises dentists to offer full oral health assessments and self-care plans on top of traditional treatments. In the first year of piloting the new approach, dentists also reported that 80 per cent of patients had reduced or maintained levels of gum disease and 97 per cent were satisfied with the dental care they received. The Department of Health and Social


Care has decided now to extend the pilot to a further 50 practices in England and it is hoped that, if proven successful, the scheme could be rolled out nationally from April 2020. However, the BDA has called on ministers to be honest that their stated goals to maintain access and embed prevention in NHS dentistry cannot be achieved on a slashed NHS dental primary care budget. BDA Chair of General Dental Practice Henrik Overgaard-


6 / MDDUS INSIGHT / Q3 2018 England to implement opt-out organ donation


AN opt-out organ donation scheme is expected to come into effect in England in the spring of 2020. The government has outlined plans to implement a new system of consent for organ and tissue donation in which everyone is considered an organ donor unless they have explicitly recorded a wish not to be, or are from one of three excluded groups. These include children under 18, individuals who lack the mental capacity to understand the changes and people who have not lived in England for at least 12 months before their death. A 12-month transition period will allow time for discussion with friends and family about


organ donation preferences. Patients will be able to opt out from the NHS Organ Donor Register either via the NHS Blood and Transplant website or by calling a helpline. The new NHS app expected to be launched at the end of this year will also allow patients to record their decision. Jackie Doyle-Price, Parliamentary Under Secretary of State for Mental Health and Inequalities, said: “We believe that by making these changes, we can save as many as 700 more lives every year.”


Nielsen said: “It’s good to see wider testing of the prototypes, but when the one variable ministers won’t change is funding cuts, we are unlikely to see progress.”


Mixed review for NHS in global comparison


A GLOBAL comparison of healthcare systems has found that the NHS performs worse than average in the treatment of eight out of the 12 most common causes of death – but provides unusually good financial protection to the public from the consequences of ill health. The independent report – How good is the NHS? – looked at three aspects of what constitutes a good healthcare system, comparing the UK to 18 similar developed countries, including France, Germany, Italy, Japan and the USA. It found that the NHS performs worse than


average in the treatment of eight out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with


breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer. The NHS is also the third poorest performer in the overall rate at which people die when successful medical care could have saved their lives (known as ‘amenable mortality’). It has a lower than average number of staff for all professional groups except midwives: one doctor for every 356 people compared to one for every 277 people on average across the comparator countries. But the NHS does provide unusually good financial protection to the public from the consequences of ill health. For example, it has the lowest proportion of people who skipped medicine due to cost: 2.3 per cent in 2016 compared to an average of 7.2 per cent across the comparator countries. Commenting on the report, Nigel Edwards,


Chief Executive of the Nuffield Trust, said: “Discussion about the NHS is often marked by an unhelpful degree of exaggeration, from those that claim it is the envy of the world to those who say it is inferior to other systems. “The reality is a much more mixed picture, but one thing is clear: we run a health system with very scarce resources in terms of staff


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