R EHABI L I TATION
cost of treatment for individuals who had suffered injuries where another party was entitled to pay compensation.
The most recent version of the regulation came into force in 2007 with the ambition of making it the obligation of the insurer to cover NHS charges in all cases where people claim and receive injury compensation. One pressing problem with the Injury
Cost Recovery system as it stands is that the funding has not kept up with the growing costs of medical care. In fact, even before the start of the COVID-19 pandemic, NHS major trauma centres were having to spend over £16,000 per week per in-patient despite the compensation fees to the NHS from insurers being capped at £5,831 per week per in-patient. In addition, the current Injury Cost Recovery system does not allow the NHS to claim for both in-patient and out-patient care.
The cap on the financial contributions from insurers is significant. For example, a conservative estimate shows that the cap is costing taxpayers and our health service at least £200 million per year. At a time of national crisis where adequate healthcare funding is absolutely vital, it is reasonable to look to those that have the funds, such as insurance companies, to step up and to provide financial support for the NHS and rehabilitation services.
The pandemic has brought attention to many problems, including the unequal divide between funding from insurers and the NHS. Indeed, throughout the lockdowns in 2020, there was a sustained decrease in road traffic accidents, and the insurance industry was able to make massive savings on ICR while the NHS saw a significant reduction in revenue received through the scheme. Given the burden facing the NHS, it is clear that it needs more support.
One way of achieving this is by ensuring that long-term funding for the NHS is given priority in law over increased profit margins
It would be a welcome approach if the insurance industry could make a positive contribution to supporting the NHS at this difficult time by voluntarily funding private rehabilitation for people who have sustained major trauma.
for insurers. The pandemic has shown that the Government is capable of acting swiftly to implement effective measures when required, and it would be welcomed to see similarly swift action from the Government concerning the outdated ICR system. Primarily, the ambitions first outlined for the ICR scheme in the Health and Social Care Act 2003 must be urgently reviewed to support the NHS and survivors of major trauma incidents. Unfortunately, 2021 will likely be a hard year for everyone, not least the NHS and our most vulnerable members of society. Yet, there is hope on the horizon with the UK’s ongoing vaccination programme. While that is underway, attention must be focused on providing funding and support for the NHS and, specifically, for rehabilitation services that have long been underfunded and under acknowledged. One proactive and effective step that can be taken immediately is for the insurance industry to support our NHS through providing vital funding for rehabilitation services.
CSJ
References 1 Alarcos Cieza, Kate Causey, Kaloyan Kamenov, Sarah Wulf Hanson, Somnath Chatterji, Theo Vos, “Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019.” The Lancet (December 2020) Volume 396, Issue 10267. P. 2006-2017.
https://www.thelancet.com/journals/lancet/article/ PIIS0140-6736(20)32340-0/fulltext
2 Department for Transport (2021) ‘Reported road casualties in Great Britain: provisional estimates year ending June 2020’ [Internet]. Available at:
https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_ data/file/956524/road-casualties-year-ending- june-2020.pdf
3 Ham, C. (2020). “The challenges facing the NHS in England in 2021”. BMJ 371. [internet] Available at:
https://www.bmj.com/content/371/bmj.m4973
4 Health Service Journal (2020) “Daily Insight: Covid versus cancer” [internet] Available at: https://www.
hsj.co.uk/daily-insight/daily-insight-covid-versus- cancer/
7029169.article
5 HelloSafe. (2020) Car insurance savings UK 2020 [internet]. Available at:
https://hello-safe.co.uk/ media/car-insurance-savings-2020
6 ITV News (2020) ‘Many Long Covid patients cannot fully return to work half a year later – study’ [Internet]. Available at:
https://www.itv.com/ news/2021-01-05/many-long-covid-patients- cannot-fully-return-to-work-half-a-year-later-study
7 Lintern, S. (2020) “Number of people on NHS waiting lists hits 12-year high”. [internet] Available at:
https://www.independent.co.uk/news/health/ nhs-waiting-times-surgery-patients-b1769206.html
About the author
Martin Usher is an associate solicitor, personal injury, for Moore Barlow, and a member of the Major Trauma Group. Martin joined Moore Blatch (now Moore Barlow, May 2020) in 2017 and works within the Serious Injury and Major Trauma teams. He has over 15 years’ experience in running serious injury and major trauma cases. He also has an in-depth knowledge of the health and social care pathways, enabling him to provide clients with immediate support to reach their maximum recovery following injury. Martin is a committee member for the Major Trauma Group, a not-for-profit community interest company that assists major trauma victims. As well as this, he is a trustee for Headway Southampton, a charity that supports people with brain injuries.
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