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Clinical Negligence Schemes

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A clinical negligence scheme is a type of insurance scheme, designed to provide financial support to help NHS trusts and general practices deal with the costs of clinical negligence claims.

These clinical negligence schemes provide general indemnity for:

  • General practices
  • NHS trusts, and
  • For any clinical negligence liabilities arising from coronavirus treatment.

What are Clinical Negligence Schemes?

According to NHS Resolution, the NHS paid £2.4 billion in clinical negligence claims in 2018-19.

The NHS has had to manage these claims, but also any future clinical negligence claims it might receive.

One solution to address this is the clinical negligence scheme, which is a type of indemnity or insurance scheme. NHS trusts and practices make regular payments designed to cover the cost of any claims they receive for medical negligence.

  • NHS trusts have been paying regularly, and voluntarily, into the Clinical Negligence Scheme for Trusts (CNST). CNST can then use these payments to manage claims and make settlements on behalf of its members.
  • From April 2019, there has been a Clinical Negligence Scheme for General Practice (CNSGP).
  • Now there is also a Clinical Negligence Scheme for Coronavirus, providing additional indemnity coverage for the NHS’s coronavirus response.

How Do Clinical Negligence Schemes Work?


The Clinical Negligence Scheme for Trusts (CNST) handles all negligence claims that people make against NHS bodies that are members of the scheme.

Membership of CNST is voluntary, but currently all NHS trusts and foundation trusts in England belong to it.

Independent sector providers of NHS care have also been eligible to join it since 2013.

The contributions of members cover the costs of the scheme.

CNST calculates projected costs of claims each year, and then calculates the total forecast expenditure for the year.

There are various factors which determine the contribution levels of individual members of the scheme:

  • The type of trust
  • The specialist kinds of treatment it provides
  • The number of clinical staff it employs

The different claim histories of members also have an impact on payments, with those trusts with fewer, less costly claims, paying less in contributions to the scheme.

If someone makes a clinical negligence claim against an NHS trust, CNST takes on full responsibility for handling the claim and meeting any associated costs.

However, the trust itself remains the defendant in any such claim.


The Clinical Negligence Scheme for General Practice (CNSGP) covers clinical negligence claims in general practice.

It applies to any incidents happening on or after 1 April 2019.

The scheme covers all providers of NHS primary medical services, including out of hours providers. This includes:

  • GPs
  • Locums
  • Students
  • Trainees
  • Nurses
  • Clinical pharmacologists
  • Agency workers, and
  • Other practice staff

As well as primary medical services, the scheme also covers other NHS services that general practice provides, known as ancillary health services. These include public health services commissioned by local authorities.

The scheme covers claims made against GP practices or other organisations that provide primary or ancillary health services.

The costs of the scheme are dealt with centrally, and GPs and others working in general practice are automatically covered by it, without needing to pay a subscription.

Clinical Negligence Scheme for Coronavirus

The most recent NHS clinical negligence scheme has been established in accordance with the new powers that the Coronavirus Act 2020 grants.

It is designed to cover any additional clinical indemnity coverage for health workers responding to the coronavirus outbreak.

The NHS has put it in place in the event that its other clinical negligence schemes do not cover a particular activity.

During the coronavirus outbreak, the existing indemnity arrangements will continue, but the new coronavirus scheme will provide an additional safeguard.

It will not replace the existing provision of CNST and CNSGP. For example, where NHS trusts are responsible for Nightingale Hospitals, CNST will still apply.

How We Can Support Your Clinical Negligence Claim

You can claim for clinical negligence against the NHS, if the treatment it provides to you has fallen below a minimum, professional level of competence, and this results in you suffering an injury.
You may also claim for clinical negligence if you are the next of kin of someone who has died due to their standard of care being negligent.

But you will need to prove that clinical negligence has occurred. This proof is central and critical to making a successful claim.

NHS Resolution handles claims against the NHS, and it tries to settle these cases out of court.

As specialists in clinical negligence claims, we can look at the evidence relating to your case, and advise you first of all whether your claim is realistic.

We will help you through the process of making your claim, and what the funding options are for it. This includes no win no fee.

For more details about making a clinical negligence claim, please call 0808 088 6004, or complete our online contact form, and we will be in touch as soon as possible.

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Gemma Pabari


Gemma Pabari


Gemma is a Solicitor within the Medical Negligence Team. Gemma has experience in advising on a range of Medical Negligence claims, to include delays in diagnosing and treating Cauda Equina Syndrome, representing clients on matters arising from complications with pregnancy.