I watched some people ‘mudlarking’…
… I clambered down the precarious stone steps onto the foreshore of the receding Thames, picked my way across the bricks and debris to where Derek and Julie were scraping and prodding in the mud.
A charming middle aged couple who had found a mutual interest that kept them active, interested and expert.
The told me they’d found Roman coins, remnants of clay pipes and all sorts of fragments and remains, each with its own unique history.
All the bits they find, in theory, belong to the King. Treasure under the Treasure Act 1996 has to be turned in, or voluntarily submitted for analysis and review via the Portable Antiquities Scheme.
You have to have a chitty from the Port of London Authority. It’s illegal to search for or remove artefacts of any kind from the foreshore without one.
Mudlarkers find all sorts of stuff, some of it very valuable; complete medieval pilgrim badges, a pewter tankard inscribed with the name of a London chop house and a Palaeolithic flint hand-axe.
Without them a lot of history would be washed out to sea. Well done the mudlarkers.
I think our great leader’s 9.5 year brochure is a bit like the Thames foreshore. Littered with junk and you must rake and scrape, to find some stuff that is interesting. Buried treasure…
… page 90, to paraphrase…
‘… David Lock KC [will] … provide expert advice on how we can improve patients’ experience of clinical negligence claims… and [the issue of]… double recovery.’
Lock is a man born with an abundance of good sense and was the lead on the excellent book NHS Law and Practice, that should be on the shelf of all senior management.
I would say Lock’s involvement signals that HMG wants independent, practical legal advice rather than simply an internal NHS view.
Not to do his work for him… but … well, why not!
He could start by de-complexifying. Patients can find the negligence claims process confusing, slow and distressing.
Clearer communication, earlier engagement and simpler claims pathways, would help.
If he was brave he could look at the no-fault systems used overseas… not to move in that direction, the Treasury will block it, but their processes are simpler.
Or… really brave; look at alternative dispute resolution models like mediation or early settlement discussions.
He’s a lawyer… how likely is he to prise his profession out of the process altogether? Very.
Claims escalate to formal litigation unnecessarily. If NHS Resolution’s processes were faster and more patient-friendly, I could see a reduction in the adversarial nature of claims.
Knowing what’s going on would make a big difference…
… despite the Duty of Candour, patients tell me they get stonewalled or misled.
Lock will certainly be up for strengthening accountability on openness, apology, and explanation early in the process.
Complaining can be a lonely business. Better support for patients with clearer signposting to advice, advocacy and support. Particularly for vulnerable groups.
There’s more to claims than compensation.
Link negligence processes more closely with patient safety so lessons are learned and shared.
David Lock’s second half will be dealing with the issues of double recovery.
Put simply; some patients claim compo from the NHS…via clinical negligence claims…
... and…
… an insurance policy… such as critical illness cover, income protection, or private health insurance.
This is double-bubble, luverly-jubbly!
In most personal injury law, compensation is intended to restore the person to the financial position they would have been in…
… not to provide a windfall.
If someone receives insurance payouts, for loss of earnings, private medical costs and NHS compensation for the same loss, courts sometimes deduct the insurance payout from the damages.
This depends on the policy type and whether the patient paid the premiums themselves.
Some argue that NHS compensation should be reduced to reflect insurance payouts, known in the trade as ‘double-dipping’.
Others argue patients should not be penalised for being prudent and buying insurance.
It’s complicated, messy and inconsistent.
The upshot… I’d expect Lock’s review to lead to recommendations on faster, fairer claims processes, with a focus on patient dignity and simplicity.
On the insurance issue, he might advise a clearer national policy, possibly recommending legislative clarification or guidance on how compensation should be calculated when other insurance payouts exist.
If he is really energetic he might go for reform of NHS Resolution, DH+ policy changes, or even law reform proposals.
This is a welcome part of Streeting’s 9.5 brochure.
Tangible, doable, affordable, needed…
… with somebody doing it who will not be larking about.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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