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Ian Adams, the current director of corporate affairs at NHS Resolution, reflects on how the organisation became a more influential voice in patient safety and health policy.
When I joined NHS Resolution a decade ago, the organisation was still known as the NHS Litigation Authority. It was a respected and well-run organisation, but one that was often viewed primarily through the lens of legal claims management. Today, as I prepare to leave for a new senior NHS role in September 2026, the organisation occupies a very different position within the health and care landscape, building on our core expertise in providing indemnity services.
NHS Resolution remains responsible for resolving compensation claims fairly and efficiently, but it has become much more than that. It is now a recognised contributor to patient safety improvement, a trusted partner across the NHS and wider health system, and an increasingly influential voice in policy discussions relating to learning from harm, dispute resolution, maternity safety and organisational culture. That transformation has been shaped by many talented colleagues, supportive board colleagues and visionary leadership under chief executive Helen Vernon. I am proud that my own roles as director of membership and stakeholder engagement, director of policy, strategy and communications, and most recently director of corporate affairs, have enabled me to help contribute to that journey.
Growing recognition
Perhaps the most visible symbol of this change was the rebranding of the NHS Litigation Authority as NHS Resolution in 2017. At the time, there was a growing recognition that the organisation’s name no longer reflected either what it did or what it aspired to become. Internal strategy work identified a need to move beyond a narrow association with litigation towards a broader focus on advice, early intervention, learning and resolution. The development of the new name followed extensive engagement with ministers, officials, staff and stakeholders. The aim was simple: to create a brand that reflected the organisation’s evolving purpose while helping reposition it as a partner in improvement, not simply an organisation involved after things had gone wrong.
The new identity was underpinned by the organisation’s first-ever five-year strategy, “Delivering Fair Resolution and Learning from Harm”. That strategy marked a significant shift in direction. It established a vision in which NHS Resolution would use its unique position, insight and data to support safety improvement, reduce unnecessary litigation and preserve resources for patient care. The concepts of “advise, resolve and learn” became central to both the brand and the organisation’s culture.
Alongside the rebranding, one of my key contributions was helping to shape and communicate successive medium-term strategies and business plans. These strategies provided the framework through which NHS Resolution expanded its influence beyond our expertise in claims management. The organisation increasingly recognised that it held one of the richest sources of information about harm occurring in the NHS. The challenge was to convert that information into actionable insights capable of improving care and preventing future incidents.
As a result, NHS Resolution became more outward-facing, working in partnership with NHS England, the Department of Health and Social Care, trusts, professional bodies, legal partners and patient safety organisations. Annual reports over successive years demonstrate how the organisation increased its focus on learning, analytics and safety initiatives, particularly in areas such as maternity care where harm carries significant human and financial costs. Programmes including the Early Notification Scheme and the Maternity Incentive Scheme helped to position NHS Resolution as an active contributor to safety improvement rather than solely an administrator of risk.
Proactive engagement
The organisation’s growing reputation has also been built through stronger stakeholder engagement. When I first assumed responsibility for membership and stakeholder engagement in 2016, our communications activity was relatively modest. Stakeholders valued our expertise but often wanted more proactive engagement and greater visibility of the learning emerging from our work. In response, we developed more structured stakeholder relationships, strengthened senior leader engagement and introduced a more strategic approach to communications, working closely with colleagues in our Safety & Learning team.
This included significant investment in media relations, digital communications and social media. A media strategy developed in 2018 recognised the need to move from a largely reactive approach towards one that promoted NHS Resolution’s expertise, insight and learning more effectively. Over time, media engagement, thought leadership, webinars, conferences and channels such as LinkedIn and YouTube became part of a more structured, multi-channel approach to external communications. By 2025, this broader engagement model had supported more than 1,000 engagement sessions, reaching over 25,000 people, helping NHS Resolution become more visible, accessible and confident in sharing its expertise with professional audiences across the NHS, government, legal and patient safety communities.
The results of this approach became increasingly apparent. Successive annual reports and accompanying communications highlighted record levels of claims being resolved without formal court proceedings. In 2021, 77% of claims were resolved without litigation; by 2022, this had risen to 80%; and by 2025, NHS Resolution reported that 84% of clinical claims were settled without the need for legal proceedings. These results reflected collaborative working across the healthcare and legal sectors, including with our legal panel, and reinforced the organisation’s reputation as a leader in modern dispute resolution.
Equally important was the development of NHS Resolution as a strategic policy partner. Through closer engagement with government, NHS England and national improvement bodies, the organisation increasingly contributed evidence and expertise to debates on patient safety, litigation reform, organisational culture and workforce concerns. Its insights on candour, fairness, learning culture and maternity safety became valued contributions to wider policy discussions.
Growing confidence
A further marker of that growing confidence came in 2019, when NHS Resolution was asked to operate the new state indemnity scheme for general practice in England. The Clinical Negligence Scheme for General Practice came into effect in April 2019, providing automatic cover for clinical negligence liabilities arising from NHS primary medical services from that date. Being entrusted by the government to take on indemnity for all GP practices and their teams was a significant extension of NHS Resolution’s remit. It reflected the organisation’s reputation for technical expertise, operational grip and fairness, while also increasing its impact across primary care by bringing learning from general practice and secondary care claims under one national framework.
The COVID-19 pandemic was one of the most difficult periods in the organisation’s recent history, and it tested every part of how we worked. Like colleagues across the NHS, we had to adapt at speed while maintaining essential services, supporting staff wellbeing and continuing to engage with members, partners and government in a rapidly changing environment. The rapid shift to remote working was particularly significant: it required not just new technology and processes, but a different style of leadership, communication and trust, since we have transitioned to become a truly national employer. Looking back, I am struck by how quickly colleagues responded, how strongly teams supported one another, and how the organisation continued to provide calm, professional and reliable support at a time of national uncertainty. For me, that period reinforced the depth of resilience within NHS Resolution and the importance of the culture we had built: collaborative, pragmatic and focused on doing the right thing for patients, members and staff, underpinned by our PEER values.
The organisation’s strategy to 2025 formalised this evolution through priorities focused on delivering fair resolution, sharing data and insights as a catalyst for improvement, collaborating to improve maternity outcomes and investing in people and systems. More recently, the 2025–28 strategy, “Resolution Through Collaboration”, has taken this further by explicitly placing collaboration at the heart of NHS Resolution’s mission.
Last year’s scrutiny of clinical negligence costs by the National Audit Office and the Public Accounts Committee also underlined NHS Resolution’s standing in a demanding policy environment. Although the scrutiny highlighted the scale of the financial challenge for government and the NHS, it also recognised the practical work NHS Resolution has undertaken to reduce the financial and emotional cost of claims: resolving more cases without litigation, expanding mediation and alternative dispute resolution, using specialist legal expertise to control defence costs, and developing approaches such as the Early Notification Scheme to support earlier learning from harm.
National policy debate
The subsequent Public Accounts Committee hearing and report placed NHS Resolution alongside the Department of Health and Social Care and NHS England at the centre of a major national policy debate. Importantly, while the wider system was challenged on the absence of a sufficiently developed plan to manage rising costs, NHS Resolution was acknowledged for demonstrating tangible action already taken and for the further contribution it could make through its data, operational experience and insight into the drivers of claims. That positioned the organisation not as a passive administrator of liabilities, but as a credible, evidence-led partner able to inform reform, support patient safety improvement and help government navigate one of the most complex financial and ethical issues facing the NHS.
Looking back, I believe one of the most significant achievements during my decade with the organisation has been helping NHS Resolution find its voice. The organisation has always possessed exceptional technical expertise. The challenge was ensuring that expertise informed wider conversations across health and care. Through brand transformation, strategic planning, stakeholder engagement, media development and partnership working, NHS Resolution has become more visible, more influential and more impactful.
As I leave after ten years, I do so with enormous pride in what the organisation has achieved. The journey from NHS Litigation Authority to NHS Resolution was never simply about a name change. It was about redefining the organisation’s place in the system. Today, NHS Resolution is recognised not only for resolving disputes fairly, but also for helping shape safer care, stronger partnerships and better outcomes for patients. That transformation will remain one of the most rewarding chapters of my professional career and is testament to many talented and dedicated colleagues, past and present, across the organisation.
Ian Adams is currently director of corporate affairs at NHS Resolution. He joins Community Health Partnerships as director of corporate services in September.
