The director of claims management at NHS Resolution talks about how he has managed a reduction in reduction in litigation rates over the past five years.
Simon Hammond has been director of claims management at NHS Resolution since January 2019. Since then, he has overseen a dramatic reduction in litigation case rates to last year’s record low of 19%. Here, he talks to Healthcare Today about his approach and how he has fostered a culture of collaboration with Trusts, claimant solicitors and the broader healthcare ecosystem.
How do you work with NHS Trusts to analyse and learn from claims? How does it work on the ground?
There are multiple ways in which we work with Trusts on a day-to-day basis. In relation to analysing and learning from claims, we have a dedicated Safety and Learning Directorate, which operates regionally to review each Trust’s claims portfolio. This involves examining the claims encountered by the Trust at a local level, supporting them in analysing these claims and collaborating with them to develop learning and quality improvement plans based on the findings.
Our team includes clinically focused professionals who work directly with our members on the ground. They assist Trusts in reviewing the claims they have received, identifying any lessons that can be drawn from them and helping to determine how such learning can be applied to drive future improvements.
Beyond improvement plans, we also publish annual scorecards which provide Trusts with a clear overview of the claims they have received across different specialities, categorised by value (low or high) and volume (low or high). This offers a comprehensive foundation for further analysis.
Additionally, we produce learning products that take a more thematic approach, examining trends across our entire claims portfolio. Increasingly, we use the SEIPS (Systems Engineering Initiative for Patient Safety) framework, which aligns with patient safety science. This methodology helps identify underlying factors contributing to harm, thereby supporting targeted safety improvement initiatives.
“It’s important to recognise that our role is primarily informative – we are not a regulatory body overseeing healthcare.”
Where does the responsibility lie in tracking what’s been done?
The way we engage with Trusts varies. It’s important to recognise that our role is primarily informative – we are not a regulatory body overseeing healthcare. Instead, we leverage tools such as our interactions with the legal team, governance frameworks and scorecards to provide insights. We do not have the full picture, as we only handle claims, whereas Trusts themselves manage a broader spectrum of incidents, complaints and concerns.
Another critical factor is the time lag inherent in claims. There is often a significant delay – sometimes years – between an incident occurring and a claim being brought to our attention. By the time we analyse a claim, frontline Trusts may have already identified the issue and taken corrective action. This delay must be factored into our approach.
Nevertheless, we have seen effective collaboration across the system. For instance, we work with the GIRFT (Getting It Right First Time) team to produce annual litigation packs, enabling Trusts to benchmark their data against the national picture. Together with GIRFT, we co-designed the Five Point Plan, which assists Trusts in reviewing their performance. Through these initiatives, we can influence improvement efforts and provide additional insights from our perspective – complementing the local data Trusts already hold – to inform their improvement strategies.
One distinct initiative is the Maternity Incentive Scheme, which operates differently from standard claims analysis. Here, we bring together system partners through a collaborative group to establish safety plan actions. Trusts must self-certify annually, confirming they have implemented the required ten safety actions to comply with the scheme.
How do you balance claims and confidentiality?
It’s important to recognise that as we act on behalf of NHS Trusts, the claims data we hold ultimately belongs to them. This means discussions with Trust legal teams about claims are open exchanges, as these matters directly involve their clinicians and services. We handle all data within strict legal frameworks, but our approach differs depending on the context.
At a Trust level, conversations about specific claims remain transparent because Trusts have full access to their own claims information for learning and improvement purposes. When sharing insights across the wider NHS system, we carefully anonymise and aggregate data to produce thematic analyses. This approach allows us to identify valuable patterns and trends while maintaining patient confidentiality and protecting identifiable details about individual cases.
“Our approach has been to minimise unnecessary stress and complexity in what is inherently a difficult process for everyone concerned.”
You have emphasised a collaborative approach to negotiation. Is this approach working?
We have seen a notable reduction in litigation rates over the past five years culminating in last year’s record low of just 19% of cases requiring litigation. It is worth remembering that a proportion of cases will always need to proceed through the courts, either because they require judicial approval or because they fall under specific legal mandates. Nevertheless, these results represent considerable progress.
Claimant solicitors play their part by ensuring proper representation for their clients and safeguarding access to justice, while we act on behalf of the NHS with an awareness of the human impact on both sides – the patient who has experienced harm and the clinicians or healthcare workers facing claims. Our approach has been to minimise unnecessary stress and complexity in what is inherently a difficult process for everyone concerned.
The benefits of this collaborative model are clear. Beyond the financial advantages, reducing reliance on formal litigation creates a more efficient system for all parties, proving that fair resolutions can be achieved without defaulting to adversarial proceedings.
In many ways, you’re a legal canary down the mine. Are you seeing any particular flashpoints at the moment with an upswing in claims?
Not at the moment. There is a relatively stable pattern in claims across specialities.
Maternity claims understandably remain a key focus area, given the tragic consequences for families and the significant financial implications – particularly where lifelong care is required for children affected by birth complications. It would be inaccurate, however, to characterise maternity as a flashpoint. The data does not show exponential growth in maternity claims compared to other specialities.
You have a number of programmes like NHS Resolution’s Early Notification and Learning from Deaths scheme. Are they working? Are you bringing down costs?
We fully recognise that every claimant approaching us is someone who has suffered harm. While not all cases meet the threshold for negligence, we treat each one with equal seriousness. For claims we determine to be non-meritorious, we work closely with the claimant’s solicitors to provide clear explanations of our decision-making process.
This approach of transparency and dialogue has been instrumental in reducing litigation rates to sustainable levels. Importantly, it also helps contain costs – non-litigated matters invariably incur lower expenses than those proceeding through formal court processes.
“The ultimate goal is singular, evidence-based guidance that clinicians can implement confidently.”
How do you collaborate with other bodies like NHS England, the Care Quality Commission and the GMC?
Our approach is fundamentally collaborative. This extends to our work with Royal Colleges, patient organisations, and specialist groups like our Maternity Voices Partnership. This forum intentionally brings together charities, patient representatives and sector bodies, creating a platform for diverse perspectives. While consensus isn’t always unanimous, these discussions ensure all voices are heard.
Within our Safety and Learning Directorate, we’re particularly mindful of our position in the wider healthcare landscape. While we possess comprehensive claims data, we acknowledge it represents only part of the picture. Other organisations hold complementary insights into specific specialities or health inequalities.
The ultimate goal is singular, evidence-based guidance that clinicians can implement confidently, secure in the knowledge it represents unified sector wisdom. Through this consolidated approach, we aim to support measurable improvements in clinical practice and, ultimately, reduce patient harm – an objective shared across the entire NHS.
Based on your work, what is the one piece of advice would you give to NHS Trusts to reduce avoidable harm and litigation risks?
My key recommendation to Trusts would be to adopt a truly holistic approach to governance. Some Trusts exemplify this particularly well by comprehensively analysing all available data – not just formal complaints, but all patient concerns raised post-treatment, incident reports, claims data and other governance information.
The power lies in bringing these disparate elements together into a unified analytical framework. A claim might not meet the legal threshold for compensation, but it often still contains valuable insights. Patient and family concerns frequently highlight areas where clinical practice could be refined, even when no negligence has occurred.
