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Guide to the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS)

Published on 25 September 2020

What does the scheme cover?

Clinical negligence claims

When there’s a breach in the duty of care by members of the healthcare professions, this is defined as clinical negligence. Specifically, this relates to the diagnosis of any illness or the care or treatment of any person, by act or omission, whilst acting in their professional capacity in the course of their employment or engagement.

CNORIS provides cover for this clinical risk. It also indemnifies negligence cases that arise during clinical research.

Healthcare professions include the following:

  • doctors
  • dentists
  • nurses and midwives
  • health visitors
  • hospital pharmacy practitioners
  • registered ophthalmic or registered dispensing opticians working in a hospital setting
  • members of other allied healthcare professions
  • dentistry
  • ambulance personnel
  • laboratory staff and relevant technicians

Holders of honorary contracts, on NHS premises by invitation, are also covered. But, the NHS may seek to recover damages if an incident involving an honorary contract holder occurs whilst the individual is outwith their agreed terms of reference.

Unless directly employed by a member organisation, the scheme doesn’t apply to: general medical and dental practitioners or pharmacists and opticians who work as independent contractors. They will be under contract for services.

Non-clinical claims

Risk is also a factor in the non-clinical work of the NHS and other scheme members.

CNORIS provides legal liability for members following loss or bodily injury affecting third parties or employees. Another benefit is protection for members against pecuniary (monetary) risks.

“Direct” volunteers and holders of honorary contracts on members' premises by invitation are all defined as ‘employees’.

A “direct” volunteer is a person who volunteers their services direct to the member, rather than through a third party volunteering organisation or charity.

Again, the member may seek to recover damages if an incident involving an honorary contract holder occurs whilst the individual is outwith their terms of reference.

The following broad non-clinical areas are covered by CNORIS:

Employers’ liability

Legal liability for injury, disease and accidents to employees resulting from, or in the normal course of, their duties on behalf of the member.

Public liability

Legal liability for injury, disease, loss or damage to property affecting third parties, whether lawfully within a member's premises or not. This includes car parking, crèche, rental and staff accommodation, but excludes motor vehicles.

Product liability

Legal liability for injury, loss or damage arising out of products provided, repaired or altered by the member to a third party. This includes catering; laundry; pharmaceutical manufacturing or repackaging; medical devices or equipment repair or servicing; crèche; rental and staff accommodation; and retail services.

Professional risks

Legal liability of members in respect of breach of non-clinical professional duty. Normally, this relates to provision of non-clinical professional advice to commercial clients, for example design work.

Miscellaneous

Employment practices liability arising out of wrongful employment practices. This also covers legal liability of members arising from the acts and omissions of members, appointed trustees in respect of Endowment Funds, and also member-appointed individuals sitting upon Ethics Committees.

Money

The scheme will indemnify the member against loss of cash or non-negotiable instruments, other than loss through employee dishonesty.

Fidelity guarantee

CNORIS will indemnify the member against loss of cash or non-negotiable instruments belonging to the member arising out of employee dishonesty, whether in relation to own assets or Endowment Funds.

Specific indemnity arrangements apply to Private Finance Initiatives (PFI), Public Private Partnerships (PPP) and Non-Profit Distributing (NPD) contracts. Members can seek advice where necessary.

Note that the scheme covers in-house crèche facilities for staff and/or the public. If a member brings in an external organisation to run a crèche then that provider needs to have appropriate insurance.

Work away from NHS premises

The location of an activity is not relevant to the indemnity scheme. Cover applies in relation to members' NHS activities even if they are on another NHS site, local authority premises or elsewhere.

One example is NHS employees working in public or community health services. They may perform outreach activities like health promotion programmes within shopping centres or healthcare delivery to prisoners. CNORIS still covers them.

An NHS body is not financially responsible for the acts of individuals working for other agencies. This is true even if those individuals are also employed by the NHS. Either the non-NHS body commissioning the work is responsible, or the healthcare professional needs to have separate indemnity cover.

However, in cases where staff injuries are a result of the negligence of another party, then please consult our Central Legal Office with a view to recovery of the loss.

External quality assurance

The NHS indemnity is relevant to claims arising in the course of NHS employment. Accordingly, the scheme covers loss that occurs in relation to an employee participating in an external quality assurance scheme. But, this is only to the extent the participation is part of NHS employment duties.