Clinical Negligence Scheme for Trusts for maternity services (CNST)

The Clinical Negligence Scheme for Trusts (CNST) has been established since 1994 and is a means by which National Health Service (NHS) Trusts fund the cost of clinical negligence litigation. Maternity services in England account for a significant proportion of the numbers and cost of claims reported to the NHS Litigation Authority (NHSLA). About 60–70% of sums paid out are due to litigation arising from maternity services. This translates to 60–70% of the hospital insurance premium being paid for maternity services. In order to reduce the number of claims against maternity services, the CNST has introduced eight standards for maternity services from April 2003. Discounts to premiums can be obtained according to the compliance met by the individual Trust in accomplishing these standards. Accomplishing these standards is set at three levels. Achieving level 1 standard would bring a 10% rebate, level 2 a 20% rebate and level 3 a 30% rebate. For some trusts, these rebates may amount to half a million pounds. These discounts are valid for the following two financial years. The financial incentive looks attractive but achieving these standards would result in better maternity care and fewer litigations.