Many people will not be aware that a government scheme, the NHS Injury Cost Recovery Scheme, exists which allows the NHS to be reimbursed for treatment provided to a person who has suffered injury in an accident if a claim for personal injury can be made.
What is the NHS Injury Cost Recovery Scheme?
If you have been injured in the course of a road traffic accident, or an accident at work, you may have required hospital treatment, or an ambulance journey as a result of your injuries.
Under the NHS Injury Cost Recovery Scheme (NICR), if a personal injury claim is successful, the compensator (usually an insurance company) is required to contribute towards the cost of the NHS treatment that you received.
How does the NHS Injury Cost Recovery Scheme work?
Insurers and solicitors inform the Compensation Recovery Unit (‘CRU’) a government body which is part of the Department for Work and Pensions, that there is a claim for personal injury compensation. The CRU obtains treatment details from the NHS Trust involved and is then able to calculate the charges that are payable, should the claim be successful. These charges are increased annually, and the current tariff system as of 1 April 2021 is as follows:
- £225 for each occasion where a claimant has required NHS ambulance service;
- £744 where a claimant has required NHS outpatient treatment; and
- £915 per day where a claimant has required NHS inpatient treatment.
The amount that can be recovered in respect of an injury is overall capped at £54,682 as at the 1st April 2021.
A NHS Charges certificate will be issued to the compensator once the CRU has calculated the amount of charges owed. This certificate will state the amount to be paid and order the compensator to pay the charges within 14 days of either the claim being settled, or the certificate being issued (if it was not available at the time of settlement).
How are the funds used?
The principle is that the costs of the NHS treatment should be met by those who are responsible for causing injury to others, as opposed to the tax payer. The funds are received by the NHS Trust which provided treatment to the claimant. The Trust will then reinvest back into patient services.
The money paid to the NHS trust is entirely separate to a claimant’s claim for damages. The claimant’s damages will not be deducted for the NHS treatment received.
It is however the case that the NHS is limited under the NHS Charges scheme as to the circumstances in which it can seek to recover costs from insurance companies. In addition the amount which the NHS is allowed to recover is capped at an amount well below the actual costs that are incurred.
It has been estimated that the difference between the amount which the insurance industry are required to pay per patient and the true cost of treating these patients is in excess of £400 million per year.
What if I was transported to hospital by Air Ambulance?
As the Air Ambulance services are mainly provided by charities and do not fall within the NHS, sadly their charges are not recoverable under the NHS Charges scheme.
These fantastic charities need additional help with fundraising in order to recover their costs, which is on average £4,600 per Air Ambulance journey.
It is unfortunate that these amazing charities cannot recover their charges under the scheme and therefore they need additional help. Many of these charities have huge running costs for example the Great North Air Ambulance Service which covers the North East and Cumbria had an estimated operating cost of £5.3 million in 2020.
If the Air Ambulance services cannot receive NHS money, is there any way my claim can help them?
In 2010, the case of Drake v Foster Wheeler in the High Court agreed that costs provided by a charitable hospice for the end-of-life care to claimants of asbestos claims were a recoverable loss. Although the principle relates to hospice costs, it is reasonable to suggest that the same principles apply to other charitable services such as Air Ambulances. Therefore, it should be possible, as part of a claim, for the cost of the services of the Air Ambulance to be claimed from a Defendant and your solicitor will be able to advise on this.
Can Major Trauma Group help?
The Major Trauma Group, of which Burnetts is a proud member, seeks to help Air Ambulance services recover their charges. Charitable hospice costs were successfully recovered in the High Court case of Drake v Foster Wheeler, and our specialist serious injury law firms believe that it is reasonable to plead that the same principles should apply to other services including Air Ambulances. Therefore, including Air Ambulance recovery costs within a claim, seeks to repay these fantastic charities, without being deducted from the overall amount of damages as this is a separate head of loss.
Where can I get further help and advice?
You and your family are also likely to need advice on a wide range of legal issues that may arise in the aftermath of a major trauma because of the impact it has on home and work life, family life, day to day activities and independence. You may need advice on employment issues, housing, welfare benefits, wills and probate or family issues. We can offer practical advice and help with financial matters and address concerns if you cannot work or have any financial concerns by way of obtaining interim payments.
If you would like our help with making a personal injury claim or legal advice please get in touch.