NHS Resolution manages clinical negligence and other claims against the National Health Service in England, and shares learning from claims to help improve safety for patients and staff. NHS Resolution has a responsibility to settle justified claims fairly and promptly and defend unjustified claims to secure NHS resources. Each case must be considered on its own merits and it is important that a proper investigation is undertaken. NHS Resolution aims to get to the right answer as quickly as possible in every case and to help resolve claims sooner, and without the need for court proceedings. To support this NHS Resolution launched a new mediation service in December 2016. NHS Resolution strategy specifically references its aim to prevent claims entering litigation unnecessarily. In certain circumstances litigation is unavoidable, for example where a child is involved and the court is required to approve a damages award or if the statutory limitation period has expired for the commencement of legal proceedings. NHS Resolution challenges important issues of principle in the courts, including the appeals courts where necessary. Decisions to go to trial are not taken lightly but sometimes it is necessary so that public funds are not spent on compensating cases which do not have merit. In 2018/19, of 106 cases taken to trial with court judgements handed down, NHS Resolution successfully defended 69%. Testing claims at trial often has wider implications for other similar cases, potentially deterring further claims without merit. In 2018/19 over 70% of claims were settled without formal court proceedings being taken. It is not possible to estimate conclusively how many litigated clinical negligence claims will result in damages being paid. NHS Resolution is an arm’s length body of the Department and is accountable to the Department. Its performance is subject to regular review through the Department’s sponsorship arrangements. The Department’s assessment is that NHS Resolution is a well-run and efficient organisation and that it has had some success, within the current legal framework, in containing the cost of NHS litigation. The National Audit Office, in its report Managing the costs of clinical negligence in trusts published in September 2017, corroborated with this assessment. A copy of the report is attached. NHS Resolution regularly agrees large-scale contracts for legal services, using its position as a bulk purchaser to obtain the best expertise at value for money for the health service. The contracts include a combination of fixed and capped fees as well as competitive hourly rates for its panel firms, which are also required to support NHS Resolution’s work to learn from claims to improve safety.