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Medics rush a patient in a hospital bed to an operating room illustrating the NHS Costs Recovery Scheme

There is a government scheme called the NHS Injury Cost Recovery Scheme. New guidance is published by the Government every year in relation to the scheme and is applied for by NHS Trusts. As an injured person, you do not have to do anything or apply for anything, even when making a claim if you sustained your brain injury as a result of the fault of another.

The principle behind the scheme is that those who are responsible for causing injury to others should meet the costs of the NHS treatment provided to the injured party rather than the tax payer.

When you first make a claim, your solicitor will ask you for some basic details which will include where you were treated when you sustained your injuries. There is a legal obligation for solicitors and insurers to inform the Government (essentially the Department of Work and Pensions) when a claim is made for personal injury compensation.

NHS Costs Recovery benefits the hospital that treated the injured person

The Hospital that treated you can then, should it wish, apply to the scheme for the recovery of those costs involved in treating you from the insurer of the party at fault.

The money recovered from the insurer/compensator goes directly to the Hospital NHS Trust that treated you, or the Ambulance Trust that may have taken you to hospital. The money will then be used to reinvest or improve patient services – it is the recovery of costs already “spent” in treating you as opposed to new costs received.

How are the costs of the NHS Costs Recovery Scheme are worked out?

The scheme itself is a simple costs based tariff system to maximise the benefits for NHS services, it does not relate to specific costs of your individual treatment and is based on the number of days/nights you stay in hospital (irrespective of the treatment you received), this currently stands at £915 per day for 2021-22 and a one off charge of £744 for outpatient treatment, no matter how many outpatient appointments you have with the Hospital treating you.

There is also a cap on the amount the Hospital can claim for your injuries, this currently stands at £54,682 which is roughly 60 days of inpatient treatment, even if you stayed in hospital longer than this. The amount of the cap is reviewed each year. The amount of ambulance charges is capped at £225 per person per journey which can be claimed currently.

The money will only be received by the NHS Trust once your claim has settled and will be paid directly by the insurer/compensator to the Compensation Recovery Unit which is an agency of the Department of Work and Pensions of the UK Government. They will then pass these costs onto the NHS Trust who treated you. This is entirely separate to your claim for damages. Your damages will not be deducted in any way for the NHS treatment you received when you had your accident.

Produced by Rachel Aram of Irwin Mitchell Solicitors

Rachel specialises in dealing with adult brain injury and spinal cord injury cases. She is dedicated to ensuring clients who receive life changing injuries receive appropriate rehabilitation promote independence wherever possible. Rachel is based at Irwin Mitchell’s Sheffield office where she manages on of the serious injury teams.

Irwin Mitchell are a national law firm whose solicitors work hard to make things easier for their clients and their family. Over the past 2 years they have helped clients recover more than £1 billion in compensation, but this is only part of the story, their solicitors also help clients access the rehabilitation, medical care and support needed to achieve the best recovery possible.

How Brain Injury Group can help?

Brain Injury Group is a network of approved personal injury solicitors with brain injury expertise. Moreover, our member firms have the complex injury experience to get the best possible rehabilitation and compensation for brain injuries.

Brain injury rehabilitation is important; to us, to our members, to you and towards getting the best outcome. We can help get you that best outcome. Get in touch to find out more from our brain injury experts.

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