Indemnity/insurance arrangements for Trust-sponsored clinical research trials 

Background

 

The Clinical Trials EU Directive 2001/20 makes it a legal requirement that provision has been made for insurance or indemnity to cover the liability of the investigator and sponsor before a clinical trial using medicinal products may be undertaken.

 

The Research Governance Framework requires that financial arrangements are in place to compensate anyone harmed as a result of negligent or non-negligent harm.

 

The NHS cannot purchase advance insurance to cover indemnity because it is backed by the resources of the Treasury.

 

Negligent harm

 

Indemnity arrangements within public bodies, especially the NHS, can address only negligent harm. This is the legal liability that arises from the NHS Trust's duty of care towards patients.

 

Negligent harm is where an NHS patient is harmed in the course of research, and an individual or group of individuals can be demonstrated to have caused that harm because of their negligence through, for example, not following an agreed procedure according to set policy or protocol. In such cases, the Trust is liable or vicariously liable and would be responsible for dealing with claims arising against the Trust for the harm caused.

The Trust participates in the Clinical Negligence Scheme for Trusts (CNST), run by the NHS Litigation Authority, which pools the risk of clinical negligence claims.

 

The Trust will only extend NHS indemnity cover (for negligent harm) to its employees, both substantive and honorary, conducting research projects that have been approved by the R&D Department. The Trust cannot accept liability for any activity that has not been properly registered and Trust approved.

 

Non-negligent harm

 

Non-negligent harm arises where an individual has been harmed in the course of research, through no fault of an individual or institution involved in the research and even though all the correct policies and procedures have been followed.

 

It is the role of ethics committees to decide whether or not a study can go ahead without a scheme of compensation for harm caused where there is no negligence.

 

NHS indemnity arrangements do not extend to non-negligent harm and NHS bodies cannot purchase commercial insurance for this purpose. NHS bodies cannot give advance undertaking to pay compensation when there is no negligence attributable to their vicarious liability.

 

The agreements between research partners clarifying who holds the respective responsibilities for the research, as well as the patient information leaflets, should specify clearly whether there are arrangements in place for non-negligent harm or if there are no arrangements in place for non-negligent harm.

 

If the principal investigator is employed by the University of Hull, the University has the responsibility for providing financial cover for damages or compensation arising from non-negligent harm (where applicable).

 

Summary

 

Hull and East Yorkshire Hospitals NHS Trust has indemnity to cover claims arising from negligent harm, but not non-negligent harm.

 

If the principal investigator is employed by the University of Hull, the University has the responsibility for providing financial cover for damages or compensation arising from non-negligent harm (where applicable).