CNORIS is a risk transfer and financing scheme for the NHS and integrated health and social care Boards in Scotland and was first established in 1999 by the Scottish Government Health Directorates in partnership with Willis Ltd. A CNORIS Steering Group was established to assist in the administration and management of the Scheme, with membership drawn from senior staff of member organisations, as well as Scottish Government. On the 1st September 2013 NHS National Services Scotland (NSS) became the appointed Scheme Manager, with the Central Legal Office (CLO) continuing to provide legal advice and guidance to members.
Originally, the primary objective of CNORIS was to provide cost-effective risk pooling and claims management arrangements for Scotland's NHS Boards, Special Health Boards and The Mental Welfare Commission for Scotland. However, with effect from 1 April 2015 forensic medical services were included within the Scheme and Integration Joint Boards and Local Authorities could apply to become members of the Scheme for the management of liabilities relating to integration functions. CLO works closely with these organisations and their legal advisors to provide a seamless risk transfer solution.
What are the Scheme's basic objectives?
- To provide advice on clinical and non-clinical scheme coverage to all parts of the NHS and specific services within health and social care integration schemes in Scotland.
- To support members in an advisory capacity in order to help them reduce their risks.
- To indemnify members against losses which qualify for Scheme cover.
- To allocate equitable contributions amongst members to fund their qualifying losses.
- To provide members with Scheme financial updates throughout the year to help with end-of-year budgeting.
- To help manage risks by providing members with clinical and non-clinical loss analysis throughout the year.
How does the Scheme work?
Members are advised annually of the expected contribution they
are to make to the
shared risks. In order to share the cost fairly between members, clinical and non-clinical risk profiles, which determine relative risks for each organisation, are created.
The Scottish Government Health and Social Care Directorate
(SGHSCD) fund all large
losses (i.e. those which breach CNORIS Scheme deductibles) during each financial year. At the end of the financial year, the total of settlements is compared with the contributions deducted from members and any adjustment required to the contributions to meet any deficit accrued in-year by SGHSCD is calculated. Any adjustment is also shared between members according to their proportion of the overall risk, or, in respect of non-NHS members, as agreed.
In eliminating the need for individual members to forecast losses, or to reserve funds within the Scheme, members have more stable financial planning for indemnified cases as members contribute a share of national losses only during the period in which they have settled. This enables the service to retain funds for investment in delivering services for the longest possible period.