FOI-03157

Thank you for your request for information about the following: 

<strong>Request</strong>

You asked us:

<i>‘I request disclosure of the following information in relation to the Vaccine Damage Payment Scheme (VDPS):<br>

Question 1. Medical Assessor Qualifications and Expertise
<li>The clinical specialties and/or sub specialties of all medical assessors currently engaged by the VDPS.</li>
<li>The relevant post graduate qualifications, training, or experience that each assessor holds in conditions associated with vaccine adverse effects (e.g., neurology, cardiology, immunology, haematology).</li>
<li>Whether the VDPS assigns claims to assessors based on condition specific expertise, and if so, the process by which this matching is undertaken.</li>

Question 2. Independent Clinician Recommendations
<li>Whether the VDPS can recommend, or holds a list of, suitably qualified independent clinicians with the relevant specialist expertise to advise claimants on:</li>
a. The statutory disability threshold under the VDPS; and<br>
b. The medical and evidential standard for establishing causation between a vaccine and a disability.

Question 3. Use of the “Green Book” Guidance
<li>Confirmation of the date on which the VDPS last reviewed and updated its internal medical guidance to incorporate emerging evidence or post market surveillance data on COVID 19 and other vaccines.</li>
<li>Whether this guidance includes literature or consensus statements published after the 2021 update to the “Green Book”.</li>
<li>The process by which VDPS ensures that assessor guidance reflects the most up to date specialist knowledge and evidence base.</li>

Question 4. Quality Assurance and Governance
<li>Any internal policy, protocol, or requirement that medical assessors must have specific and demonstrable expertise in the claimant’s condition or in vaccine related adverse events before determining eligibility for payment.</li>
<li>Any audit reports or quality assurance findings (from 2021 to present) on the accuracy, consistency, or reliability of medical determinations under the VDPS.’</li></i>

The NHS Business Services Authority (NHSBSA) received your request on 28 August 2025.

We have handled your request under the Freedom of Information Act 2000 (FOIA).

<strong>Our response</strong>

I can confirm that the NHSBSA holds some of the information you have requested.

<strong>Question 1 - Medical Assessor Qualifications and Expertise
<li>The clinical specialties and/or sub specialties of all medical assessors currently engaged by the VDPS.</li>
<li>The relevant post graduate qualifications, training, or experience that each assessor holds in conditions associated with vaccine adverse effects (e.g., neurology, cardiology, immunology, haematology).</li>
<li>Whether the VDPS assigns claims to assessors based on condition specific expertise, and if so, the process by which this matching is undertaken.</li></strong>

<strong>Medical assessor qualifications and expertise</strong>

The NHSBSA does not hold information on the medical assessors' qualifications or expertise. This is because this information is the responsibility of the third-party medical assessment supplier.

I hope, however, that the following information provides reassurance on this point:

All claims are assessed by the supplier with a consistent approach.

Each case is considered on its own merits, by an experienced medical assessor.

The contract with our supplier does not require them to tell us details of medical assessors’ qualifications or their experience.

The contract requires that all assessments carried out are undertaken by suitably qualified and experienced Registered Medical Practitioners. This includes being registered on the UK General Medical Council register, with a licence to practise and meet or exceed the following requirements:

<li>they are a Registered Medical Practitioner with at least five years’ post graduate experience; and</li>

<li>they have experience of the performance of medical and/ or disability assessment, addressing questions of causation and impact in the context of legislative or policy requirements to assist the decision maker.</li>

<strong>Claim allocation</strong>

The NHSBSA contracts a third-party medical assessment supplier to carry out medical assessments for the VDPS. The allocation of claims to medical assessors is the responsibility of the supplier.

<strong>Question 2 - Independent Clinician Recommendations
<li>Whether the VDPS can recommend, or holds a list of, suitably qualified independent clinicians with the relevant specialist expertise to advise claimants on:</li>
a. The statutory disability threshold under the VDPS; and<br>
b. The medical and evidential standard for establishing causation between a vaccine and a disability.</strong>

Following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. This is because the NHSBSA does not hold a list of suitably qualified independent clinicians with the relevant specialist expertise to advise claimants on the points you have raised.

Under the government's rules for the VDPS, to qualify for a Vaccine Damage Payment, it must be proved that:
<li>an eligible vaccine was received</li>
<li>on the balance of probabilities, the vaccine caused the disability</li>
<li>the resulting disablement is severe</li>

Severely disabled means at least 60% as defined by the principles for assessing the extent of disablement. These are set out in:
<li>https://www.legislation.gov.uk/ukpga/1992/4/contents</li>
<li>https://www.legislation.gov.uk/uksi/1982/1408/schedule/2</li>

More information about eligibility, including a list of eligible vaccines, is available from the government's Vaccine Damage Payment webpage.

<strong>Question 3 - Use of the “Green Book” Guidance
<li>Confirmation of the date on which the VDPS last reviewed and updated its internal medical guidance to incorporate emerging evidence or post market surveillance data on COVID 19 and other vaccines.</li>
<li>Whether this guidance includes literature or consensus statements published after the 2021 update to the “Green Book”.</li>
<li>The process by which VDPS ensures that assessor guidance reflects the most uptodate specialist knowledge and evidence base.</li></strong>

This information is not held by the NHSBSA 

The Green Book is not owned or updated by the NHSBSA. Medical assessors use resources to support their assessment, including the Green Book and Principles of Medical Assessment guidance. 

A list of resources is available online at: <br>
https://www.nhsbsa.nhs.uk/vaccine-damage-payment-scheme-vdps-claim-process

The Principles of Medical Assessment guidance was created by the NHSBSA to ensure that the principles are consistently and appropriately applied. This document was last updated during March 2025. 

The contract with the third-party medical assessment supplier places an obligation on them to ensure that medical assessors keep up to date with ongoing, new and emerging evidence, including any updates to the Green Book. 

The contract also requires that all assessments carried out are undertaken by suitably qualified and experienced Registered Medical Practitioners. This includes being registered on the UK General Medical Council register, with a licence to practise and meet or exceed the following requirements:

<li>they are a Registered Medical Practitioner with at least five years’ post graduate experience; and</li>
<li>they have experience of the performance of medical and/ or disability assessment, addressing questions of causation and impact in the context of legislative or policy requirements to assist the decision maker.</li>

All relevant information is considered to make a complete and fair assessment. The medical assessor thoroughly considers:<br>

<li>information given on the claim form</li>
<li>any further evidence submitted</li>
<li>any pre-existing conditions that are not caused by the vaccine</li>
<li>medical records (if required)</li>
<li>clinical research</li>
<li>epidemiological evidence</li>
<li>the current consensus of expert medical opinion</li>

Cases are determined on a case-by-case basis using facts from the individual case. For example, medical records directly from healthcare providers involved in a claimant’s care. Medical assessors write a detailed outcome report for each claim which explains the evidence available at the time of the medical assessment and how it was considered. 

A selection of outcome reports are quality assured by the NHSBSA and measured against the principles and standards expressed in the Principles of Medical Assessment. This is to ensure that the principles are consistently and appropriately applied. An Integrated Quality Assurance (IQA) form is completed by NHSBSA. 

The following link will take you to the “Principles of Medical Assessment”: https://www.nhsbsa.nhs.uk/vaccine-damage-payment-scheme-vdps-claim-process

<Strong>Question 4 - Quality Assurance and Governance
<li>Any internal policy, protocol, or requirement that medical assessors must have specific and demonstrable expertise in the claimant’s condition or in vaccine related adverse events before determining eligibility for payment.</li>
<li>Any audit reports or quality assurance findings (from 2021 to present) on the accuracy, consistency, or reliability of medical determinations under the VDPS.</li></Strong>

Following a search of our paper and electronic records, I have established that the NHSBSA does not have an internal document specifying the expertise or qualifications of medical assessors. This is because the contract between NHSBSA and the supplying organization requires that all assessments carried out are undertaken by suitably qualified and experienced Registered Medical Practitioners. This includes being registered on the UK General Medical Council register, with a licence to practise and meet or exceed the following requirements:

<li>they are a Registered Medical Practitioner with at least five years’ post graduate experience; and</li>
<li>they have experience of the performance of medical and/ or disability assessment, addressing questions of causation and impact in the context of legislative or policy requirements to assist the decision maker.</li>

A selection of outcome reports are quality assured by the NHSBSA and measured against the principles and standards expressed in the Principles of Medical Assessment. This is to ensure that the principles are consistently and appropriately applied. An Integrated Quality Assurance (IQA) form is completed by NHSBSA. 

I am unable to provide a copy of the IQA forms as this is personal information and falls under the exemption in section 40 subsections 2 and 3(A)(a) of the FOIA. As the requested information contains personal information including special category personal data, I consider this information is exempt. This is because it would breach the first data protection principle as:

a)	it is not fair to disclose their personal details to the world and is likely to cause damage or distress.<br>
b)	these details are not of sufficient interest to the public to warrant an intrusion into their privacy.

The requested information is exempt if disclosure would contravene any of the data protection principles. For disclosure to comply with the lawfulness, fairness, and transparency principle, we either need the consent of the data subject(s) or there must be a legitimate interest in disclosure. In addition, the disclosure must be necessary to meet the legitimate interest and finally, the disclosure must not cause unwarranted harm.

This means that the NHSBSA is therefore required to conduct a balancing exercise between the legitimate interest of the applicant in disclosure against the rights and freedoms of those identified in the IQA reports.

While I acknowledge that you have a legitimate interest in disclosure of the information, the disclosure of the requested information would cause unwarranted harm. Disclosing this information would be unfair and as such this would breach the UK General Data Protection Regulation first data protection principle.

Please see the following link to view the section 40 exemption in full: <https://www.legislation.gov.uk/ukpga/2000/36/section/40>

In addition, disclosure of the requested information is also a breach of the common law duty of confidence. An individual who has been identified could make a claim against the NHSBSA for the disclosure of the confidential information.

The information requested is therefore being withheld as it falls under the exemption in section 41(1) ‘Information provided in confidence’ of the FOIA.

Please click the below web link to see the exemption in full: <https://www.legislation.gov.uk/ukpga/2000/36/section/41> 

The following exemptions apply to anonymised or summarised IQA reports 

__Section 21 of the FOIA – Information which is already reasonably available to you__

The Principles of Medical Assessment outlines the quality standards expected within the Vaccine Damage Payment Scheme (VDPS) medical assessment reports. As mentioned in this document, it also incorporates previous learning that may be useful to consider in the preparation of Outcome Reports written by Medical Assessors.  Any feedback provided as part of the quality assurance process is measured against the principles and standards contained within this document.  

The Principles of Medical Assessment is available on our website at the following link: 

<https://www.nhsbsa.nhs.uk/sites/default/files/2025-04/Principles%20of%20medical%20assessment.docx>

Additionally, the NHSBSA has made available in our response to FOI 02581 training materials which is has provided to the medical assessors based on the feedback it has provided during the IQA process.  

You can view our response and this information by clicking the weblink below and scrolling down to the end of the page: 

<https://opendata.nhsbsa.net/dataset/foi-02581>

__Section 43(2) - Information which is considered to be commercially sensitive__

The specific quality assurance findings you requested are being withheld as they fall under the exemption in section 43(2) of the FOIA, as releasing the information would be likely to prejudice the commercial interests of the NHSBSA and our third-party medical assessor, Crawfords & Company.  

Please be advised that we have consulted with our third-party supplier, Crawfords & Company, for their views in relation to disclosure of the requested information and how this would adversely affect their commercial interests. Feedback from this consultation has been incorporated into the public interest test detailed below. 

In applying this exemption, we have balanced the public interest in withholding the information against the public interest in disclosing the information. 

Please see the below web link to see the exemption in full - 

<https://www.legislation.gov.uk/ukpga/2000/36/section/43>

__Public Interest Test:__

__Considerations in favour of disclosure:__

* Public accountability and increased trust from members of the public in relation to transparency of information regarding Covid-19 vaccines and the Vaccine Damage Payment Scheme. 
* Public interest in citizens being confident in making informed decisions in relation to vaccines and that these decisions are taken based on the best publicly available information. 

__Considerations against disclosure:__

* The requested information includes the proprietary information of Crawford & Company. Disclosing this information in the public domain would enable competitors to replicate or exploit these methods, giving them an unfair advantage in future tendering rounds.  
* Protecting fair competition ensures value for money in procurement and tendering processes. Disclosure would distort the market and potentially increase costs to the taxpayer if competition is compromised. 
* In a commercial environment, the timing of a disclosure is of critical importance. Information relating to commercial activity is at its most sensitive when the procurement activity is still underway. This FOI request was received when this contract was being reprocured. 
* Potentially serious detrimental effect on the commercial interests of the NHSBSA due to a reduction in the effectiveness of the competitive tendering process should the NHSBSA choose to re-test the market at a later time. This is because potential suppliers would not have the confidence that the NHSBSA would publicly disclose proprietary information. Disclosing information that is commercially sensitive to a particular supplier during a live procurement where it could be viewed by a competing supplier would put that supplier at a disadvantage whilst potentially creating a competitive advantage for other suppliers.  As such the procurement would not meet transparency and equal treatment obligations and could introduce the risk of a successful procurement challenge had the information been disclosed under FOIA. 
* The NHSBSA believes that disclosing the requested information may decrease the effectiveness of any future competitive tender as it may prejudice the NHSBSA’s ability to obtain best quality of service and value. 
* Training materials on effective report writing have been released under FOI. As such, the NHSBSA are meeting transparency requirements without needing to release additional commercially sensitive information.  
* Quality standards and principles are publicly available on the NHSBSA website, and these incorporate lessons learnt from the Quality Assurance process. As such, there is transparency in the quality standards expected of the NHSBSA with it’s suppliers. 
* Maintaining confidentiality of proprietary methods safeguards innovation and efficiency. 

__Conclusion of public interest test:__

The NHSBSA recognises that there is a public interest in the disclosure of information which facilitates openness, transparency, and accountability in public authority dealings; however, there is an inherent public interest in the NHSBSA being able to work in competitive markets, whereby the financial and reputational benefit is in to the wider public interest. 

Having undertaken the balancing exercise, the NHSBSA concludes that the public interest in maintaining the exemption outweighs the public interest in disclosure. 

<strong>Data Queries</strong>

Please contact <a href=mailto:foirequests@nhsbsa.nhs.uk>foirequests@nhsbsa.nhs.uk</a>  ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

<strong>Reusing the data and copyright</strong>

If you plan on producing a press or broadcast story based upon the data please contact <a href=mailto:communicationsteam@nhsbsa.nhs.uk>communicationsteam@nhsbsa.nhs.uk</a>. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2025” This information is licenced under the terms of the Open Government Licence:<br>
http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.


Tags: NHSBSA corporate, VDPS, Vaccine Damage Payment Scheme, nhsbsa
Organization: Freedom of Information Disclosure Log