2019 in view pt 1 – DHSC aim to launch state-backed indemnity for GPs in April 2019

Brexit is not the only messy, unclear, untried scheme to be launched in the first half of this year.

The government is aiming to launch the state-backed indemnity scheme on 1 April 2019. Though designed to make indemnity more affordable for GPs, there are concerns that, at this late stage, many important details about how the scheme will operate remain to be seen. And what has been revealed of the scheme so far has raised concerns about the range and type of coverage and the funding arrangements.

And simply that it will not be effective in reducing the rising costs of negligence claims which were triggered largely by the way that personal injury claim amounts are now calculated.

  • From FAQs released by DHSC in November 2018, we learned that
    “...the scheme will cover clinical negligence liabilities of general practice staff delivering primary medical services commissioned under GMS, PMS and APMS contracts and any integrated urgent care delivered by general practice through schedule 2L of the NHS standard contract. This includes standalone out of hours services commissioned under an APMS contract and services delivered by GP practices under primary medical services contracts in secure environments.”
  • Some have inferred that it is likely to cover GPs via the organisation they work in rather than individually.
  • The defence organisations are concerned that the details of the scheme revealed so far are not adequate - GPs will still need to buy cover for medico-legal help outside of the scope of the clinical negligence scheme. This would include help with GMC investigations and representation at coroner courts, which MPS have pointed out can be high-stakes cases with consequences for GPs.
  • It’s not clear whether claims-made policies (which only insure against claims received during the period of cover), or occurrence-based cover (protecting you from any covered incident that “occurs” during the policy period, regardless of when a claim is filed) will be included or not. Occurrence-based cover was the usual type of indemnity policy in operation for many years via the main defence organisations, until a state-backed indemnity scheme was mooted and MDU famously halved its subscriptions to become claims-made in the belief that the state-backed scheme would be occurrence-based and mop up historical claims.
  • DHSC announced that the state-backed scheme “will be funded from existing resources allocated for general practice” causing disappointment and alarm that practice incomes would be further pressured
  • The scheme will not just fund GP indemnity run by an independent organisation, the scheme will actually be operated by an NHS organisation called NHS Resolution.

So what will this all mean for salaried and locum GPs? Whatever happens there will still be a need for existing medical indemnity providers to cover all those areas of risk not covered by any state-backed scheme, and there's a possibility that, at least for GP locums, we may need to factor an element of our indemnity fee into our sessional fees. But all of that is up for debate and as yet to be decided. NASGP will keep members up-to-date as and when we hear more.

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