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Stevens: Crown indemnity may not be the right solution for GPs

Exclusive NHS England’s chief executive has cast doubt on how useful crown indemnity will be for GPs, suggesting that it may not reduce costs for practices.

In an exclusive interview with Pulse, Simon Stevens reiterated that he wanted to relieve the pressure of soaring indemnity costs from practices, but pointed out that GPs would still have to pay premiums to the NHS Litigation Authority.

The recently released General Practice Forward View promised a consultation with the profession on ‘potential solutions’ to the soaring cost of medical cover. But it seemed to confuse crown indemnity with 'crown immunity’, claiming that such a scheme would ‘mean it is not possible to sue for damages’.

Lawyers told Pulse that these were two different types of scheme. When asked by Pulse to clarify NHS England's position, Mr Stevens said: 'The idea of [patients not being able to] sue wouldn’t be viable. 

'Crown indemnity would just mean the NHS Litigation Authority, rather than defence organisations or commercial insurers, charging premiums to practices.

‘We have been talking with the FDA, GPC and others about this, together with the defence organisations. We’ve got a number of tangible propositions we want to consult on. But, for me, the fundamental point is there’s absolutely no reason in principle why GPs should personally be on the hook for rising indemnity costs in a way that hospital doctors aren’t.’

The GP Forward View said that NHS England had 'to date, not seen evidence' that including practices in the Clinical Negligence Scheme operated by NHS Trusts would bring down costs for GPs. Indemnity costs are a major barrier to the development of primary care to take on more secondary care services, as envisioned in the Five Year Forward View blueprint for the health service.

Other solutions mooted by GP leaders have included direct reimbursement of indemnity costs.

Jack Stephenson, a solicitor at Harrison Dury, said: ‘It would appear that [NHS England] has mixed up crown indemnity with crown immunity. The latter is a legal doctrine by which the state cannot commit a legal wrong and is immune from civil suit or criminal prosecution. If GPs had crown immunity, this would indeed mean that they could not be sued for clinical negligence.'

An NHS England spokesperson insisted it was not a mistake, but that the GP Forward View’s statement on crown indemnity ‘could have been clearer’.

A recent Pulse survey, of more than 900 GPs, showed that GPs paid an extra26% more on average in indemnity fees last year, although the figure could be higher as many said they had cut shifts in response.

Tackling the indemnity issue

The GP Forward View said NHS England proposals, to be put forward in full by July, will include looking at:

  • how costs could be contained for individuals working under certain ‘clinical governance standards’;
  • whether costs could be reduced to individuals under specific circumstances, such as for example GPs going part-time;
  • enabling the new larger multispeciality community practices (MCPs) to take on corporate indemnity covering all of their GPs under one policy;
  • and looking at whether it could bring in a cap on costs that claimaint lawyers can recover from clinical negligence claims.

Readers' comments (13)

  • Spinal Tap moment
    "What's wrong with being sexy?'

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  • Vinci Ho

    Ha ha ha ha
    I thought only me with so 'poor' English would confuse the word indemnity with immunity.....

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  • So they'll start charging hospital docs too.

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  • they are not confused - they know what they are doing.

    by fudging the issue they are hoping to 'kick it out of play' probably until after the next election - it's classic delay tactics. they have no intention of providing assistance as it will cost them money. Given the opportunity they will probably use this to start charging hospital doctors to bring them into parity with GPs. That's how they think. It's not what they can do for you it's what they can do to save money.

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  • Moronic propensities don't seem to lull. If they want to charge, let them charge everybody across the board including Hospital and Community healthcare professional. One fee to the NHS Litigation authority for every professional and liquidate MPS/MDDUs etc who are having a rollicking time at the expense of general Practice. In it's annual statement MPS bragged that it had a reserve of 2 billion !! in it's annual statement. Now Steven's doesn't want a part of that money because it's chums earnings, isn't it and some of them are Lords.
    Money is held in Cayman's probably and not taxable because most likely they are also registered as a charity digging wells in Africa

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  • No, you should pay crown indemnity LIKE you pay it for hospital doctors.

    Call it a hidden payrise, so the Daily Wail wont bleat at it.

    If you absorb the cost then you will finally tackle litigation costs in the UK

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  • They could reimburse our costs. That way there is an immediate benefit to GPs and an incentive for NHSE to get the costs down.

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  • why dont they do what they did when they offered us an opt out of ooh? take £3-5K off my gross income in return for nhs indemnity. if they dont do anything about compensation culture and let costs spiral - their problem. if they do they win.

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  • Anything right for GPs can't be right for them- could have been a listing from Murphy's law.

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  • Just not listening, are you Simon?

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