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Independents' Day

BMA hosts summit on rising GP indemnity costs

The BMA is hosting a summit concerning the rising cost of GP indemnity tomorrow, with the meeting coming as NHS England has made the issue ‘a priority’.

NHS England has been invited to attend the symposium, after which the GPC is hoping to ‘have a better idea’ of what is being considered in response to the problem.

GP leaders have warned that rising cost of indemnity is another deterrant for GPs to join general practice and a Pulse survey recently revealed that half of GPs turn down out-of-hours shifts because the cover is too expensive.

There are also concerns that these more expensive rates will be rolled out for ‘extended hours’ work - an issue the GPC has previously raised in light of the Government’s rollout of seven-day GP appointments.

One alternative option would be to include GPs under the crown indemnity scheme covering hospital doctors - as voted for by the LMCs Conference in May - but NHS England has so far refused to say whether this is a consideration.

GPC executive member Dr Charlotte Jones said: ‘Medical indemnity is expensive and I’ve been told by NHS England that dealing with it is a “priority”. NHS England is very aware of the problems.

‘There is an indemnity symposium this Wednesday which NHS England has been invited to – we should have a better idea of what is going on after that. Subsidising indemnity is one of a range of solutions- I don’t know how advanced discussions are.’

In the light of the mounting pressures GP leaders told Pulse that NHS England should seriously consider subsidising the cost of indemnity.

NHS Alliance chair Dr Michael Dixon said: ‘[NHS England] must take it seriously – anyone who does out of hours work is being hit hard and if the seven-days policy is seriously being taken forward then indemnity has to be paid for. It has to be done and quickly, otherwise it is just another extra demand on practices.’

Last week the Family Doctor association said indemnity fees had leaped up by one quarter in the last year. Its figures showed that the average annual fee for a GP doing 10 sessions a week had gone up to £11,320 in 2015, as members’ annual cost per session rose from £869 in 2014 to £1,132 in 2015.

Medical defence organisations say this is driven by a 10% year-on-year rise in claims, but some GPs have decided to shop around for indemnity with private insurers in response to increases.

An NHS England spokesperson said: ‘We understand the impact of indemnity costs on general practitioners and it is a priority issue for us to resolve. We are exploring options for how indemnity schemes could be developed.’

The cost of indemnity for new staff groups, such as physician associates and pharmacists, is a further concern to GPs.

A spokesperson for leading defence organisation MDU said that ‘the increasing reliance on nurse practitioners and the broadening of their clinical role is evident from the increasing number of claims we are seeing arising out of their involvement in clinical care’, adding that: ‘We expect to see a similar pattern in relation to other new roles that emerge.’

Physician associates will either have to cover their indemnity costs themselves or be covered by a practice as an employee, a cost which will put further pressure on already stretched practice budgets, said Dr Dixon.

He said: ‘Practices already cover their nurse practitioners is something happens – I assume physician associates will be looked after the same way. It will put the cost of practice policies up however.’

The NHS England spokesperson said: ‘We are keen to work with stakeholders to address the barriers to implementing new models of care and developing an extended workforce in primary care. This will include how better we can address indemnity costs, but at this stage it is too early to advise how this may work.’

A GP leader who wished not to be named said: ‘I have been assured by someone at NHS England that this is something they are taking seriously and are considering funding.’

Dr Charles Alessi, vice-chair of the National Association of Primary Care said that NHS England ‘could well be the right place for funding to come from’ but noted that other options were likely to be considered. 

Readers' comments (15)

  • My excellent ANPs indemnity fees have gone up from £800 (hundred) to £8000 (thousand) per year. There has never been a claim made against her

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  • That sounds about right.

    They see undifferentiated patients without the training of a GP - surely that is higher risk than a fully qualified GP seeing them, not less?

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  • Doctors in the UK seem to have it all against them!

    i can remember 3years ago my indemnity being over 700 pounds per month; and within that was only included 2 pout of hour sessions per month. if i wanted to do more sessions the rate climbed significantly.

    I can remember when i went to see my bank manager at a well known high street bank to sort out bank accounts abroad (because i was emigrating), she asked me if if i owned 2 properties.....she had seen my mortgage payments and another debit to MDU services and thought i owned 2 houses! she was shocked when i told her the second payment was for medical insurance......... and that was back then, if the headlines here are correct its got far far worse........

    thankfully where i am now theres almost like a crown indemnity so i pay about 1000 quid per year and am not limited in amount of work i can take on........more money saved means im happier; also less defensive medicine practiced too.

    why oh why didnt i leave earlier!!!!!!

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  • All moaning aside, NHSE need to fix this pronto. When the scales of "why do I even go to work anyway" are next checked and we find them drifting into parity, the decision to leave will be a logical one. If work does not pay, work is not done.

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  • Anon 8:33
    My defence union fees now cost way more than my mortgage, and account for more than two months of my take home pay every year. Hospital and nursing colleagues cannot believe how much GPs are paying for the privilege of their daily bashing in the media

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  • BMA cannot sort this out - it's all part of the squeeze towards privatisation of the health service.

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  • This is a good business.why will people budge?

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  • If we are not careful there will not be a service to indemnify.

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  • The government is made up of lawyers and similar professions. These are the people who have made massive amounts of money from asset stripping doctors and the NHS in legal fees. They also want to privatize the NHS. Why would they do anything about this, it's not in their interests? The whole thing stinks.

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  • George Elliott in 'Mill on the Floss'...''lawyers are scoundrels...'' found it funny 20 years ago but seems there's more than truth in that statement.

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