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GPs go forth

DH now says indemnity scheme will cover all practice staff

The state-backed indemnity scheme announced by Jeremy Hunt last week is intended to apply to practice staff as well as GPs, the DH has confirmed.

The Department of Health has published a fact sheet that provided more details on how it intends for the scheme to function, in addition to the details the secretary of state was able to give on stage at the RCGP Annual Conference last week.

Critically it suggests that practice staff are expected to be covered in the scheme when Mr Hunt said at this stage he was only confident in saying it would cover ‘all doctors in general practice’.

Other key details include:

  • The suggestion that it would be a practice policy, providing cover to ‘providers of GP services (e.g. GP contractors)’ and out-of-hours provider;
  • This would ‘include the activities of practice staff’ working in the delivery of GMS, PMS and APMS services;
  • It would only provide ‘clinical negligence’ cover. GPs would want their own indemnity for professional and regulatory issues such as GMC proceedings and coroners’ courts;
  • A decision is yet to be made on whether the scheme could be extended to GPs in prison health or armed forces;
  • DH wants a scheme in place ‘as quickly as possible’ but it is likely to take 12 to 18 months.

In his announcement to the RCGP conference, Mr Hunt said it would cover ‘all GPs for all NHS work’ but stopped short of including practice staff as he didn’t want to misspeak and u-turn later.

However the fact sheet published by the DH after his speech does confirm that this is its intended ambition.

It says: ’We envisage the scheme would provide clinical negligence cover to providers of GP services (e.g. GP contractors OOH providers of GP services) through which the activities of individual GPs would be covered.

‘It would be available to all contractors who provide primary medical services: GMS, PMS and APMS plus any other integrated urgent care delivered through NHS Standard Contracts.

‘The cover would include the activities of practice staff including other medical professionals working for the practice in the provision of these contracted services, and students/trainees working in this area.’

The suggestion that the scheme would be for contractors providing primary medical services suggests that it would be a policy with partners which covers doctors working for them.

Dr Mark Sanford-Wood, deputy chair of the BMA’s GP Committee and its lead on indemnity, told Pulse: ‘The full extent of the cover will require very careful examination. In essence we want to indemnify all normal GP work but defining that is quite tricky. Even taking the broad stance of all “NHS commissioned services” does not work because most GPs hold public health enhanced services contracts from local authorities. That definition will be very important.

‘I am sure that most GPs will still wish to retain membership of an MDO for non-litigation processes such as GMC hearings etc.’

Readers' comments (5)

  • Vinci Ho

    For those of us who are familiar of DoH documents and publications (LMC members, for instance) , the choice of words are always careful with even encryption sometimes.
    Read this document through , you might find more questions than answers:
    (1) 'State-backed' is clearly not crown , the word we preferred instead. My preliminary understanding is that we will still have to pay a fee from our pocket but the amount as well as any future increase , is under the scrutiny of the government. Then again , 12-18 months before the state can accomplish this 'backing' is rather mysterious.
    The practical question is , 'does DoH have an estimation of how much money is actually involved?'
    (2) My gut feeling sensed something strange when MDU announced a 50% reduction of current subscription fee almost simultaneously when the health secretary made his announcement. Call me a conspiracy theorist . Clearly, there is some variation in terms of how much different medical defence organisations have been charging their members . Also , more than half of our subscriptions to MDOs are for covering litigation related issues. So if this stated-backed indemnity is solely litigation related , one can probably work out how much we should pay for the coverage of non-litigation processes.
    (3) This announcement cannot stop one from drawing implications from the overall political big picture. The Chancellor got himself caught in lines of fire as far as his party's civil war is concerned. Deep down , he is refusing to put billions of domestic money(for health and education) aside for a possible 'no deal' outcome of Brexit negotiations with EU. But he is under intense pressure from some backbenchers to do so. Hence , I am not 100% convinced about this scheme without a statement from the treasury office. If this is a new money , one should expect some mentioning in the next Chancellor's budget announcement.
    (4) Based on the original argument that high indemnity fee is one big obstacle that is hindering recruitment and retention, particularly in out of hours , the impact of this scheme has to be positive to deem itself as one solution to our crisis.
    Clearly , 12-18 months will take the time up to late 2019 , how can one ensure this scheme can help the government reaching the target of 5000 more GPs by 2020. We need to see this money now.
    Well ,one thing is for sure , the time will have passed the deadline of Brexit on 31/3/2019. If you are a strong believer of Boris , there will be £350 million more per week for NHS .
    (5) Only GPs in England can benefit so far , why? The typical technocratic answer in the document was that it would be down to individual devolved administration in Scotland, Wales and Northern Ireland . Aren't we talking about a crisis for all UK GPs?

    The rumour was the prime minister would have a cabinet reshuffle soon . I am afraid once again ,one day of politics is too long .
    Watch the space , folks .

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  • Secure environments GP

    Good analysis Vinci.
    There will be a catch, we will pay the money somehow.
    18 months of complex negotiations can change a lot.
    I was sitting in front of Jeremy Hunt at the Conference. Psychological and behavioural analysis of his eye movements and expressions was telling me a different story.

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  • I'm eating my hat.

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  • nice summary with thoughts vinci
    you should do a blog (do you have one already?) or could pulse consider hiring you

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  • If Vinci ran for RCGP chair he would win by a landslide.

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