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Independents' Day

GP indemnity fees 'up by one quarter' in just one year, says FDA

GP indemnity costs have increased by 25% in just one year, a snaphot survey of members of the Family Doctor Association (FDA) has shown.

The survey of 96 GPs, carried out at the end of August, revealed 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.

The survey did not distinguish between in and out-of-hours cover in reaching the calculation, but FDA said most respondents did ‘little’ work out of hours.

However, the FDA said it was ‘of concern’ that GPs were being charged more for out-of-hours, and that some indemnity providers were also charging these more expensive rates for ‘extended hours’ work - an issue the GPC has previously raised in light of the Government’s rollout of seven-day GP appointments.

In response to the statistic, FDA chair Dr Peter Swinyard said the Government must look at the ‘frightening’ increase and consider alternative schemes to pay for GP indemnity.

Dr Swinyard said: ‘It is grossly unfair that indemnity cover for NHS work is only paid personally by GPs. All hospital staff enjoy cover from the Crown Indemnity scheme, although many “top-up” their cover through the mutuals.

‘Insurance in the open market is prohibitively expensive and has caused the retirement of doctors who cannot afford the fees or the risk of the excess payments. NHS England and the three devolved administrations must accept that NHS work requires NHS cover and bring GP cover in line with hospital doctors.’

A majority of respondents to the FDA survey indemnified for 7-9 sessions of clinical work across 4-5 days per week, with the main three medical defence organisations, although two GPs indemnified with a commercial insurance company.

The statistics come after Pulse reported on a GP quoted £30,000 a year by a defence organisation to be indemnified to work out of hours earlier this year, and as a recent survey showed four in five GPs have limited their work out of hours due to concerns over indemnity costs.

NHS England has acknowledged GPs’ concern but has made no indication as to whether it will subsidise costs going forward, following a completed pilot of covering the cost of GPs working out of hours briefly during the winter period.

Although the GPC are in talks with NHS England about possible solutions, LMC leaders warned of potential downsides of joining the crown indemnity scheme at LMCs Conference this year, including GPs potentially forced to accept sanctions or settlements to keep costs down for the NHS.

Pulse has already revealed is becoming increasingly common as GPs look to alternative provides to reduce spiralling indemnity fees, or tailor their cover.

Commenting on indemnity fees in general, GPC executive member Dr Beth McCarron said: ‘Medical indemnity costs are now more than a month’s drawings. I’ll have to work over a month for nothing every year just to insure myself, that is just not sustainable and we need urgent investment in core general practice and real urgent solutions to the spiralling costs of indemnity.’

MDU director of professional services Dr Matthew Lee said: ‘With claims inflation rising at 10% each year, this inevitably must be reflected in indemnity subscriptions. The MDU is campaigning for legal reform.’

MPS medical director Rob Hendry said: ‘The sad reality is that GPs are more likely to be sued now than ever before and a GP can now expect to be sued twice over an average career… Each individual’s subscription rate is considered on its own merit and MPS does not apply out-of-hours rates to all GPs working extended hours.’

MDDUS chief executive Chris Kenny said as long as GPs were providing predominantly non-emergency work within extended hours and had access to full patients records these sessions would be treated the same as in-hours work.

He said: ‘MDDUS charges subscriptions that are based on a detailed consideration of likely future costs.’


Readers' comments (13)

  • There was an easy win for Jezza in his new deal. Bring all GP's in house for NHS work, and offer Crown Indemnity. No new money per se, sellable therefore to the Daily Mail, instant 10k per partner boost to most practices, and considerable goodwill at at time when this is rare. I wrote and told him that. Still waiting for a reply.

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  • which other profession spends 10-15% of their income on indemnity alone?

    No wonder no one wants to be a GP. I'm nearing that point too TBH

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  • Indemnity costs must be reimbursed. GPs absorb risk for the benefit of the tax payer. The cost must be borne by the beneficiary.

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  • This is day light robbery.God help us.

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  • If this was a 'free market' the customer would be footing the bill ie prices would go up to cover this excessive cost.In the soviet style health system we call the NHS the providers sustain this cost of increased expectation of 'the customer is always right',this is an anachronism.Unless the indemnity is increased as time goes by this job will be unsustainable in its current form. Increasing RELP and or a decrease in clinical commitment(less sessions/less risk/less cost).I wonder what it will cost for unsupervised physisicians assistants with crown indemnity less than what we pay.I don't think so .Down the pulghole we continue to go!

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  • Took Early Retirement

    Do what some American Obstetricians did: put all your money/property into a trust and then don't pay indemnity. Of course, you'd need unanimous agreement in the partnership and to change your partnership deed. I suspect it could be done by those who have the will.

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  • 07.53 Could that be why the GMC have been sending out emails advising us it is now a statutory requirement for doctors to have indemnity? All looks a bit fishy to me.

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  • Indemnity cost will go much higher when the physician associate model is rolled out across the UK.

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  • i am recently qualified and doing the sums it is far better for me to work less as a locum than work more as a salaried GP. Indemnity fees is a large part of this - every session I do less I pay around £500 less a year and as a locum I can earn more and be more in control.

    i.e. it pays to work less....not the best model for NHS primary care.

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  • at this rate of increase within 5 years indemnity will be over 100k per year
    hence forth all of us will want to be emplyed

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  • @ Anonymous | GP Partner | 03 September 2015 8:33am

    Ding ding ding bingo!

    They are herding us into salaried posts for their buddies businesses eg Virgin

    I would rather eat shit

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  • I think we are past the point grumbling-we now have to charge more-simple solution and then work less to pay less indemnity

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  • Gaurav Tewary

    Hmmm... Interesting figures and comments. I moved to Australia and pay a lot less in indemnity even though general practice here includes a lot more hands in stuff like skin exclusions, fracture reductions etc. Found myself asking a simple question. Why is cost of indemnity going up in UK? The major players there are not for profit organisations whereas in Oz they are big insurance companies. My own feeling now is that the GP as gatekeeper model is totally outmoded and incompatible with modern medicine. On the one hand you have consumers demanding 24/7 instant fixes and in this scenario you expect just 1 sector of the industry to act as a moral and financial vanguard to 'protect the taxpayer'. Most complaints relate to missed and delayed diagnosis which is directly related to 'rationing', whether that be appointments, investigations, referral pathways whatever. In Oz I feel no such pressure. Neither I guess do others and consequently the rate of complaints is lower here which leads to lower indemnity premiums. Lower by a factor of 10!

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