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GPs buried under trusts' workload dump

Annual hikes in GP indemnity fees to be reimbursed from April 2017

The NHS will introduce a £60 million Indemnity Support Scheme for GPs to compensate the costs of inflationary increases in insurances costs, Pulse understands.

An NHS England board paper had said this would start immediately, but a later statement clarified that practices will begin receiving the money from April 2017, which will cover any increases in indemnity fees.

It will be worth £30m over each of the next two years, Pulse has learnt, and NHS England said it would be based on ’an agreed and transparent methodology, based on best available data’.

NHS England will also extend last year’s successful £2m winter indemnity scheme for out-of-hours GPS this into this winter, which saw 500 additional GPs working 14,000 extra out-of-hour shifts.

This funding injection - first trailed in the GP Forward View - is part of a ‘two-pronged’ strategy on rising indemnity costs, focusing on immediate support and a longer-term approach to reduce costs for GPs.

The longer-term approach will see NHS England working alongside the Department of Health, GPs, indemnity providers and the NHS Litigation Authority to bring about ‘fundamental reform’ of the current system..

The GPC told Pulse they ‘cautiously’ welcomed the extension of the scheme and the immediate moves to tackle spiralling inflation costs, but said these were ‘interim’ solutions and wider reform would be needed.

It also said it was seeking clarification from NHS England on how exactly these inflationary costs would be calculated, as today’s announcement provides little detail.

GPs have cited the spiralling cost of indemnity - a 26% increase last year - as a major reason for reducing their hours, with doctors saying it was no longer ‘worth increasing your hours’.

Some doctors in the North East even switched to locum work in Scotland because of the lower costs of indemnity.

Papers filed for the NHS England board meeting say the proposals had been worked up with the Government, indemnity providers and the profession and recognise this is a ‘complex’ issue.

The board papers stated: ‘To alleviate the immediate pressure of rising costs for GPs from indemnity, we will introduce a new Indemnity Support Scheme for practices for at least the next two years.

‘This will seek to cover the inflationary rises of indemnity costs for practices, using an agreed and transparent methodology, based on best available data.’

It added that work is ongoing to ‘look at the scope for more fundamental reform of the system, and consider the case for any more specific targeting.’

Dr Charlotte Jones, chair of GPC Wales and the UK lead on urgent care, said: ‘GPC UK cautiously welcomes the announcement today of this interim solution designed to cover the average inflationary uplift for indemnity for practices.

‘We are awaiting further details of the financial modelling and are actively involved in working with NHS England on finding long-term solutions for this complex problem, as this is just a short-term, interim recognition of the costs whilst the wider issues are looked.’

Health secretary Jeremy Hunt said the Government had listened to GPs’ views that the current indemnity system was unsustainable.

He said: ‘We want the best working conditions for GPs so that they can provide the best service for patients. We have listened to concerns and know that for GPs, paying rising indemnity fees out of their own pockets feels unfair and unsustainable – so are today committing millions to help.”

NHS England director of primary care Dr Arvind Madan said: ’Three months on from the launch of the GP Forward View, we’re now getting on with implementing these plans. We understand the pressure on GP practices and today’s announcement shows how we’re getting on with immediate practical steps to deliver GPs much-needed support.’

This article was updated at 12:30pm on 28 July 2016, following NHS England providing more information

 

Readers' comments (35)

  • Call me a sceptic or should I say learned NHS experience. My guess would be complicated forms to fill in, delayed payments, wrong payments. All their measures are half-hearted. Just give us the crown indemnity for god's sake and stop messing around! Why are we treated less favourably than our hospital colleagues when we do the most work?

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  • What does this actually mean???? My indemnity has gone down from last year because I have dropped a session. How do they work out the inflationary rises? Who will get the payment - the practice or the GP? What about locums? So many questions with too few answers.

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  • So that's :
    average
    inflationary
    and
    uplift
    Averaged over what - all practitioners, including those whose costs are static?
    Inflationary - 0.5% index?
    Uplift - annual increase applied by insurers?
    Meaningless weasel words as usual.

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  • why the cynicism ? - isn't NHSE a fine, competent and trustworthy group of people ?

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  • By the time they actually agree what they will put into our bank account I will be retired. This is words what is needed is action now. All a bit like the 5 year plan. All tomorrow nothing now.

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  • fine, but what happens to locums???

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  • Cost rise 10% but inflation 0.5%?

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  • Good news in principle if it comes to something. I've had no claims and no change in my clinical practice this year from a very part time out of hours salary role which costs me a quarter of my gross salary in indemnity fees. ( On the plus side, I barely pay any income tax as a result of this huge expense on a relatively low GP income)... MPS have put the fee up by £1000 for my next year - no obvious reason, except it is 'all unscheduled care' which is higher risk & they have increased the indemnity cost of this type of work. No surprise shifts aren't filled most weekends.. So NHSEngland that's a bit above inflation according to my maths, how & when will I be able to claim / reduce this cost please?
    Please Pulse do follow up on this issue, your website crashed when this breaking news feature popped up on my emails, it is a big issue for everyone in primary care.

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  • Good news in principle if it comes to something. I've had no claims and no change in my clinical practice this year from a very part time out of hours salary role which costs me a quarter of my gross salary in indemnity fees. ( On the plus side, I barely pay any income tax as a result of this huge expense on a relatively low GP income)... MPS have put the fee up by £1000 for my next year - no obvious reason, except it is 'all unscheduled care' which is higher risk & they have increased the indemnity cost of this type of work. No surprise shifts aren't filled most weekends.. So NHSEngland that's a bit above inflation according to my maths, how & when will I be able to claim / reduce this cost please?
    Please Pulse do follow up on this issue, your website crashed when this breaking news feature popped up on my emails, it is a big issue for everyone in primary care.

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  • Look forward to seeing the detail as we all know indemnity costs are crippling us GPs....not to mention service provision. I hope this stop gap feeds into a sustainable fundamental change to the current unsustainable system. The proof will be in the details and speed of subsequent action taken.

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  • I didn't feel the need to comment anonymously for above as nothing to be frightened about what I said. But Pulse wouldn't let me submit unless I changed to post as 'anonymously.

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  • WORST than interest rate saving. 50 p per £100 will be £5 per thousand so if you pay £10,00 then you will get £50 after you filled lots of forma. this will be classed as income liable to 40% tax.
    i am locum and pay 7k so will get £35 help.
    do you think it is incetive to carrry on working?? they have not said they will pay locum.

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  • Peter Swinyard

    Problems here. [1]Arvind Madhan has said "we're getting on with implementing" but no payments until at least next April. That's 9 months away. Anyone heard of cash flow? That's really getting on with it...
    [2]The small print on the NHSE website says that this will be workload sensitive. How? By the discredited Carr-Hill formula? Potentially will disadvantage practices with more doctors per head of population who take less in drawings to provide better care? [3]no clarity on locum or sessional doctor reimbursement - my practice pays all indemnity for the salaried doctors so I am paying for 4 doctors, not just for me.
    And no-one even mentioning direct reimbursement of the usurous imposed precept of the CQC.

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  • I think that they will pay full costs of indemnity for salaried docs and for partners. there does have to be a drive to make being a partner worthwhile.

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  • There's no beating our politicians when it comes to making rocket unintelligible rocket science out of simple facts.
    What did the poet mean by cover of increase?
    It looks more like an offer of a free for all to Indemnity providers to increase premiums to limits as government is going to foot the bill for any increase anyway. But what if the 60mln doesn't suffice?
    Instead of giving blanket cover like to secondary care, this Tory government is again indulging in feeding friends and family from government funds but not realizing they are losing the plot completely and this is going to backfire so badly that you will have NHS shreds floating in the clouds by next autumn.
    God save the NHS or well, can He? - probably He's also going to move abroad to Scandinavia to find a GP:)

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  • Vinci Ho

    My message to Agent Hunt is :
    If you really want to reair relationship and hence attract people to join and stay in general practice , implement this properly and completely . Too often we heard loud noises down the corridor but very little actually would happen .
    Otherwise , the verdict is 'about f*****g time '!

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  • Vinci Ho

    Correction
    .....repair relationship....

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  • This simply isn't good enough. We demand crown indemnity just like our hospital colleagues

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  • Newly qualified. First year indemnity fee £7500. Couple this with fees for LMC, GMC, RCGP, BMA, BMJ, DRB, Accountant, locumorganiser, Doctors bag with essentials... the list gpes on. I feel like a cash cow. £10k before I even see my first patient. Add to this the burden of paperwork and time sorting all this ridiculousness out. No wonder my elders are leaving or reducing their hours. Its like being in a vacuum that is already sucking the goodwill out of me.

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  • Crown indemnity cover will only arrive when GPs vote on their feet an leave the profession in abundance - by which I mean going into other medical careers or working as a GP abroad. Until then the government is quite happy to put up with all your moaning while you suck up all the rising costs of indemnity cover and take it all on the chin.

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  • and for gps that don't work in standard gp practices and already do ooh ????..
    yes thought so, will continue to be deemed high risk with high costs and ignored .

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  • As usual, The DEVIL IS IN THE DETAILS...the main issue is lack of Clarity!!!

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  • Took Early Retirement

    Yes, having read that, it is not at all clear to me what it means. I read it that you will all continue to pay these massive premiums but that further increases may be covered by this fund. Surely, if there are c 30,000 GPs and £30M for a year, that is £1,000 per GP. Which won't go near covering a 10% increase in premiums, will it?

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  • Fund partners and salaried docs and the locums will come running back or charge us more.

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  • The maths doesn't add up. £30m it's a drop in the ocean. It simply isn't enough. When it is divided amongst us all it just can't cover it. I presume the admin will come from that cash and therefore it'll be even less.
    Another scheme that'll improve things not at all. The titanic is sinking and they are handing out balloons. I can't even roll my eyes at these schemes any more.

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  • I do not think anything good will come off it. more frustration when your expectations fail (r u really getting the annual hike or inflationary hike!) lucky if we get it. I am sure we will have a load of rubbish paperwork to fill in, on top of what we already doing.
    Why is this discrimination between hospital doctors and GPs when it comes to insurance. Why not NHSE indemnify all GPs under crown indemnity scheme??
    That will solve a lot of our problems and definitely Jeremy Hunts problem to certain extent. Otherwise he will be dreaming about 7 day week GP service, as more GPs continue to retire or migrate to greener pastures.

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  • CLOWN immunity!

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  • Funny that the NHS England director of primary care is also CEO of the Hurley Group. Clearly interested in the small struggling practices and their demise.

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  • Took Early Retirement

    Much better to send the money to a Trust: they need it, clearly.

    http://www.bbc.co.uk/news/uk-england-36922039

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  • 11:02- This conflict of interest is state sponsored corruption and nobody will look at it as the Cameron-Hunt syndrome thrives. This is just one example, I'm sure a lot of us can point to examples in our local areas. Makes you feel you were in a banana republic.

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  • £50 if you pay 10k. height to generosity.
    this is also subject to scrutiny
    better not spent that money on helping gp's

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  • More meaningless management speak
    -agree with above, nothing short of crown indemnity to put us on a par with hospital doctors is going to cut it.
    Meanwhile myself and thousands of other GPs continue to pay what amounts to another mortgage every month in indemnity fees.

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  • Why April 2017? - We all have usually started our GP careers in August or Feb' - so that two sets of uplifts they wont have to help with. Usual pile of steaming sh*t that we have come to expect.

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  • to feed an elephant you provide a slice of banana. this is what it is. that too after he has performed his circus act.

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  • "Each practice will receive a lump sum payment in April 2017 based on the rate at which costs have risen."

    So what provision there is for locum/sessional GPs in this respect?

    Soaring indemnity costs are a universal issue for GPs (that is for all types of GPs, not just those attached to a particular practice as a partner/salaried) - but especially locum GPs where indemnity costs are higher than for anyone else.

    The locum workforce is a vital part of ensuring the system ticks along and equal consideration should be given to providing an Indemnity Support Scheme for locums (who have been hit by the biggest rises) as much as anyone else.

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