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Rising medical damages ‘main barrier’ to improving general practice

Rising awards in medical damages cases are one of the main barriers to improving primary care services as they are increasing the costs of GPs’ indemnity, NHS England’s director of commissioning has said

Speaking at the 2016 Health and Care Innovation Expo in Manchester, Rosamund Roughton said that the increase in the number of claims has not been linked to the quality of general practice.

She added that the only way for the Government ot manage these costs in a ‘sensible way’ would be to look at the way the judicial system operates.

This comes as NHS England has announced it will reimburse rising indemnity costs to practices directly, but at the same time will consider long-term ways of reducing indemnity costs.

Ms Roughton suggested that the long-term measures would be focused on tackling high damages awards.

She said: ‘It is certainly one of the main things that I can see as a barrier. The rise in indemnity costs is not being driven predominantly by the rise in the number of claims. It is not linked to general practice or quality. The rise in the damages being awarded by the courts is an important thing to be clear about.

‘It is really for Government in the longer term to ask “what does this mean?” and look at the way the judicial system operates because fundamentally that’s the only way we will begin to manage these costs in a sensible way.’

Dr Nigel Watson, chief executive of Wessex LMC, who was also on the discussion panel, emphasised how this burden is reduced when GPs work as part of a trust indemnity scheme: ‘To put it in context, a full time GP will spend between £12,000 to £15,000 a year on indemnity. Where we have new models of care and employed practice as part of a trust indemnity scheme, that drops to £1,000.

‘A lot of GPs find that quite attractive but there are quite a lot of GPs who work part time who say they could do more sessions but if they’re going to have to pay £3,000 or £4,000 per session, what is the incentive to do it?’

This comes as NHS England has announced it will reimburse rising indemnity costs to practices directly. Rising indemnity have prevented GPs from taking up extra sessions, particularly out of hours work and some doctors in the North East even switched to locum work in Scotland because of the lower costs of indemnity.

Rising indemnity have prevented GPs from taking up extra sessions, particularly out of hours work and some doctors in the North East even switched to locum work in Scotland because of the lower costs of indemnity.