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The waiting game

GP groups sign indemnity deals with private insurance firms in attempt to reduce costs

Exclusive An insurance broker has cut a deal with three GP groups and is in talks with several others to provide indemnity cover to GPs independently of the medical defence organisations.

Insurance broker Lockton said a GP federation, formed of 15 practices, had signed a deal that would save GPs an estimated 75% compared with their previous combined indemnity costs, while two out-of-hours groups had also signed deals with profit-making companies.

However, the established medical defence organisations (MDOs) said that the premiums signed with private companies will not necessarily provide the same level of indemnity as their own.

It comes as there has been mounting concern over the cost of indemnity, with one out-of-hours GP claiming that they had been quoted premiums of up to £30,000 by the medical defence organisations.

Pulse also reported yesterday that GPs were facing escalated indemnity fees based on Government plans for seven-day access, while out-of-hours providers had warned they were increasingly struggling to fill shifts due to hikes in costs of GP defence subscriptions to cover out-of-hours shifts.

GPs working for Vocare - a social enterprise that runs GP out-of-hours services as well as urgent care centres - will save ‘hundreds of thousands of pounds’ through the deal, Lockton said.

Under the deal, GPs working for Vocare will have all of their out-of-hours shift work covered by the provider, while they will still have to indemnify themselves for their regular in-hours work, which will significantly reduce their premiums.

Kevin Culliney, partner and healthcare specialist at Lockton, said incidents against out-of-hours providers are ‘few and far between’.

He added: ‘Their claims records are excellent, so we are at a bit of a loss at the moment to understand where the big increases in the MDO premiums have been coming from for out of hours, because it is not reflected in the record of the providers.’

‘This is creating some competition in the market. From the point of view of GPs who have seen their indemnity costs rising year on year, competition has got to be a good thing and I would think the MDOs will take another look at how they are charging. So from the GPs’ point of view it has got to be good news.’

John Harrison, chief executive at Vocare, said they had struggled to fill shifts before and when they asked GPs what the main issue was, rising cost of indemnity was a key issue.

He told Pulse: ‘What we decided to do, as part of our budgeting for this year, was taking on the cost of the indemnity. What it means is that we will have better recruitment. It is easier for us to fill shifts.’

Earlier this week, the GPC said some GPs are being charged higher fees for covering the seven-day access evening and weekend sessions because medical defence organisations were basing the costs on risk algorithms developed for urgent out-of-hours work - even though the work involved delivering predominantly routine, non-emergency care.

GP leaders are warning that some out-of-hours services could be left completely unmanned and this year’s LMCs conference voted to consider a move to crown indemnity.

However, the MDOs warned GPs working for organisations covering their indemnity costs to carefully check the terms and conditions.

Dr Sharmala Moodley, deputy head of underwriting at the MDU, said: ‘Where a federation or out-of-ours provider is purchasing indemnity for its GPs in bulk, it is important for a GP to understand the extent to which he or she will be indemnified by the arrangement.’

MDDUS CEO Chris Kenny said: ‘Unlike insurers, MDDUS is in the market for its members, not its shareholders. We’re not in it for the profit and we are in it for the long haul… We help our members for any claim that arises, even when you are retired and ceased practicing years before.’

MPS head of medical services Dr Nick Clements encouraged members to contact them to discuss subscription rates ‘so they reflect their specific needs and ensure adequate and appropriate indemnity for their scope of practice’.

He said: ‘MPS’s analysis of claims shows that the sad reality is GPs are more likely to be sued now than ever before. A full-time GP is expected to be twice as likely to receive a claim for clinical negligence than just seven years ago, and over the course of a career can expect to receive two clinical negligence claims.’

Readers' comments (13)

  • If you have a Lord and MP sitting on the Board of an Indemnity Provider, someone who had to leave his job due to an investigation into his former post in a Hospital, how can you expect the system to reform or the government to take any action to ease the indemnity woes of GPs and Nurses in Primary Care? It's connections at the top level that have prevented reforms and for the plight we are in.

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  • Bringing more competition into the market is welcome but we also need transparency.
    How are the premiums set?
    Are there any minimum standards of cover?
    How do we know that dubious claims are properly defended?
    How can we be confident that expert witnesses are what they claim to be?
    Who are the ultimate beneficiaries of these claims? How are settlement deals being made?
    What happens if an insurer fails as has happened before?

    Until the system becomes less opaque, the medical profession cannot trust the system to deliver anything that even remotely looks like justice.

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  • Took Early Retirement

    Read the small print carefully. Run off cover, for example?

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  • The problem is the govt. it has told crown indemnity to go after GPs to recover part of the costs when the hospital has to pay out and you can't fight the govt because it has unlimited tax payer funds

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  • Govt sounds more like an untouchable organized syndicate.

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  • As above, some advice for my colleagues.

    Buying your own cover from a specialist broker when they stop run off for whatever reason may cost you £25k-30k.

    Don't say you weren't warned. Anyone remember St Paul's!

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  • I don't care who makes the money from my indemnity, shareholders or members, neither one benefits me. I just care about who gives me the best cover for the cheapest. More competition is only a good thing in this area.

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  • also, you must remember all MDOs are INSURANCE, not a protection scheme. They will not fight claims where it is simply cheaper to settle. Just like car insurance.

    Don't expect them to care about you at all they are only interested in the financial bottom line.

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  • Took Early Retirement

    9.25 I think there is some truth in what you say, though MPS and MDU deny it. I'd like to see them being much more robust. Might not even mean that premiums would rise, if they also tried, aggressively, to recover costs from dodgy complainants

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