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NHS promises to address rising indemnity fees but stops short of full funding

NHS England is not going to cover GP indemnity costs as part of its general practice rescue deal, despite calls from the profession to do so, instead focusing on a ‘discussion’ to address rising fees.

It said it will consult with the profession, medical defence organisations, commerical insurers and the NHS Litigation Authourity to ‘consider potential solutions’, the General Practice Forward View has revealed.

NHS England proposals, to be put forward in full by July, will include looking at: how costs could be contained for individuals working under certain ‘clinical governance standards’; whether costs could be reduced to individuals under specific circumstances, such as for example GPs going part-time: and enabling the new larger multispeciality community practices (MCPs) to take on corporate indemnity covering all of their GPs under one policy.

As revealed by Pulse, private insurance providers are already signing deals with GP federations to cover indemnity fees at discount group rates, but the GPC has expressed that its preference is for GPs to remain in their defence schemes with the subs reimbursed ‘rather than a hybrid system of cover which could potentially leave the GP vulnerable in the event of a claim’.

The Forward View also reiterated the Government’s plan to consult on whether it could bring in a cap on costs that claimaint lawyers can recover from clinical negligence claims.

Addressing calls for Crown indemnity, NHS England said it did ‘not believe’ that this was actually ‘the intent of the profession’, as this would ‘mean it is not possible to sue for damages and that the small minority of patients who had suffered harm as a result of clinical negligence would not have recourse to any financial compensation’.

It said: ’Rather, we believe that the shared aim of those working in the NHS is to bring down the overall costs associated with negligence claims in an appropriate fashion…’

Having also highlighted NHS England’s £2m winter scheme to cover the cost of indemnity for extra out-of-hours shifts, which has led to tens of thousands more shifts being booked, the Forward View concludes: ’Taken together, this represents a significant programme of work to reform indemnity in general practice, addressing some short-term pressures whilst looking to bring down the overall costs to the system.’

A recent Pulse survey, of more than 900 GPs, showed that GPs paid an extra 26% more on average in indemnity fees last year, although the figure could be higher as many said they had cut shifts in response.

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Readers' comments (22)

  • 'include looking at how costs could be contained for individuals working under certain ‘clinical governance standards’'

    There it is.
    Er from the will of the masters at your own risk.

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  • With indemnity fees going up faster than a rat out of a sewer, it is clear that the government do not give a rat's xxxx about the effect this is having on GP's.
    And why should they as they want to end it all so it can go private as the higher the indemnity fees the harder it is for GPs to be independent.
    They will be laughing all the way to the mega healthcare providers as they have got the spin out of this yet have not promised a bean.

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  • If all doctors had enough time to do the job properly, reasonable defence fees would be acceptable. When a system is underesourced and mistakes to some extent due to this why should the vulnerable doctors pay for the system deficiency.
    We are not dealing with an ethical group of Overseers or all this would be put to right.
    Very obvious tactics as expressed above.

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  • Addressing calls for Crown indemnity, NHS England said it did ’not believe’ that this was actually ‘the intent of the profession’, as this would ’mean it is not possible to sue for damages and that the small minority of patients who had suffered harm as a result of clinical negligence would not have recourse to any financial compensation’
    ??????????????????????????????
    what !!!!!!!!!!!!!!!!!!!!!!!!
    it is most definitely this doctors intent

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  • Agree with previous. We want crown indemnity.No one is happy to fork out £8000 to cover a strained under-resourced system that keeps creating more rules and standards and not actually funding where it is needed. If the 7days working and OOH comes it will be over £10K! Not worth working.

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  • The whole flavour of this is pretty worrying - it sounds as though receiving some of the cost of indemnity will be conditional on working for a mega practice.

    It also sounds as though indemnity may be provided under the type of brokered/pooled arrangements with insurance companies that have proved so useless in the past and left GPs with poor advice and the threat of large 'run off cover costs'.

    I agree with other posters, on this type of topic in Pulse, that GPs need to have crown indemnity to deal with the cost of claims and the option of payment to a mutual to meet 'reputational risks'.

    Ideally GPs need the same type of arrangements that our hospital colleagues enjoy - otherwise every GP will be working harder and harder simply to prop up the mutual indemnifiers' pooled funds and keep the lawyers' gravey train running.

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  • 5.49pm, absolutely otherwise we are effectively subsidising the failings of the NHS by our indemnity fees. Doctors who are on the front line and get the sharp end of the stick from the patient.
    As if it is our fault if we are exhausted, are covering several people's jobs and also working for free.
    also if a mistake is made in hours we are not scheduled to work, are we protected in what we do by the hospitals??? For instance, could they turn around and say well she/he should not have been working extra hours, they were not scheduled for in the rota and so it was the doctors fault that she/he was too tired so they are the one to blame!
    Doctors should NEVER work overtime unpaid as it is too risky for us, however much we want to do it, it just is not worth it as we will end up getting the blame.

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  • A shocking lack of understanding of how indemnity works from NHS England! It does NOT preclude patients receiving compensation, that would be Crown Immunity. Crown Indemnity is a form of indemnity like any other, but organised by the government. Patients would have exactly the same recourse to compensation as they would in secondary care, where crown immunity was introduced in 1990 to combat rising fees.

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  • Read James Kirkup in the online Telegraph to think what right wing tories think of general practice
    Nigel(ed) could you arrange an interview with Pulse with this oik

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  • In other words it's doing jack all

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