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GP practices will get 52p per patient to cover rising costs of indemnity

Every GP practice in England will receive 52p per registered patient to offset the average increase to the cost of medical indemnity this year.

In an update on the GP contract announcements last week, NHS England said that the £30 million fund will be divided based on the size of a practice’s registered list at a rate of 51.6p per patient.

GP leaders told Pulse that negotiations to decide whether this would be best paid as a one-off lump sum in early April, or incrementally across the year, were still underway.

In a letter to regional NHS England primary care leads and CCGs, NHS England director of commissioning Rosamond Roughton said: ‘Payments for indemnity costs… will be made based on registered patients at 51.6p per patient.’

This is part of an overall 3.3% funding uplift that amounts to £238.7 million in the 2017/18 GMS contract, and includes full reimbursement of CQC fees and the dropping of the unplanned admissions DES.

GPC chair Dr Chaand Nagpaul said that practices would ultimately have the discretion over how the funding was divided between doctors working for the practice.

He said: ‘We’re in discussions about the best way to have it paid. You’ve been given the amount and distributing it will be up to individual practice discretion, anyone in a practice – including locums – will have to factor in a rise.’

According to Dr Nagpaul, it would be impossible to be ‘prescriptive’ about a methodology where some GPs may have seen significant increases related to out out-of-hours, or GPwSI, work, which this payment is not intended to cover.

He said: ‘It’s important not to make this more bureaucratic than necessary, this covers the average rises in indemnity costs which have been projected from MDO feedback.

‘One needs to ensure the distribution of the money is fair within practices. Guidance will follow, but it will never be able to be too prescriptive because of the variation in circumstances of individual doctors.’

Practices will be given a share of £30m worth of funding to cover indemnity costs over the next two years – as pledged in the GP Forward View.

Mitigating the rise to indemnity costs

The £60m funding injection to offset indemnity inflation – first trailed in the GP Forward View – is part of a ‘two-pronged’ strategy to tackle 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.

This includes proposals to cap the fees lawyers are able to charge in low-value compensation claims.

NHS England is also repeating the £2m winter indemnity scheme for out-of-hours GPs this year, having successfully trialled reimbursements for indemnity hikes last winter.

Indemnity providers say inflation to indemnity costs is linked to steep rises in legal claims against GPs, amid a growing trend for increased litigation.