GP locums in Wales could face ‘potentially financially crippling’ effects from the new requirement to join a staff bank in order to receive state-backed indemnity, GPs have warned at the UK LMC conference.
Wales brought in state-backed indemnity for all GPs in 2019, but in recent months has stipulated all locum GPs must join the new Locum Hub Wales to qualify for the cover.
In a motion that was overwhelmingly carried at the LMCs conference earlier in the month, the BMA’s sessional GPs committee warned of the potential ‘significant financial impact on locums’ from the change.
GPs during the debate said the amount of detail that has to be put into the system – including logging each shift – is at risk of administrative error, meaning GPs may not be able to prove they had indemnity cover and could be left to pay for clinical negligence costs.
They said the system was ‘clunky’ and that the website does not allow users to download a record of shifts entered.
The motion also pointed to ‘concerns’ about the how data entered by GPs would be used in future. It called for all future changes to accessing the indemnity scheme to be agreed by both the sessional GPs committee and GP Committee Wales before implementation.
GPs said they also feared governments in other parts of the UK could impose a similar system for locums.
Dr Nimish Shah, a GP and medical secretary at Morgannwg LMC, proposed the motion, and explained: ‘You need to document the name of the practice, the dates worked, the hours worked and the type of cover you provided – normal, maternity, paternity, adoption, illness or Covid-related.
‘The Welsh Government say they need this for workforce data collection – why? How safe is it? What do they plan to do with it?’
He added: ‘Then we’ve also got an optional field. They ask about the fee charged, whether it was pensioned and how much, whether you did on-call, how many and the length of face-to-face and telephone appointments and whether you did home visits or not.’
Dr Phil Cox, a sessional GP and vice chair of Morgannwg LMC, said there were concerns GPs in the future may not be able to show they were covered.
He said: ‘I’ve been inundated with concerns from colleagues regarding indemnity changes. From the lack of consultation to the lack of clarity regarding when the changes take effect – and the consequences of administration errors having potentially financially crippling implications.’
He added: ‘GPs may be required to prove the shift is covered by the indemnity scheme years in the future and have to trust a clunky website where users are unable to download a record of shifts entered for their own records.
‘An administrative error for a GP, when entering those shifts, one IT error for the website…could leave a GP without indemnity cover for a potentially ruinous medico-legal case.’
In a separate motion at the conference, put forward by Northern Ireland LMC’s southern division, GPs called for the provision of an ‘indemnity solution’ by the Northern Ireland Department of Health.
Northern Ireland has no state-backed indemnity scheme in place and GPs have to pay for the cover themselves through a medical indemnity organisation.
But the high costs are contributing to recruitment difficulties as GPs can choose to work in England and Wales where the fees are covered by the Government, warned GPs putting forward the motion, which was overwhelmingly carried.
Proposing the motion, Dr Conor Moore, chairman of Northern Ireland LMC’s southern division, said: ‘This is not only a financial disadvantage, but a disadvantage in terms of recruitment and retention of future GPs.’
He added: ‘We repeatedly hear from GPs working in other areas of the UK that they want to return home but see a return to Northern Ireland to practise would significantly financially disadvantage them.
‘Some colleagues also consider moving to other parts of the UK to practise because of the ongoing significant cost of indemnity.’
Dr Mark Sanford-Wood, from the GPC UK executive team, stressed the problem was a UK matter and that ‘urgent’ action was needed.
He said: ‘While indemnity has never been a problem in Scotland, it’s certainly true that the launching of a highly-successful state-backed indemnity scheme in England and Wales creates immediate problems for Northern Ireland, whose GPs have only to hop over the Irish Sea to benefit from the removal of something like £10,000 a year of indemnity expenses.’
In recent months talks have begun between the BMA’s Northern Ireland GP Committee and the Government in Northern Ireland to secure state-backed indemnity for GPs across the country.
If an agreement is reached it would mean all UK countries have a state-backed indemnity scheme in place, apart from Scotland where indemnity costs are lower.
Motions in full
SESSIONAL GPs COMMITTEE: That conference, in respect of the All Wales Locum Register/ Locum Hub Wales: (i) expresses concern about the data collection changes required for indemnity implemented on 1 February 2021 (ii) requires absolute clarity on how data collected through this route is being used (iii) believes that recent changes could have a significant financial impact on locums (iv) mandates that all future changes must be agreed by both the Sessional GPs committee and GPC Wales before implementation.
NORTHERN IRELAND SOUTHERN: That conference is seeking assurance that an indemnity solution is found for GPs in Northern Ireland and agreed with NI Department of Health in the near future. This is urgent as the upcoming decision on the discount rate could increase indemnity subscriptions to a level where it would not be viable to work as a GP in NI.