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BMA hosts summit on rising GP indemnity costs

The BMA is hosting a summit concerning the rising cost of GP indemnity tomorrow, with the meeting coming as NHS England has made the issue ‘a priority’.

NHS England has been invited to attend the symposium, after which the GPC is hoping to ‘have a better idea’ of what is being considered in response to the problem.

GP leaders have warned that rising cost of indemnity is another deterrant for GPs to join general practice and a Pulse survey recently revealed that half of GPs turn down out-of-hours shifts because the cover is too expensive.

There are also concerns that these more expensive rates will be rolled out for ‘extended hours’ work – an issue the GPC has previously raised in light of the Government’s rollout of seven-day GP appointments.

One alternative option would be to include GPs under the crown indemnity scheme covering hospital doctors – as voted for by the LMCs Conference in May – but NHS England has so far refused to say whether this is a consideration.

GPC executive member Dr Charlotte Jones said: ‘Medical indemnity is expensive and I’ve been told by NHS England that dealing with it is a “priority”. NHS England is very aware of the problems.

‘There is an indemnity symposium this Wednesday which NHS England has been invited to – we should have a better idea of what is going on after that. Subsidising indemnity is one of a range of solutions- I don’t know how advanced discussions are.’

In the light of the mounting pressures GP leaders told Pulse that NHS England should seriously consider subsidising the cost of indemnity.

NHS Alliance chair Dr Michael Dixon said: ‘[NHS England] must take it seriously – anyone who does out of hours work is being hit hard and if the seven-days policy is seriously being taken forward then indemnity has to be paid for. It has to be done and quickly, otherwise it is just another extra demand on practices.’

Last week the Family Doctor association said indemnity fees had leaped up by one quarter in the last year. Its figures showed that the average annual fee for a GP doing 10 sessions a week had gone up to £11,320 in 2015, as members’ annual cost per session rose from £869 in 2014 to £1,132 in 2015.

Medical defence organisations say this is driven by a 10% year-on-year rise in claims, but some GPs have decided to shop around for indemnity with private insurers in response to increases.

An NHS England spokesperson said: ‘We understand the impact of indemnity costs on general practitioners and it is a priority issue for us to resolve. We are exploring options for how indemnity schemes could be developed.’

The cost of indemnity for new staff groups, such as physician associates and pharmacists, is a further concern to GPs.

A spokesperson for leading defence organisation MDU said that ‘the increasing reliance on nurse practitioners and the broadening of their clinical role is evident from the increasing number of claims we are seeing arising out of their involvement in clinical care’, adding that: ‘We expect to see a similar pattern in relation to other new roles that emerge.’

Physician associates will either have to cover their indemnity costs themselves or be covered by a practice as an employee, a cost which will put further pressure on already stretched practice budgets, said Dr Dixon.

He said: ‘Practices already cover their nurse practitioners is something happens – I assume physician associates will be looked after the same way. It will put the cost of practice policies up however.’

The NHS England spokesperson said: ‘We are keen to work with stakeholders to address the barriers to implementing new models of care and developing an extended workforce in primary care. This will include how better we can address indemnity costs, but at this stage it is too early to advise how this may work.’

A GP leader who wished not to be named said: ‘I have been assured by someone at NHS England that this is something they are taking seriously and are considering funding.’

Dr Charles Alessi, vice-chair of the National Association of Primary Care said that NHS England ‘could well be the right place for funding to come from’ but noted that other options were likely to be considered.