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GP indemnity fees ‘up by one quarter’ in just one year, says FDA

GP indemnity costs have increased by 25% in just one year, a snaphot survey of members of the Family Doctor Association (FDA) has shown.

The survey of 96 GPs, carried out at the end of August, revealed 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.

The survey did not distinguish between in and out-of-hours cover in reaching the calculation, but FDA said most respondents did ‘little’ work out of hours.

However, the FDA said it was ‘of concern’ that GPs were being charged more for out-of-hours, and that some indemnity providers were also charging these more expensive rates for ‘extended hours’ work – an issue the GPC has previously raised in light of the Government’s rollout of seven-day GP appointments.

In response to the statistic, FDA chair Dr Peter Swinyard said the Government must look at the ‘frightening’ increase and consider alternative schemes to pay for GP indemnity.

Dr Swinyard said: ‘It is grossly unfair that indemnity cover for NHS work is only paid personally by GPs. All hospital staff enjoy cover from the Crown Indemnity scheme, although many “top-up” their cover through the mutuals.

‘Insurance in the open market is prohibitively expensive and has caused the retirement of doctors who cannot afford the fees or the risk of the excess payments. NHS England and the three devolved administrations must accept that NHS work requires NHS cover and bring GP cover in line with hospital doctors.’

A majority of respondents to the FDA survey indemnified for 7-9 sessions of clinical work across 4-5 days per week, with the main three medical defence organisations, although two GPs indemnified with a commercial insurance company.

The statistics come after Pulse reported on a GP quoted £30,000 a year by a defence organisation to be indemnified to work out of hours earlier this year, and as a recent survey showed four in five GPs have limited their work out of hours due to concerns over indemnity costs.

NHS England has acknowledged GPs’ concern but has made no indication as to whether it will subsidise costs going forward, following a completed pilot of covering the cost of GPs working out of hours briefly during the winter period.

Although the GPC are in talks with NHS England about possible solutions, LMC leaders warned of potential downsides of joining the crown indemnity scheme at LMCs Conference this year, including GPs potentially forced to accept sanctions or settlements to keep costs down for the NHS.

Pulse has already revealed is becoming increasingly common as GPs look to alternative provides to reduce spiralling indemnity fees, or tailor their cover.

Commenting on indemnity fees in general, GPC executive member Dr Beth McCarron said: ‘Medical indemnity costs are now more than a month’s drawings. I’ll have to work over a month for nothing every year just to insure myself, that is just not sustainable and we need urgent investment in core general practice and real urgent solutions to the spiralling costs of indemnity.’

MDU director of professional services Dr Matthew Lee said: ‘With claims inflation rising at 10% each year, this inevitably must be reflected in indemnity subscriptions. The MDU is campaigning for legal reform.’

MPS medical director Rob Hendry said: ‘The sad reality is that GPs are more likely to be sued now than ever before and a GP can now expect to be sued twice over an average career… Each individual’s subscription rate is considered on its own merit and MPS does not apply out-of-hours rates to all GPs working extended hours.’

MDDUS chief executive Chris Kenny said as long as GPs were providing predominantly non-emergency work within extended hours and had access to full patients records these sessions would be treated the same as in-hours work.

He said: ‘MDDUS charges subscriptions that are based on a detailed consideration of likely future costs.’