Exclusive GPs are being billed inflated indemnity costs to extend their cover for seven-day working as they are based on out-of-hours premiums, the GPC has claimed.
The GPC said some GPs are being charged higher fees for covering the extra sessions because medical defence organisations were basing the costs on risk algorithms developed for urgent out-of-hours work – even though the work involved delivering predominantly routine, non-emergency care.
Medical defence organisations insisted they did not necessarily class the extra sessions as out-of-hours work, but consider fees on a case-by-case basis.
It comes as the GPC is beginning work on looking at indemnity fees and how they can be reduced for GPs. Pulse has previously reported that out-of-hours GPs have been quoted premiums of up to £30,000.
But the GPC has said that the medical defence organisations are lumping routine weekend working in with out-of-hours care when calculating risks in many instances.
Dr Dean Marshall, a lead negotiator for the GPC on contracts and regulation, told Pulse: ‘Because people are now say, doing Saturday morning surgeries in a network, the defence bodies don’t have any historical risk data so what they do is basically say that’s the same as out-of-hours. And it’s not – often you will be sitting seeing booked patients.’
The GPC is in talks with the defence bodies to try to resolve the issue, Dr Marshall said, but he warned GPs to be ‘absolutely clear’ in the meantime what the work they are doing involves before getting cover.
He said: ‘What we’ve been saying to the medical defence organisations is they need to look at the way they assess risk. We’re not criticising them, but we they need to be absolutely sure that their assessment of the risk is based on an understanding of what the GPs are actually doing.’
The extra costs for extended hours add to the growing crisis in securing indemnity cover, which has led to GP leaders warning that some out-of-hours services could be left completely unmanned and this year’s LMCs conference voting to consider a move to crown indemnity.
The GPC is planning a symposium in mid-September, bringing together the medical defence bodies, NHS England and the NHS Litigation Authority, in an attempt to resolve some of the problems.
However, Dr Marshall warned the latest issues could ultimately make the Government’s plans for extending working hours unviable.
Dr Marshall said: ‘There is a fair amount of money being thrown at it just now, but once that money is stopped people will realise it may not be viable because of the additional costs.’
Medical defence bodies insisted that they did not uniformly apply ‘out-of-hours rates’ to extended hours work and considered each GPs’ case individually.
Dr Iain Barclay, head of medical risk and underwriting at the Medical Protection Society, said: ‘Membership subscriptions are set fairly to reflect the level of risk experienced by each area of practice. The subscription rate for GPs are each considered on their own merit and MPS does not apply “out-of-hours” rates to all GPs working “extended hours”.’
A spokesperson for the MDDUS said: ‘We are pleased to reassure our members that work undertaken in “extended hours”, where a GP is providing predominantly non-emergency care and has access to full patient records, will be treated the same as sessions undertaken within the normal working week for MDDUS subscription purposes.’
The spokesperson added: ‘We would assess the risk on a case-by-case basis and provide an individual subscription for the GP concerned.’
The Medical Defence Union issued the following statement: ‘We tailor our subscriptions to our individual member’s needs. If members have any queries about their subscriptions we would encourage them to contact us.’