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Paying out-of-hours indemnity ‘added 15,000 GP shifts this winter’

Exclusive Over 500 GPs have booked extra out-of-hours shifts under NHS England’s £2m winter scheme to cover their medical indemnity costs.

NHS England told Pulse that 550 GPs in total have made use of the scheme – which pays the indemnity of GPs for extra shifts they take on, and not those they had already had indemnity for – since it was introduced in December. 

This totalled 14,264 extra shifts made available to patients needing out-of-hours GP care, which experts said equates to around one or week’s work of shifts.

The GPC said that the scheme was ‘clearly a step in the right direction’, while medical defence organisations said that they have seen an increase in members taking on cover for out-of-hours shifts since the scheme was launched.

NHS England is set to run the experimental scheme until the end of March while continuing discussions with the GPC on longer-term solutions to the problem of rising indemnity fees for out-of-hours work.

The scheme was introduced after increasing evidence that the cost of indemnity fees was putting GPs off taking on out-of-hours shifts, with a Pulse survey revealing that half of GPs turn down out-of-hours shifts because the cover is too expensive.

NHS England said on introducing the scheme that fees were acting as ’a barrier to delivering care’.

An NHS England spokesperson told Pulse this week: ‘The NHS England winter indemnity scheme is a positive first step. We’re pleased by the response to the scheme, which has helped unlock some of the barriers for GPs to commit to additional clinical sessions in out-of-hours and urgent care centres at this busy time of the year.’

GPC urgent care lead Dr Charlotte Jones said that the scheme was ‘clearly… a step in the right direction’, adding that ‘anything that helps recruitment and retention of GPs whether doing unscheduled work out of hours or in other environments is to be welcomed’.

On the longer-term issue of rising indemnity costs for GPs, she said the GPC was continuing ‘to push for a wide range of options ‘

She added: ‘Reimbursing indemnity organisation fees is personally my preferred option as it means their current provider is continuing to cover the doctors scope of work rather than a hybrid system of cover which could potentially leave the GP vulnerable in the event of a claim.

Medical defence organisations hailed the scheme, with an MDDUS spokesperson saying they have seen ‘a significant number of members applying since its launch’, with the MDU saying ‘the application process is working smoothly and we are still receiving new applications to work additional sessions.’

Urgent care expert Henry Clay, from the Primary Care Foundation, said: ’My conclusion is that NHS England has perhaps paid indemnity fees for enough doctors to cover England with the typical demand on out-of-hours services for between one and two weeks.

The rising cost of indemnity

Money - coins - cash - online

Money – coins – cash – online

Earlier this year, the Medical Defence Union (MDU) told the House of Commons Health Committee that the cost of GP negligence claims is rising by 10% per year.

However, at the same time, a Pulse survey showed GPs were picking up 26% rises to their subscription fees.

Last year, the Family Doctor Association warned of an impending ’meltdown’ in out of hours this winter as a result of indemnity fees rising by as much as a quarter year-on-year, making it unaffordable for doctors to commit to extra shifts.

Longer term solutions proposed by the Department of Health as well as MDOs themselves included fixing or capping legal costs for small-value claims, amid reports of cases where lawyers charged the MDO more in fees than the patient received as compensation.