Exclusive A practice has seen the indemnity fees for its advanced nurse practitioner rise by £7,000 in 12 months, despite having had no problems during the year, leaving it struggling to pay the fees.
The advanced nurse practitioner (ANP) was told by the Medical Defence Union that the fee had gone up to £7,995 for annual cover this year – the equivalent of four months’ salary – despite previously paying less than £900 last year for cover in the same job.
It comes as there have been fears about the costs of indemnity for other practice staff, such as ANPs and physician associates, with the Government promoting them as being the best way to fill gaps caused by the shortage of GPs.
The GPC said that the only way to stop escalating indemnity fees for all GPs and practice staff is for the Government to pay the costs or to cap legal costs.
Rachel Drago, an ANP at the Clarence Park Surgery in Weston Super Mare, said the practice had traditionally paid her fees but added that it simply could not afford the bill.
She said: ‘The practice would pay it tomorrow if they could. But we don’t have the money. We are a tiny practice.’
She said she was not given any prior warning of the increase in her subscription fee by the MDU. Instead, she received a bill for £7,100 the day after her indemnity cover was due for renewal – and was informed the MDU had already taken a first instalment of £795 via her existing direct debit agreement.
Mrs Drago – who has more than 10 years’ experience in general practice – said she was told the increased fee was based on her work in a ‘high-risk, non-indemnified environment’.
Mrs Drago said she had not been able to negotiate an alternative quote from the MDU and was still attempting to find cover elsewhere, but had been told ANPs would automatically be facing quotes in the region of £4,000 to £10,000 from any indemnity provider.
She told Pulse the fees hikes would see ANPs left with no choice but to consider leaving general practice altogether.
When I take into account all my other costs, it is barely worth me going to work
She said: ‘When I take into account all my other costs, it is barely worth me going to work. How many other professions have to give up four months’ salary to perform their job?’
Dr Peter Maksimczyk, a GP partner at the practice, said Mrs Drago had been an excellent ANP, and there had been no issues with her.
But he added: ‘We haven’t worked out who will pay it. It is the equivalent of a 20% salary increase.’
‘They’re bringing in physician associates – but who will pay for this?’
The ANP indemnity hike comes amid a crisis in indemnity for practices that has seen GPs given quotes as high as £30,000 for doing out-of-hours work, and will cast doubt on the government’s programme to bolster general practice by expanding roles of pharmacists, nurses and physician associates (PAs) employed within practices.
The MDU said in a statement: ‘We cannot comment on individual subscriptions but we would encourage any member with concerns about their individual membership to contact us to discuss the indemnity options available to them.’
Dr Richard Vautrey, deputy chair of the GPC, said the rising legal fees were a ‘rate-limiting factor’ for the government’s plans for expanding non-GP roles in practices, as well as other initiatives such as extended practice hours.
He added that either the government would have to find a solution, either by paying indemnity of GP staff ‘or by cutting the costs of indemnity’, which can only be done by legal reforms, ‘or capping legal costs, in the way other countries have done’.