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GP forced to quit out of hours after being quoted £5k indemnity for one session

Exclusive A GP has been forced to stop out-of-hours work after a medical defence organisation quoted indemnity costs of £5,000 annually for one session a week.

The MDDUS had quoted the fee to the GP after she moved from Cumbria to Wales to work for the Betsi Cadwaladr health board, while continuing to work out-of-hours shifts in Cumbria for one session each week.

The MDDUS said doing one or two sessions a week is ‘higher risk’ and therefore more expensive.

But GP leaders, who are involved in ongoing talks surrounding the upcoming state-backed indemnity scheme, said it is an ‘unacceptable predicament’ for GPs to decide what work they can take based on financial implications.

Dr Charlotte Hattersley had been a GP in Cumbria before moving to North Wales to be a clinical lead in the ambulatory care unit at Llandudno General Hospital.

In addition to this, she had sometimes returned to Cumbria to do some out-of-hours work and locuming sessions.

Dr Hattersley told Pulse that she holds a full time contract with Betsi Cadwaladr health board, so the indemnity for her role as clinical lead in a hospital is covered by the Welsh Risk Pool.

But she said since moving to Wales and doing just half a day or one evening of extra work each week has caused her indemnity costs to increase to £100 per session.

She added that she was previously paying about the same figure for multiple sessions per week.

Dr Hattersley said: ‘I don’t know how they justify those costs. I’m active in medical work, I’m keeping up to date and my appraisal is up to date. I’ve had no claims against me.’

She added: ‘I can live without the money. But actually, for out-of-hours saying [to me] can you please help us – I can’t do anything. I’ve chosen not to do any work for desperate practices and desperate out-of-hours services.

‘In an NHS where people are struggling to get those extra sessions in, it’s not financially viable for me to help out – which seems ludicrous in a service that’s creaking.’

MDDUS director of development David Sturgeon, said: ‘When somebody first takes on GP indemnity only doing one or two sessions, as in this case, the cost is initially expensive. Evidence proves there is a higher risk in this scenario and even more especially if that session is out of hours.’

‘The rate structure after this initial step is much more gradual, for example to add another two or three sessions is roughly an extra £300.’

The BMA said they could not comment on specific cases, but said the ‘spiralling costs’ of indemnity is one of the biggest issues that need to be tackled in general practice.

Dr Richard Vautrey, BMA GP committee chair, said: ‘GPs are facing the unacceptable predicament of having to decide what work they take based on the potential financial implications at a time when patient demand is at unprecedented levels.’

‘As general practice continues to struggle to recruit and retain doctors, we also know that unfair and unsustainable indemnity arrangements are having a real impact on how GPs view their future in the profession.’

The Welsh Government also committed to launching a state-backed indemnity scheme, and is working with GPs, MDOs, health boards and the Welsh Risk Pool in order to ensure that GPs in Wales are ‘not at a disadvantage relative to GPs in England’.

What is happening to GP indemnity?

The state-backed indemnity scheme was welcome news to GPs when it was announced last October, following years of rising costs of negligence cover.

However the announcement left many unanswered questions and prompted a mixed response from medical indemnity organisationsas well as caveats from the DHSC.

The DHSC has said the scheme will cover all practice staff, and most recently it told Pulse the scheme may potentially cover both future and historic claims.

GPs have been encouraged to participate in a survey to inform the negotiations.

This comes as, over the past years, GPs have been contending with indemnity cost hikes of up to 25% annually, according to reports.