GP indemnity: State deal 'a natural step' as integration blurs NHS boundaries

A state-backed GP indemnity scheme feels like a natural step as the divide between primary and secondary care is eroded, says Medical Protection Society (MPS) chief executive Simon Kayll. But further reforms are needed to cut the overall NHS bill for negligence claims.

Medical Protection Society chief executive Simon Kayll
Medical Protection Society chief executive Simon Kayll

The government’s decision to change the discount rate significantly increased the cost of settling claims where there is an element of future care costs or loss of earnings, at a time when the cost of clinical negligence was already at risk of becoming unsustainable.

The fact that the government has recognised the importance of protecting GPs from the increased costs, after months of discussions, is positive. MPS has been clear from the outset that GPs should not have to shoulder the financial burden.

The support solution proposed – an extension of NHS indemnity to GPs in England – would, in time, deliver access to state-backed indemnity for all NHS doctors in England, and will be welcome news to many GPs.

NHS reforms

It will also feel like a natural step for many. The line between primary and secondary care in the UK has become increasingly blurred following NHS reforms. Indeed NHS England stated in last year’s GP Forward View that GPs should be ‘no more exposed to the rising costs of indemnity than hospital doctors’.

State-backed indemnity for GPs also builds on the government’s winter indemnity scheme, which has for the last three years provided welcome, additional indemnity funding for unscheduled care undertaken by GPs, helping to enable a well-staffed and flexible workforce during the difficult winter months.

There are a number of decisions yet to be made, around the cost of the new scheme and how it will operate. It is important that the government develops this detail as soon as possible - GPs will need certainty that the ‘small print’ is fair and meets their needs and we will continue to push the government to ensure this happens swiftly.

We do however know that assistance with complaints, GMC inquiries, inquests and disciplinary proceedings would not be included in the scheme, and we would continue to offer this support to GPs, just as we have for hospital doctors since NHS indemnity was introduced for them in 1990.

As with hospital doctors, the new scheme would also only be provided for NHS contracted work. Non-NHS work - such as providing tele-consultations for private firms, writing medical reports or doing medicolegal work - would still require separate, adequate claims indemnity – all of which MPS would continue to provide to its members. Furthermore, as it is likely to be 12-18 months before the new arrangement is in place, it is essential that GP members maintain their existing level of indemnity until it comes into effect.

Indemnity costs

When considering the catalyst for government action – the change to the discount rate, exacerbating an already challenging claims environment for GPs – many may ask whether a new scheme would reduce the cost of clinical negligence. Unfortunately, despite this important development, a new indemnity scheme would not solve the underlying issue of rising clinical negligence costs. The cost of claims will always need to be paid for, and will continue to increase unless the root of the issue is tackled. Transferring the risk to a different provider does not change this.

The need for whole system legal reform - to achieve a balance between compensation that is reasonable but also affordable – is becoming more urgent. In fact, there has never been a more important time. Our Striking A Balance campaign launched in June sets out how legal reform could work and we stand ready to work with Government on this.

We are also calling on the government to urgently reform how the discount rate is set. They have committed to doing so, and this is welcome, but the timescales are unclear and costs will continue to rise in the meantime. Furthermore, a return to the pre-existing rate is highly unlikely.

Ultimately, we want to ensure any new indemnity scheme provides our GP members with the best possible protection against claims, while delivering a smooth transition to the new arrangement once it is up and running. We are committed to securing the best outcome for our members.

Some of your questions will be answered on our dedicated web page, and we will provide a further update in the next few days.

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