Skill mix in GP practices is under threat because of the soaring cost of indemnity not just for GPs, but for the wider practice team, NHS Alliance co-chair Heather Henry told GPonline.
One in three GPs say that their medical indemnity fees have increased 20% in the past five years, this website revealed last summer. Fees for nurses have also been rising fast, Ms Henry warned.
'Members of the NHS Alliance general practice nursing network have told us that they have seen increases in insurance premiums increase to up to £6,000 per annum for nurses who are non medical prescribers and for advanced practitioners,' she said.
'Members claim that such hikes in insurance make nurses with advanced qualifications less attractive to GP employers. This has the effect of diluting skill mix and GPs will therefore continue to struggle with their workload rather than be able to delegate to a nurse.'
The comments from NHS Alliance co-chair Heather Henry come after GPonline reported that crown indemnity could be offered to practices that adopt a new national GP contract being rolled out for new care models.
The voluntary new contract - which could be unveiled as part of a support package for primary care expected to be announced soon - would move away from individual practice contracts to a model in which multiple GP practices covering up to 50,000 patients would operate under a collective deal.
Ms Henry warned that extending crown indemnity to practices within a new care model but denying it to others within the local area could create a 'postcode lottery'.
New GP contract
'Crown indemnity is being considered as part of the new GP contract being offered to groups of practices organised into multispeciality community providers,' she said. 'In my opinion the scheme would benefit all practices - not just those involved in new models of care. My fear is that otherwise there would be a postcode lottery, with smaller practices unable to afford advanced nursing care.'
Ms Henry added: 'Practice nurses working for smaller employers often need the most support. We must avoid widening inequality for both practices and the populations they serve. Employers, LMCs and CCGs need to offer support to all practice nurses in their area so they receive clinical updates. Employers need to take revalidation seriously so that nurses can continue to develop and adhere to the code of practice and in this way litigation risks are also reduced.'