GP medico-legal fees will fall 80-90% under state-backed indemnity

GPs in England and Wales will pay 80-90% less for medico-legal cover from 1 April as state-backed indemnity takes effect, GPonline can reveal, with costs for some full-time GPs falling well below £1,000 a year.

Falling costs (Photo: Martin Nancekievill/Getty Images)
Falling costs (Photo: Martin Nancekievill/Getty Images)

Responses from the three main providers of medico-legal cover suggest that the rate for eight sessions of NHS work will fall below £1,000 for some GPs, with additional costs depending on individual circumstances.

BMA leaders have suggested increased competition from new entrants to the market for medico-legal cover is likely to add to downward pressure on fees - and an insurance broker firm offering cover for GPs told GPonline it was offering a package for less than £1,000 per year, or potentially as little as half that amount for non-NHS work only.

GPs part-way through an annual indemnity package as the state-backed deal kicks in next month may also be in line for refunds on fees paid in 2018/19, defence organisations have confirmed. Partners could also see significant additional savings as practices benefit from reduced costs for indemnifying salaried GPs and practice staff.

State-backed indemnity

The state-backed GP indemnity scheme that takes effect from 1 April will cover the cost of clinical negligence for GPs and other practice staff carrying out NHS work - but GPs will need to maintain cover for non-NHS work, GMC representation and other matters.

The MDDUS confirmed that 'in some cases, GP members will be paying approximately 10%' of the fees they have paid to date once state-backed indemnity takes effect. The MPS confirmed that 'a GP working eight sessions can expect their subscription to be less than £800' - roughly 10% of the £8,000 estimate quoted by the BMA last year for average annual GP indemnity costs - plus a supplement for 'fee-paying or private work'.

The MDU told GPonline that its 'new subscriptions are generally over 80% lower than the subscriptions in place in 2017 when state indemnity was announced'.

This website revealed on Tuesday that GPs due to renew their indemnity cover in April had begun to receive letters from MDOs confirming rates that would take effect under the state-backed scheme.

Reduced costs

One London GP working eight sessions a week had been told his fees would drop to £1,360. This GP was previously paying around £4,500 per year under the MDU's half-price 'transitional benefits' scheme - equivalent to £9,000 under traditional 'occurrence based' indemnity cover - effectively an 85% cost reduction compared to the situation before plans for state-backed indemnity emerged.

The BMA's GP committee chair Dr Richard Vautrey said yesterday the union had 'always been suggesting [fees] would be around £1,000' - and the information put together by GPonline suggests that the major reductions in costs GPs have been hoping for are beginning to materialise under the revamped indemnity model.

When former health secretary Jeremy Hunt announced plans for state-backed GP indemnity in November 2017, he acknowledged that GPs were being forced out of the profession by soaring fees. GPs were paying around £8,000 on average per year and rising following sharp increases that saw fees rocket by 50% between 2010 and 2016.

MDDUS chief executive Chris Kenny said: 'As our GP members require benefits for fewer services and a much lower risk it is inevitable that their fees will reflect that change.

Variation in fees

'In some cases, GP members will be paying approximately 10% of their previous amount to continue their membership with our new product. Fees will reflect individual circumstances and the level of cover required for the services the GP is providing.'

MPS chief executive Simon Kayll said its GP members would received personalised letters setting out new subscription rates 'in the next couple of days. He said: 'A GP’s subscription will depend on a number of factors including the amount of private or fee paying work they undertake and the number of sessions they work.

'As an illustration, a GP working eight sessions can expect their subscription to be less than £800. This subscription includes advice and support with medico-legal issues from their NHS and private work as well as our 24-hour medico-legal advice line and risk management support.

'If a member carries out fee paying or private work they would need to add protection for any claims that may arise from this activity. The cost of this additional claims protection is dependent on their earnings from private or fee paying work. GPs can earn up to £2,500 from standard GP fee paying work for a subscription cost of £90. We expect that this will be adequate for many Medical Protection members. Those doing more private work can seek a tailored quote online or by calling our Member Services team.'

An MDU spokesperson said: 'NHS GP members working in England and Wales can expect to benefit from very significantly reduced subscriptions with the introduction of state-indemnity for NHS claims, even compared to the MDU’s previous transitional benefits rates which were themselves around 50% below our previous occurrence rates. Our new subscriptions are generally over 80% lower than the subscriptions in place in 2017 when state indemnity was announced.'

Tristan Lennox-Gentle, a director at specialist insurance broker MIAB told GPonline the company was offering GPs a 'two-stranded' policy with a legal defence element and a clinical negligence element for a total of less than £1,000 per year.

He said the firm could provide GPs wanting 'a good value product that covers only legal liability and defence' cover at a fixed price of 'less than £450' per year irrespective of the number of sessions worked. However, he said that although this option alone may be suitable for some doctors carrying out no non-NHS work whatsoever, his preference was to provide the two-part package of cover comprising the basic legal element and a 'malpractice element'.

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