What is the winter indemnity scheme?
NHS England first established a winter indemnity scheme to subsidise costs for GPs working in out-of-hours and unscheduled care in 2015. Funding for this year’s scheme is £10m.
This year's scheme runs from 1 October 2018 until 31 March 2019 and it covers the cost of professional indemnity for any additional out-of-hours, unscheduled care or extended hours work taken on by GPs if this is not provided by the employer and not already covered by your existing indemnity arrangements.
NHS England defines out-of-hours or unscheduled care as services providing primary care 6.30pm to 8am on weekdays, or any time at weekends and bank holidays. It also includes unscheduled care providers, which provide services at any time of the day to patients not registered with the provider and where clinicians may only have limited access to clinical records.
For the first time this year's scheme covers extended hours, where patients might be pre-booked and GPs will have access to the full patient record and be seeing a mix of patients similiar to routine in-hours care.
The scheme only covers GP sessions, not other healthcare professionals such as advanced nurse practitioners, pharmacists or paramedics.
How can GPs access the scheme?
GPs should access the scheme via their medical defence organisation. The MDOs then claim back reimbursement for these sessions from NHS England.
GPs must have agreement from their out-of-hours or unscheduled care provider to apply for additional sessions under the scheme before any work is carried out. They should also check that their provider falls under the winter indemnity scheme.
NHS England says retrospective cover is ‘strictly prohibited’. It advises GPs to ensure they have cover in place as soon as possible and regularly review their requirements so they can gain access to further sessions when needed before they are undertaken.
GPs have to provide consent for their MDO to share their details (their name and the place they expect to work) with NHS England to enable audit checks to take place.
What do the defence organisations say?
Details of where to apply for the funds from each defence organisation can be found below.
The MDU says its members ‘can work the requested sessions pending our confirmation that your application has been accepted, as long as we have not previously declined to indemnify any aspects of your GP work’. If the MDU has previously declined to indemnify aspects of your work you must wait for confirmation that you are eligible for the scheme before you work the requested sessions.
MDU members are also required to use a log to record the sessions they work and at the end of the scheme provide the MDU with a copy of this. If you want to change the number of sessions you have applied for, or intend to work for other providers, you will need to complete another application form, which will replace the initial application.
Medical Protection requires its members to request a call back from a member service adviser to take part in the winter indemnity scheme. You will also need to request a call back from the link below if your situation changes and you are no longer able to undertake the sessions agreed or would like to increase the number of sessions you work.
The MDDUS requires members to fill out the application linked to below. As with the other MDOs, GPs must confirm details with the provider they are working for prior to applying and contact the MDDUS again if their plans change and they wish to work more or fewer sessions, or work for another provider. The MDDUS provides additional cover in blocks of 8, 16, 24 or 32 sessions.
GPs who are members of the Medical Defense Society can also access the scheme - details of where to apply can be found below.