Negotiations continue as legislation for state-backed GP indemnity takes shape

Legislation paving the way for state-backed GP indemnity in England has been put in place, just over a month before the scheme takes effect - but talks are ongoing about the cover it will provide.

A document laid before parliament on 25 February outlines the state-backed GP indemnity scheme that will take effect from 1 April.

The 'explanatory memorandum' says: 'These regulations establish an indemnity scheme for general practice that will be administered by the secretary of state for health and social care. The scheme provides cover for future clinical negligence liabilities of general practitioners and others working in general practice in respect of activities carried out for the purposes of the national health service in England. The regulations will come into force on 1st April 2019.'

Medico-legal experts have welcomed the legislation being put in place - despite concerns from some about its 'unproven nature' compared with existing indemnity arrangements.

Clinical negligence

The document confirms that the scheme will cover 'liabilities for clinical negligence arising from the activities of not only GPs but also of any other person working in a general practice setting (including locums, trainees, dispensing doctors, nurses and clinical pharmacists)'.

The five-year GP contract deal published at the end of January made clear that the scheme would be funded by a one-off adjustment to global sum funding for practices - although overall investment is intended to leave GPs with a 1.4% increase in contract funding even after this is deducted.

However, with just five weeks to go until the scheme is set to take effect, the document put before parliament makes clear that negotiators have yet to agree in full the extent of cover it will provide. Medical defence organisations have been in discussions for more than a year with the government over whether the scheme will cover historic liability - and have been divided on this issue.

The document published this week makes clear that although the scheme 'will cover future liabilities of general practice incurred on or after the 1st April 2019, i.e. the date on which the regulations come into force', further work is still being carried out 'with the intention that a state indemnity scheme is established to cover existing liabilities also'.


This suggests that little has changed since a statement from health minister Steve Brine when the five-year GP contract agreement was made public on 31 January. The minister said at the time that the government 'intends to establish the arrangements for an existing liabilities scheme in April 2019, subject to satisfactory discussions with the medical defence organisations'.

MPS medical director Rob Hendry said: 'With less than five weeks to go until the state-backed scheme launches, it is good to see that the legislation underpinning the scheme has now been put in place.

'These regulations make it clear that the state-backed scheme will only provide indemnity against clinical negligence claims which relate to the provision of NHS contracted work. We can’t stress enough that GPs will still need to have their own claims indemnity for any non-NHS work they do – such as providing tele-consultations for private firms, writing medical reports or doing medicolegal work.

'The state-backed indemnity scheme also won’t provide support for things such as GMC inquiries, complaints, inquests and disciplinary proceedings. It is important that GPs maintain membership with an MDO so they can continue to request this support, just as NHS doctors do.'

MDDUS chief executive Chris Kenny said: 'We welcome the long overdue appearance of these regulations to enable the operation of the new scheme. We are also working with NHS Resolution to help in the preparation of more user friendly documentation for doctors.

'What the regulations show is how far the nationalised claims only product falls short of the integrated service currently offered by medical defence organisations.'

Defence organisations have yet to confirm how fees for cover will change following the introduction of state-backed indemnity, although fees are expected to fall significantly. However, GPonline revealed last month that the government had warned that if reduced indemnity costs deliver higher-than-expected profits for practices, money could be clawed back.

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