NHS Resolution moves to allay fears over state indemnity 'small print'

Information about GPs will only be passed to the GMC under 'very rare circumstances' through the state-backed indemnity scheme, according to NHS Resolution.

Indemnity concerns (Photofusion/Getty Images)
Indemnity concerns (Photofusion/Getty Images)

The statement from the NHS organisation that administers the Clinical Negligence Scheme for General Practice (CNSGP) - the state-backed indemnity scheme for GPs that took effect from April - comes after medico-legal experts raised concerns.

The Medical Defence Union (MDU) revealed that it had contacted NHS Resolution (NHSR) over 'serious concerns' about the potential for doctors who provide information in good faith to be referred to the GMC by the organisation providing indemnity for them.

MDU chief executive Dr Christine Tomkins said: 'We are seriously concerned that the body assisting GPs with claims from incidents after 1 April 2019 can use information provided by them in good faith to refer GPs to bodies such as the GMC or NHS England in the public interest. Especially as GPs who don’t provide information requested by NHSR can be refused indemnity.'

GMC referral

The MDU has demanded 'transparency' over how decisions to share doctors' information with a regulator would be made. Dr Tomkins added: 'We expect most GPs have no idea that, if it thinks there is a public interest in doing so, NHSR intends to share information provided for a claim with the GMC or for performers list or other investigations.

'What’s more there are no plans to warn GPs their information is about to be shared or give them an opportunity to comment. We don’t think this is fair.'

But a spokesperson for NHS Resolution told GPonline that under the scheme for hospital doctors, which it also runs, no doctor had been referred to the GMC in more than 20 years.

The spokesperson said: 'The CNSGP is designed to provide more stable and affordable indemnity cover, and NHS Resolution is committed to delivering a high quality service to those working in general practice.

'NHS Resolution would not pass on concerns about a practitioner other than in very rare circumstances, such as a clear risk to patient safety or that of other practitioners. Under the Clinical Negligence Scheme for Trusts (CNST), which makes similar provision, this step has not been taken in the last 20 years.'

Indemnity deal

The MDU's warning over the potential for information to be shared with the GMC came alongside other concerns over the 'small print' of the indemnity deal.

The defence organisation has called for a clear definition of what constitutes an admission of liability by a doctor - amid concerns that doctors' duty to comply in an open and honest way with investigations could leave them exposed under a rule that can deny them indemnity if they admit liability 'without first obtaining the secretary of state's written consent'.

The MDU launched legal action against the government earlier this month over part of the state-backed indemnity scheme. It said that following months of talks the government had 'proposed no scheme that would be acceptable for the MDU's GP members' existing liabilities'.

BMA leaders called the legal dispute 'disappointing' and said GPs would be 'understandably concerned'.

Under the Clinical Negligence Scheme for GPs (CNSGP) in England, which took effect from April, all GPs are covered for NHS clinical negligence claims relating to incidents that happened on or after 1 April 2019.

However, the government has agreed commercial terms with only one of the three main organisations that have provided GP indemnity in recent years. It has agreed terms with Medical Protection (MPS) - but has yet to agree a deal with either the MDU or MDDUS.

As a result, although state-backed indemnity covers 'future liabilities' - incidents from 1 April 2019 onwards - for all GPs in England, it only covers 'existing liabilities' - events before 1 April - for the roughly one in three GPs who are MPS members.

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