State-backed indemnity will be paid for from existing GP funding

The state-backed GP indemnity scheme due to begin from next year will be funded 'from existing resources allocated for general practice', the government has confirmed.

No new money for indemnity deal (Photo:
No new money for indemnity deal (Photo:

With just over four months to go until the scheme is due to start, the government has yet to reveal in detail how it will work - but a document released on Thursday confirms that it is unlikely to be paid for with new money.

A set of 'frequently asked questions' published by the DHSC reveals: 'Our intention is that individuals covered by the scheme will not be required to make any payments into the scheme. We would expect funding for the scheme to come from existing resources allocated for general practice, and discussions are ongoing with the GPC.'

GPonline revealed last month that existing practice income could be top-sliced to fund the state-backed GP indemnity scheme, and reported last week on warnings that partners could face a substantial pay cut if funding for the scheme was stripped from global sum payments to practices.

Indemnity costs

An element of funding in the current GP contract is related to indemnity costs that were reflected in the pre-2004 Red Book contract, although costs have risen substantially in recent years. Practices have also received extra funding to cover increased indemnity costs in recent years - with £30m for 2016/17 and £60m for 2017/18.

These elements of pay are likely to be factored in as the government calculates how to pay for the state-backed indemnity deal first announced by former health secretary Jeremy Hunt in October 2017.

Meanwhile, the government revealed on Thursday that overall funding for primary and community care is set to rise by £3.5bn over the next five years. The share destined for general practice has not been made clear - but part of this funding could help fund the indemnity scheme.

GPC chair Dr Richard Vautrey said last month that discussions were ongoing about how the cost of state-backed indemnity would be 'shared'.


The update published by the government reveals that 'subject to satisfactory agreement on funding, the scheme will cover clinical negligence liabilities of general practice staff delivering primary medical services commissioned under GMS, PMS and APMS contracts and any integrated urgent care delivered by general practice through schedule 2L of the NHS standard contract'.

The document advises GPs to contact their current medical defence organisation to confirm whether they will receive any rebate of fees paid to date for indemnity when the scheme is introduced.

It says: 'On the launch of the scheme, you will be covered for any clinical negligence arising from the NHS activities that are within scope of the scheme. You may need to continue with your current indemnity or other arrangements in respect of activities and services not covered by the scheme.

'The precise rebate arrangements (if any) that may be provided by MDOs will depend on the approach taken by the relevant MDO. Where indemnity is paid for in advance for a whole year, some MDOs have stated publicly that they will reimburse doctors for the portion of cover they will no longer require once the state scheme begins. You should check the arrangements relating to rebates with your MDO or insurer.'

The BMA has estimated that the average annual indemnity fee for a GP in England rose by more than 50% between 2010 and 2016, with further rises since then.

GPC chair Dr Richard Vautrey told GPonline: 'Indemnity continues to be one of the biggest concerns of GPs, and especially partners, as they face rocketing bills purely to be able to their jobs.'

He added that the precise detail of the deal remained 'subject to negotiations', but the GPC has warned previously that any deal must ease the burden of rising indemnity costs that has been a factor driving doctors out of the profession in recent years.

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