State-funded indemnity scheme

The MDOs are in the later stages of pricing their post-April product.  GPs should remain members of one of the MDOs to ensure they have cover for GMC, criminal/coroners cases, private reports/HGV medicals etc.  There will be a competitive market for this cover after April and this is likely to influence pricing decisions.  In the meantime, all indications suggest the market rate for this cover is likely to be broadly in the £800 - £1,200 range.  Renewals falling due before April 1st are likely to be in line with current costs.

For GPs working in community hospitals the intention behind the agreement with NHS England is that all roles will be covered by state indemnity.  There will be two sorts of state indemnity: the Clinical Negligence Scheme for Trusts (CNST - currently and loosely referred to as Crown Indemnity) and the Clinical Negligence Scheme for GPs (CNSGP).  Both of these are or will be administered by NHS Resolution (NHSR).  People working in these settings will need to be aware of which arm of NHS Resolution will be providing their cover, but GPC has been assured that there will be no gaps between CNST and CNSGP.  However, the detail of whether the GP is to be covered by CNST or the new CNSGP is not yet settled. 

Currently GPs working in community hospitals, A&E and urgent care centres may be doing so under a number of arrangements, the most common being either direct employment by the trust of the GP or a sub-contracting arrangement from the Trust to a practice or other provider (with whom the GP may be a partner or salaried). It appears that to date both of these arrangements have generally seen GPs being indemnified through their own MDO, although not in all circumstances.  In general, where the engagement is direct along the lines of an employment/locum basis then these arrangements would ordinarily need to be covered under CNST.  This may represent a change for some trusts who may not have been offering this to date.

All trainees will be covered for clinical negligence under the CNSGP scheme.  DHSC has assured the GPC that no doctor will be out of pocket as a result of the introduction of the scheme. There is a patchwork of arrangements in operation by different deaneries with some buying block products for their trainees.

The NHSR webpage on CNSGP has gone live and includes advice on scope:

https://resolution.nhs.uk/services/claims-management/clinical-claims/clinical-negligence-scheme-for-general-practice/

There is also an email address for queries of all types including scope:

CNSGP@resolution.nhs.uk