Good medical Practice reminds GPs of the necessity to have cover for clinical negligence claims to ensure patients have recourse to financial compensation if they are harmed through any negligence in their care, specifically:
101 You must make sure that you have appropriate and adequate insurance or indemnity that covers the full scope of your practice. You should keep your level of cover under regular review.
This used to be provided at significant personal cost to a GP, via cover with their Medical Defence Organisation (MDO) but on 1 April 2019 the Clinical Negligence Scheme for General Practice (CNSGP) was introduced. This is a state backed indemnity scheme run by NHS Resolution, covering clinical negligence claims arising from NHS General practice services.
So, is cover with a MDO no longer required? Does the CNSGP cover the full scope of your practice? No it does not.
Daily general practice includes many activities that may not be covered by the CNSGP. Any issue arising from work that a GP can charge the patient for is automatically excluded by virtue of not being NHS work (otherwise you could not charge for it). Think of insurance forms, private referral letters, letters to “whom it may concern” etc.
The CNSGP provides a helpful table of what is and is not covered in the scheme.
It may seem unlikely that a claim for negligence may arise from such work but consider the following scenarios:
- A patient who comes to harm from delayed treatment, who claims part of the delay was attributable to your alleged failure to include all relevant information on the referral letter to the private consultant.
- Your practice nurse gives a chargeable travel vaccination to your patient who later alleges the vaccine was given incorrectly and they have suffered nerve damage at the injection site
- A patient claims they were sacked from their employment following information in a report you provided which they allege was incorrect.
None of these scenarios would be covered by the CNSGP and could leave you significantly out of pocket even if ultimately the claim is successfully defended. Remember that a claim for negligence does not only arise when there has been actual negligence but when a patient perceives there may have been. It can be several thousands of pounds of solicitor fees later, before it is established that no negligence contributed to the patient’s condition.
It is therefore vital if you wish to avoid unexpected and expensive legal fees to ensure that you have adequate cover for the entirety of your clinical work. This can now be done at relatively minimal expense through professional protection cover with a MDO.
Not only can such cover protect you against the clinical work that is excluded from the CNSGP, but it will also offer you assistance and legal protection if you become subject to professional investigations by the GMC, NHSE or involved in Inquests with your local Coroner. Most MDO’s will also assist in the response to complex complaints, which may precede any claim alleging negligence. A well worded complaint response may prevent the claim from occurring and reduce the likelihood of GMC/NHSE referral regarding the same matter.
If you have any concerns or questions please contact GPSupport@lmc.org.uk and we will be happy to discuss this further with you.