Table of Contents
Even if you are a safe doctor, indemnity is your extra coverage to protect you as a doctor in the UK in case of clinical negligence claims. Yes, your NHS Trust will have provided you with coverage, but this coverage is more about keeping the hospital happy and safe than it is about ensuring your well-being. That being said, this coverage also only takes into account claims from contracted NHS duties. So let's first list out what IS NOT covered by your NHS professional indemnity:
- defense of medical staff in GMC disciplinary proceedings for stopping at a roadside accident, and other good Samaritan acts not listed in your contract
- clinical trials not covered under legislation
- work for any outside agency on a contractual basis
- work for voluntary or charitable bodies
- work overseas
So at the end of the day, it's better to be safe than sorry, and by keeping an extra coverage over your work, you are ensuring your security.
What is medical indemnity coverage for doctors in the UK?
We know all that doctors work hard to take care of their patient and they are trained to provide the best possible safe care. But things go wrong. Medical Indemnity coverage protects a doctor against claims that arise out of professional negligence and breach of duty from the professional services, such as treatment and care that a doctor have provided to patients.
GMC's Good medical practice requires doctors to have insurance or indemnity in place where necessary.
GMC has regulatory powers to check whether doctors have adequate and appropriate insurance or indemnity.
- check that any doctor practicing in the UK has adequate and appropriate insurance or indemnity cover
- remove a doctor’s licence to stop them from practicing altogether, if they learn that they don’t have adequate and appropriate insurance or indemnity or if they fail to give us the information asked for
- refuse to grant a licence to a doctor if they can’t assure them that they’ll have the adequate and appropriate insurance or indemnity in place by the time they start practicing in the UK.
A doctor must have adequate and appropriate insurance or indemnity in place when they start to practice medicine in the UK. Under the law, a doctor must have cover against liabilities that may be incurred in practicing medicine having regard to the nature and extent of the risks. The type and level of insurance or indemnity a doctor requires depends on factors including where a doctor works, whether they are employed (and, if so by whom and for what services) or self-employed, and the nature of work they do.
Does NHS provide professional indemnity to doctors in the UK?
NHS bodies and organisations are financially responsible for the clinical negligence of their employees. All NHS Trusts/ Health Boards in England, Scotland and Wales are members of the state-backed NHS medical schemes.
- In England, indemnity is provided through the Clinical Negligence Scheme for Trusts (CNST), which is administered by the NHS Resolution.
- In Wales, indemnity is provided through the Clinical Negligence Scheme for Trusts and Health Board by Welsh Risk Pool Services.
- In Scotland, indemnity is provided by the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS). NHS National Services Scotland is the Scheme Manager, with the Central Legal Office providing legal advice and guidance to Health Boards.
- In Northern Ireland, each health and social care trust provides its own indemnity, funded by the Department of Health, Social Security and Public Safety.
The legal and professional requirement that all individual doctors hold adequate and appropriate clinical negligence indemnity cover is fulfilled through their Trust/Health Board, either through their membership of an NHS scheme or arranged directly.
Source: NHS Medical Indemnity
But as mentioned earlier, it is still a better option to have additional indemnity coverage to cover all your work scopes.
Is Insurance different to Indemnity?
- Indemnity works on the basis that the claim is covered as long as the cover was in place when the incident occurred, rather than when the claim is made.
- Insurance is like your car insurance - you are only covered whilst the policy is in place and/or for a defined period after, called “run off”.
- Any insurance arrangement needs to ensure cover is provided for any incidents, no matter how long after the incident the claim arises.
- The run off period is insufficient in most insurance policies. There can often be a delay in a claim arising particularly in some cases involving children where it can be 10-20 years.
- The three major Medical Defence Organisations (MDOs) provide indemnity cover and not insurance.
- Insurance companies may limit the level of cover or have certain exclusions.
- The three key questions to ask about insurance apart from ensuring the cover is adequate are:
- Will it cover me for criminal investigations?
- Will it cover me for GMC investigations?
- How long is the run off period?
So, it's better to sign up for indemnity, not insurance.
What should be covered by indemnity?
- Medical Negligence Claims.
- Criminal and GMC investigations.
BMA (British Medical association) is a trade union and it does not cover medical indemnity for professional negligence claims for doctor in the UK but it's function is to protect you in other ways. From rota discrepancy, contract checking, dealing with maternity pay to salary related issues to lobbying with related stakeholders regarding the overall well being of doctors in the UK is looked after by BMA.
Join the BMA now. Currently it's free to join until 1st of October 2020.
How to apply for Indemnity coverage?
Firstly you must decide who to apply with. The organizations most of us tend to go for are as follows:
- Medical and Dental Defense Union of Scotland (MDDUS)
- Medical Defense Union (MDU)
- Medical Protection Society (MPS)
It's best to obtain quotes from each, and see which company provides you with the coverage you need for the fee you're willing to pay. Ensure you complete the applications keeping in mind what your role in the hospital is and your title as well, so that you can get the most accurate quote.
So the steps on how to obtain indemnity coverage are as follows:
- Decide on an indemnity organization
Contact several organizations, through their website in order to obtain a quote.
- Provide accurate information in the application
Make sure you give your correct role in the hospital, as well as provide the correct information for all of the questions asked.
Select an organization that works best for you, be it on cost, or the level of coverage you hope to receive. In general, all tend to work in the same way, but personal preferences and first-hand reviews should always take precedence to cost.
- Setting up payment
Submit your application and set up a payment system. Direct debit tends to be the easiest.
- Update as needed
Make sure to update your insurance coverage and profile information as your career progresses and your job changes.
When should I review my indemnity arrangements?
You should do this at regular intervals and whenever your scope of practice, private practice income or employment or contractual arrangements, change.
The terms of your insurance or the scope of your indemnity protection may require you to tell your provider if certain things happen, such as sanctions being imposed on your registration, or if you join the Specialist Register.
Above all, you should also know how to be safe doctor in the NHS as this can be a completely new healthcare system for you.
So remember that indemnity is for your safety as well as the safety of your patients. It is something you will want to have but hopefully never use!