All Change in the World of Primary Care Protection

All Change in the World of Primary Care Protection

Written by Robert Lynch, Managing Director

Medical indemnity protection has become increasingly topical as primary care responds to NHS England’s General Practice Forward View and extends the scope of services provided as well as the clinicians who provide it. MIAB's MD, Robert Lynch, explains what's going on.

Multispecialty Community Providers (MCPs) and the Primary Care Home model (PCH) are prompting consideration of risk, exposure and cover required to protect staff as well as the corporate entity itself in respect of its vicarious liability.

All this is compounded by the inexorable rise in the cost of indemnity traditionally provided by the three medical defence organisations (MDOs). Earlier this year a survey in Pulse of 900 UK GPs reported an average annual membership fee increase of 26%, and worryingly more than a quarter of respondents saw hikes in excess of 40%.

Estimates vary, but it is thought that 97% of medical professionals arrange their indemnity protection via MDOs with the remainder obtaining cover under an insurance-backed contract.

Insurance-backed cover, which is the norm in most other countries, is little known here but a perfectly acceptable alternative, and more and more medical professionals are considering such protection for specific areas like Out of Hours because of its relative affordability.

One of the key differences is that insurance protection is regulated by the FCA and also legally enforceable. Insurance contracts give clear definitions of what is and isn’t covered so the insurer cannot turn down a claim if it falls within the terms of the policy.

Conversely, MDOs’ cover is discretionary, so claims are only settled after agreement by the Board. This lets them consider each case on its merits but also allows them to decline to assist.

It is reported that few GPs understand that their MDO cover is discretionary, meaning there is a possibility (however slim) that cover may be declined with absolutely no redress (even though this is mentioned on application forms, websites and documents etc.).

While there are only three MDOs, there are a number of insurers, ranging from blue-chip household names to specialist Lloyd’s of London syndicates; because of this, customers can compare cover, shop around and get a good deal, keeping prices competitive.

For provider companies and federations that require protection against the actions of their employees (vicarious liability), there is a greater array of choice: many insurers offer it, as in fact do MDOs, having reacted to market demand. However, invitations to tender for the provision of services often stipulate a professional liability insurance policy is in place, as opposed to discretionary cover, ensuring contractually-reliable consumer protection.

While the majority of practitioners are reluctant to change indemnity cover, many are telling us that the price rises are forcing their hands. If you’re looking at this option, it is advisable to use a broker who can assess your requirements, has access to a variety of insurers and policies, and ensures cover is suited to your needs.

Find out about MIAB's Indemnity products or read more about MDOs v Insurance Policies.

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