Indemnity Insurance for GMC Regulated Doctors

Indemnity Insurance for Doctors – GMC Requirements

Doctors Defence Service provides legal services to doctors by way of insurance backed instructions or on a fee paid basis. Doctors Defence Service does not itself provide medical indemnity insurance services, but we can refer doctors to the independent providers (such as those mentioned below), who might be able to provide cover for work as a medical doctor.

Since July 2014, registered practitioners have had to have in place appropriate indemnity cover, pursuant to the Health Care and Associated Professions (Indemnity Arrangements) Order 2014. Some employers, such as the NHS, will indemnify certain types of employment as a routine.

The 2014 changes to the Medical Act 1983 are set out in the original explanatory note that accompanied the 2014 Order:

Schedule 1 contains amendments to the legislation regulating health care and associated professions. Part 1 amends the Medical Act 1983 by substituting a new section 44C (indemnity arrangements) which requires medical practitioners to have appropriate cover under an indemnity arrangement in respect of liabilities which may be incurred in carrying out work as a medical practitioner. The amendment also makes it clear that a medical practitioner cannot carry out work as medical practitioner unless there is an indemnity arrangement in force in relation to that medical practitioner. The amendments also introduce enabling powers for the General Council to make regulations requiring a medical practitioner to inform the Registrar if their cover provided under an indemnity arrangement ceases to be in force, and to inform the Registrar if appropriate cover under an indemnity arrangement is provided by an employer. Failure to comply with the provisions can be dealt with as a ground on which a licence to practise may be withdrawn by the Registrar, or under section 35C(2) and (4) as fitness to practise matter. Consequential amendments are also made to section 29F (appeals). The provisions do not apply to visiting medical practitioners from relevant European States who are entitled to be registered under Schedule 2A and are entitled to provide medical services on a temporary and occasional basis in the United Kingdom.

As a doctor, do I need to make personal indemnity insurance arrangements under GMC regulations?

A clinician employed by the NHS will not necessarily need their own private policy, in addition. You should check to ensure that you have NHS indemnity cover, when working for the NHS. Not all clinicians are covered, depending on the contractual arrangement. Check with your employer to ensure that you understand the scope of any indemnity insurance available.

Many doctors do not realise that their private indemnity arrangement will not cover all of the work that they might undertake. It is therefore important to apprise one’s insurer or medical defence organisation of the full scope of practice and any changes to practice or products used. A failure to do this could lead to a doctor being without cover, and then they would be personally liable for any compensation claims and the legal costs related, unless they operate within a limited liability entity.

The GMC code of conduct Good Medical Practice has required registered medical practitioners to hold appropriate indemnity cover since at least 1998. The 1995 edition of Good Medical Practice (1995) (which was withdrawn in July 1998) is silent on the issue of indemnity cover.

The 1998 edition of Good Medical Practice (1998) (which was withdrawn in September 2001) held that:

20. In your own interests and those of your patients, you must obtain adequate insurance or professional indemnity cover for any part of your work not covered by your employer’s indemnity scheme.

The 2001 to 2006 edition of Good Medical Practice (2001) (which was withdrawn in November 2006) held that:

The  2006 to 2013 edition of Good Medical Practice (2006) (that was withdrawn on 24/3/13), held that:

The subsequent edition of Good Medical Practice (2013) came into effect on 25/3/13, and held that:

The GMC has provided further guidance on the need for indemnity insurance and its scope:-

You must also have appropriate arrangements to cover you for liabilities that arise from your practice as a doctor whenever a claim is brought (such as ‘run off’ cover).

Doctors must therefore ensure that their indemnity insurance covers all of their work. In some instances a doctor might have to have a number of insurance products in place. If they work for the NHS as an employee they will usually be covered by the NHS’s indemnity scheme. Any private or other work they undertake as a registered medical practitioner will likely require a separate insurance indemnity arrangement to be put in place.

Doctors Defence Service notes that, in correspondence to our doctor clients, the GMC has interpreted the requirement to have indemnity insurance as including the costs of any legal action, not just the compensatory award element. Indemnity products should therefore include cover for both the doctor’s own defence legal costs and the costs of the lawyers who bring a claim on behalf of a patient. The GMC’s interpretation is as follows:-

A doctor that undertakes work who does not have such indemnity insurance arrangements in place is likely to face GMC fitness to practise proceedings for misconduct. Further, any appraisal or other declarations that they have made, that declare that they have had in place appropriate indemnity insurance when they have not, could lead to misconduct proceedings.

Standard medical appraisal declarations frequently include wording such as the following (taken from NHS England MAGMAF):

A doctor who knowingly (or recklessly) signs such a declaration could find themselves facing fitness to practise proceedings for misconduct.

Some doctors have found themselves in difficulty in the past where they have undertaken a new procedure or used a new product that has not been approved by the insurer, or where someone has overlooked renewing the insurance on their behalf. A doctor in such a situation may find that they are without cover for that aspect of work. Regular checks should therefore me made to ensure that a suitable indemnity insurance policy is in force and that the full scope of practice and number of clinical sessions being undertaken is fully covered.

To see examples of clinical negligence claims made against doctors, see our dedicated page: Clinical Negligence Civil Claims Against UK Doctors

DDS

Defence Service does not endorse any particular indemnity insurance provider, and does not receive a commission. No fee is charged to the insurance companies for the placement of information and links on this page.

If you are a doctor seeking advice on regulatory or other matters relating to indemnity insurance arrangements, contact Doctors Defence Service on 0800 10 88 739, without obligation.