What’s Next For GP Indemnity?
As the winter GP indemnity scheme for 2017-18 has recently drawn to a close, health practitioners and healthcare providers up and down the country have been asking the probing question: what’s next for the GP indemnity scheme?
As we enter into the summer months, what is in store for doctors who wish to continue providing vital out-of-hours care to patients, but who cannot afford the rising costs of indemnity protection without government support?
What is the GP indemnity scheme?
By now, most general practitioners will be well acquainted with the GP indemnity scheme. This programme has been run by NHS England since 2015, to subsidise costs for GPs working in out-of-hours and 111 services, whose protection is not provided by their employer. Whilst the scheme was initially backed with £5m, in 2017, this figure increased to £10m.
The scheme focussed on winter care provision, having run from 1 October 2017 to 2 April 2018, on the basis that the winter months increase pressure on the NHS, and result in higher costs for out-of-hours indemnity.
The flaws of the seasonal scheme
Many believe that a winter indemnity scheme is not enough. As GP Online states: “BMA leaders say pressure on the NHS – and high out-of-hours indemnity costs – will not end with winter.” The British Medical Association have warned that, unless the scheme is extended, staffing in out-of-hours services will drop from April.
Their recent surveys found that 82 per cent of doctors who worked out-of-hours named indemnity support as a major influencer in their decision to do so, with 80 per cent saying they would cease working out-of-hours if the scheme was not extended beyond 2 April.
In fact, over two thirds of the 500 GPs they surveyed did not have any out-of-hours sessions booked beyond April, suggesting that the conclusion of the winter scheme will have a notable impact on the availability of these services to patients in need.
GPC deputy chair Dr Mark Sanford-Wood told GP Online:
“GPs already face a huge financial burden in the face of rising indemnity fees which are even more inflated for out-of-hours work. This added expense to cover them for out-of-hours services often proves unaffordable and prevents shifts being filled and desperately needed doctors from attending patients at these times.”
Calls for year-round state-backed cover
Concerns over the seasonal reduction in out-of-hours staffing has led to widespread calls for the government to establish a year-round GP indemnity cover scheme. According to Pulse, GPG chair Dr. Richard Vautrey recently wrote an open letter to NHS England’s primary care commissioning director Dr David Geddes, stating the former’s concern over the ending of the scheme. Vautrey wrote:
“This scheme has been central to enabling GPs to work additional hours. The discontinuation of the scheme will have a great impact on out of hours and unscheduled services and in turn increase pressures on general practice even further.”
Many have noted that it is essential to safeguard out-of-hours GP services, particularly following the revelation that the number of serious incidents reported in these sessions has increased by 26 per cent.
As a result of the critique, the government plans to introduce a state-backed GP indemnity scheme. The new scheme will be introduced in April 2019, and includes NHS out-of-hours services, also extending the deal to GPs in all positions, rather than solely covering partners, as was previously the case.
This scheme will see GP practices paying a membership fee to get their fees covered, but requires individual GPs to maintain their indemnity cover under MDOs alongside the state-backed policies.
“We envisage the scheme would only cover clinical negligence risks arising from the delivery of GMS/PMS/APMS contracts and any other integrated urgent care delivered through NHS standard contracts.”
However, this proposal has also received its share of criticism. As GP Online reports, with GP indemnity costs having risen by 50 per cent between 2010 and 2016, the average cost for cover is £8,000 per year. According to the BMA, this means that the government could have to source over £100m annually to fulfil their pledge.
What’s next for out-of-hours GPs?
So what does the future hold for GPs working in out-of-hours services? Well, whilst the newly-proposed state backed cover might prove problematic down the line for the government itself, the introduction will only encourage more GPs to move towards working in out-of-hours services.
GPs may be facing a short period of uncertainty in indemnity cover, but with higher salaries and more flexible working arrangements than in-practice positions, plus improving employee rights, the long-term future of out-of-hours GP careers appears promising.