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State-backed indemnity, which started on 1 April 2019, only provides indemnity for clinical negligence claims arising from primary care work under an NHS England or Wales contract.
GPs still need the expert guidance MDU membership provides, such as support with patient complaints, GMC referrals, ombudsman investigations, performers' list actions, coroners' inquests and even criminal investigations.
Subscriptions will be even lower than current transitional benefits membership. This is because the state-backed indemnity scheme will pick up clinical negligence claims for NHS primary care work from 1 April 2019 onwards.
In the last 12 months, the MDU has opened over 6,000 case-files on behalf of GPs and their staff relating to matters that will not be covered by the new scheme such as patient complaints and GMC investigations. As doctors ourselves, we know that you will still need the expert support and guidance that MDU membership provides. We are here to help defend your reputation and career.
As the state-backed indemnity scheme will cover clinical negligence claims arising from work you do under an NHS contract in England and Wales, after 1 April 2019 your MDU subscription will significantly reduce. We will write to members to explain the impact on their membership, ahead of their next renewal.
The scheme is not intended to provide indemnity for this work.
We know that some types of fee paying work are part and parcel of a GP’s job. That’s why MDU membership includes indemnity for the types of fee paying work that GPs would ordinarily undertake.
Yes you can. You have a continued professional obligation to have indemnity in place for all clinical work you do, including work which is not indemnified under the state-backed indemnity scheme. Simply tell us what private work you intend to do when you approach your renewal and we will adjust your subscription accordingly.
The MDU can typically indemnify the work in the list below. Where the services relate to the provision of care to patients, they must be patients registered at the practice (and only occasionally non-registered patients such as temporary residents). If this is the case, the MDU does not have a cap on the income that can be earned from this work.
The activities listed below are likely to require payment of an additional subscription. GP members doing such activities should contact our membership team to confirm that we can indemnify the work and whether an additional subscription is payable.
If all of the care resulting in the claim was provided after 1 April 2019 then you should contact NHS Resolution in England or NHS Wales Shared Partnership - Legal & Risk Services.
For all other matters (medico-legal advice, complaints, GMC investigations, Coroner’s inquiries, police investigations etc) and for claims where the care in question was provided before 1 April 2019 you should contact the MDU as you did before.
You are welcome to contact the MDU’s medico-legal advisory team to gain their input into any statements you have been asked to make in relation to a claim being handled by NHS Resolution. However if you have everything you need there is no requirement to contact the MDU.
The precise arrangement of the state-backed indemnity scheme is still not known. Once we know the full details of the scheme we will update members.
There is no change as the devolved governments in Scotland and Northern Ireland have not introduced a state-backed indemnity scheme for GPs and as yet have not indicated an intention to do so.
In our experience, a GP is likely to receive claims for clinical negligence infrequently in their career, whereas the likelihood of needing assistance with a complaint or other professional matter such as GMC investigations, is much higher.
GPs should not compromise their own protection.
Support with GMC fitness to practise investigations.
Indemnity for work not covered by the NHS state-backed indemnity scheme, including activities such as writing reports as well as any private clinical work you do.
Until the government confirms details and timescales for the state-backed indemnity scheme, you need to renew your membership. Once we know more detail about the scheme we will contact you to explain the impact on your subscription.
If members on transitional benefits remain MDU members there would be no need to purchase EBR (run-off). EBR needs to be purchased:
MDU members have already benefited from a significant reduction on their subscriptions as a result of transitional benefits membership.
When the state scheme starts we would anticipate providing a partial refund of subscription where a member had a substantial part of their MDU transitional benefits membership year still to run when the scheme is introduced and they convert to a new form of membership.
The exact nature of the refund would depend on the precise arrangements for the state scheme and we will update members when we know more.
Refunds will be processed within the next few months.
MDU members have already benefited from significant savings on their subscriptions as a result of transitional benefits membership.
We anticipate providing a partial refund of subscription where a member has a substantial part of their MDU transitional benefits membership year still to run when the scheme is introduced and they convert to a new form of membership.
We will contact members in the next few months about this.
As set out in the MDU's member guide, run off is payable in the following circumstances:
Otherwise there would be no need for you to purchase run off from us.
GP members on transitional benefits membership will renew onto traditional MDU occurrence membership.
Importantly, MDU membership will include:
We know how it feels when you get 'that call'.
Watch our video which follows a fictitious case, based on real MDU files. It demonstrates how a seemingly simple patient examination can lead to multiple investigations.
We can offer GPs support and guidance that state-backed indemnity will not provide.
It is anticipated that the state-backed indemnity scheme will provide support for clinical negligence claims for GPs and primary care staff arising from contracted NHS duties in England and Wales.
State-backed indemnity will not provide support for complaints made against any practice staff, costs associated with matters brought to the GMC or other registration bodies, or any criminal investigations.
Yes. State-backed indemnity scheme will provide support for clinical negligence claims for primary care staff arising from contracted NHS duties in England and Wales.
We are reviewing GROUPCARE practice benefits. If your practice has a GROUPCARE scheme in place we will contact you again when details of state-backed indemnity have been confirmed.
Previously the cost of free practice nurse membership was part of a GP partners’ subscription as they could be held vicariously liable for the nurse’s acts or omissions. Practice nurses were given full membership so we could deal directly with them on a claim and also assist with other medico-legal matters linked to the claim.
Going forward the state scheme will pick up nurse claims therefore we are simplifying our GROUPCARE scheme and removing the partner subscription supplement. This means practice nurse membership can no longer be subsidised.
Practice nurses are welcome to remain in MDU membership to receive personal access to our 24 hour helpline and support with issues such as NMC referrals. While maintaining membership for practice nurses for work indemnified by the state scheme (and for primary care services provided to patients registered at the practice that fall outside the state scheme such as travel vaccinations or completing employers forms or medical reports for third parties) is optional, they would need to retain MDU membership to receive indemnity for any work they undertake on patients not registered at the practice. This work should be declared to the MDU and an additional subscription may be payable. We will continue to support practices (both partners and practice managers) in their management of medico-legal matters arising from care provided by all members of the practice team.
In past years, nurse practitioners in GROUPCARE practices would typically pay a reduced subscription (compared to our standard non-GROUPCARE nurse practitioner rates) because the price was subsidised by an additional subscription collected through the GP partner supplement reflecting the practice’s vicarious liability for its employees.
In the last 18 months, nurse practitioner subscriptions were further reduced due to the transitional benefits scheme, which offered benefits on a claims paid basis.
Once the new state scheme launches, NHS care provided by nurse practitioners will be covered by the scheme. As a result we are simplifying our GROUPCARE scheme and removing the partner subscription supplement. This means nurse practitioner membership can no longer be subsidised.
Nurse practitioners should remain in MDU membership to access the other benefits of MDU membership, such as representation at NMC disciplinary hearings, support with complaints or coroners’ investigations, access to 24 hour medico-legal advice and indemnity for fee paying work for patients registered at the practice. Nurse practitioners would also need to declare to the MDU any work they do on patients not registered at the practice which may incur an additional subscription.
The state scheme will provide indemnity for clinical negligence claims for all practice staff working under an NHS England and Wales contract and therefore HCAs and phlebotomists will no longer require individual membership for medico-legal support. Where members in these roles are part way through their membership year, their membership can continue until their renewal date, but renewal will not be offered. Practice managers can ask for advice and support for issues arising from HCAs and phlebotomists through their own membership.
Real-life member experiences where state-backed indemnity wouldn't have been enough.
The MDU supported member at an inquest and a HSIB investigation.
The MDU helped a member respond to complaints to NHS England and the GMC.
The MDU provided guidance following a complaint to the ombudsman.
The MDU supported the member during a coroner’s inquest and clinical negligence claim.
The MDU assisted with a Coroner’s report and a response to a negligence claim.
The MDU assisted a member following complaints made to the GMC and NHS England.
The MDU advised on how to deal with a complaint.