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    Monday, 18 June 2018 17:31
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    Thursday, 14 June 2018 14:27
  • Generics concessionary price hikes cost CCGs additional £86.3 million in 2017-18, finds NAO

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    Friday, 08 June 2018 08:36
  • £10m fund announced to help improve GP retention

    £10m fund announced to help improve GP retention

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gpstressMay 11 2016

Medical defence organisations (MDOs) are starting to question whether GPs having the recommended minimum personal liability cover of £10 million is sufficient.

Claims have been settled for more than this value, and “it is not unusual for an MDO to pay a claim for more than £5m on behalf of a GP member,” new BMA GP Committee guidance has stated. “As a general policy, NHS England expects all GPs on the England National Performers List who are insured to have minimum personal liability cover of £10 million for 2016, but this will need to be reviewed annually; some MDOs question whether this is sufficient, as claims have been settled for more than £10 million.”

The BMA has worked with the three MDOs - the Medical Defence Union, the Medical and Dental Defence Union of Scotland, and the Medical Protection Society - to produce the guidance which focuses on the situation in England. It points out that under the Clinical Negligence Scheme for Trusts (CNST), doctors working for NHS bodies or organisations providing services to NHS patients are indemnified for their NHS work through their employing organisation.

“However, GP contractors, locum GPs and salaried GPs employed by practices are not indemnified by the NHS scheme and therefore require personal medical indemnity. Similarly, doctors undertaking private work or work in independent hospitals are responsible for arranging their own indemnity with a medical defence body of their choice.”

Among the considerations for GPs discussed in the guidance are:

  • GPs are increasingly likely to be sued , with full time GPs now twice as likely to receive a claim than seven years ago;
  • awarded damages are not an indicator of the seriousness of negligence, but are “calculated on the basis they should as far as possible put patients back in the position they would have been before the episode took place”; this
  • may mean the costs of life-long health and social care for young patients or a sum to reflect loss of future earnings potential in previously high-earning patients;
  • aspects taken into account in the GP subscription rate, such as work outside core NHS contract services, the location of premises, and whether the practice employs other health professionals;
  • options for GPs unable or unwilling to obtain medical indemnity through one of the MDOs;
    the need to check the indemnity arrangements for all employed staff for whom the GP is vicariously liable.

In a separate announcement, the MDU has warned that doctors should be aware of the risks when recommending any healthcare apps to patients. There are currently an estimated 165,000 healthcare apps.

Writing in the MDU’s digital journal, Dr Ellie Mein, MDU medico-legal advisor, said: “Although apps that meet the definition of a medical device must comply with the requirements of the relevant medical device directive and will fall under the regulatory responsibility of the Medicines and Healthcare Product Regulatory Agency (MHRA), in reality it can be difficult to regulate such apps due to the sheer volume and diversity of those available.”

Among her advice to doctors is that:

  • it would be prudent to suggest an NHS endorsed app so that there is some reassurance about the quality of the app;
  • if a patient attends a consultation with information derived from an app, the doctor should listen to the patient’s concerns in the same was as if the information had come from any other source;
  • if a doctor encounters a situation where a patient has come to harm due to using an app that may be classified as a medical device, it is good practice to notify the MHRA.

Links:

BMA Medical Indemnity for GPs

MDU apps warning

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