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NHS medical indemnity

This guidance describes the scheme introduced in January 1990 and alerts members to its limitations, in addition to new requirements raised through subsequent statutory instruments.

You are advised to retain defence body membership or take out personal indemnity insurance and ensure that the cover is adequate for the activities you undertake.



On 1 January 1990 health authorities took over financial responsibility for negligence attributable to medical and dental staff of the hospital and community health services. The arrangements, which have since been extended to NHS trusts, apply throughout the UK.

As a result, it should no longer be a contractual requirement for NHS employed doctors to hold indemnity insurance, i.e. membership of a defence society, for work undertaken as part of their employment contract.

However, the requirement that all doctors hold adequate and appropriate indemnity cover is a responsibility enshrined in the GMC's 'Good medical practice', and as of 16 July 2014 this became a legal requirement under the Health Care and Associated Professions (Indemnity Arrangements) Order 2014.

Therefore it is vital that doctors understand what their contracted NHS duties are, and arrange separate indemnity cover for any work they do outside the scope of the employing authority or trust indemnity scheme.

Doctors are strongly advised to brief themselves on the extent of the employing authority or trust indemnity scheme ('the indemnity scheme') by reading this guidance and Health Service Guidelines HSG(96)48, NHS Indemnity: Arrangements for Handling Clinical Negligence Claims Against NHS Staff. In addition, our full guidance below contains information on the activities that should be covered by your employing authority or trust indemnity scheme and those that separate indemnity should be arranged for.

Doctors should contact their medical defence society or other insurer for advice on the type of cover they require, depending on both the services they need and the nature of the work they undertake.

Both the BMA and the health departments advise all doctors employed by the NHS to retain defence body membership or take out other personal indemnity insurance. They should also ensure that the cover they opt for is adequate for the activities they undertake.

Doctors who are thinking of changing their defence union should consider the wider implications of such a transfer, for example which union will provide cover for past events.


Related pages

Medical indemnity guidance for GPs
Medical indemnity for NHS-funded treatment in the independent sector
Medical defence organisations and indemnity for doctors new to the UK



NHS medical indemnity (PDF)