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Since the new state-backed indemnity scheme or CNSGP (clinical negligence scheme for general practice) went live, there has been much discussion and confusion over what is and is not covered. As a portfolio GP this can be a minefield, especially for sessional GPs. This is compounded by the different products and pricing structures offered by the MDOs (medical defence organisations).
This is the first in a series of blogs to unpick the confusion.
What does the CNSGP cover?
The clue is in the name; CNSGP covers clinical negligence, meaning that NHS Resolution has taken over the responsibility for clinical negligence future liabilities arising from the delivery of NHS primary medical services. These liabilities used to be paid by the MDOs, and the lion’s share of your indemnity subscriptions would be to fund those liabilities – this is why you will have noticed a significant drop in your indemnity costs.
In short, an activity is covered by the CNSGP if all of the following questions are answered yes:
If you apply these questions to the different types of work you do, it should become apparent which roles or activities are covered and which aren’t.
What does the CNSGP not cover?
Firstly, not all complaints by any means lead to a claim of clinical negligence. CNSGP will only step in when a claim is made. Therefore, complaints with no attached claim will be dealt with by your MDO, which is why maintaining membership of such an MDO is essential. Things such as advice, support and help responding to complaints all remain within the remit of your MDO.
Furthermore, medicolegal liabilities aside from clinical negligence claims fall outside CNSGP such as GMC hearings, inquests, CQC investigations, disciplinary proceedings and criminal investigations such as gross negligence manslaughter. These all require MDO cover.
Finally, the scheme does not cover claims arising from non-NHS work, even if delivered in an NHS environment. Activities such as insurance medical reports, DVLA medicals, firearms forms and even simply signing a form to say someone is fit to fly are not covered by CNSGP. Clarifying with your MDO what such work you do is essential as some MDOs may assume you are doing these non-NHS activities and charge you accordingly, whereas others may assume you don’t. You may find you are paying for cover for work you don’t do, or conversely not paying for cover you need. This is particularly important for locums.
More information on the scope of the CNSGP can be found here https://resolution.nhs.uk/scheme-documents/scheme-scope/
I’ll be writing some further blogs on this topic to drill down further into the detail, so watch this space.
Matt Mayer is the deputy-chair of sessional GPs committee
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