If you continue without changing your settings, we’ll assume you’re happy to receive all cookies from the BMA website. Find out more about cookies
When you visit any web site, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalised web experience.
Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms.
You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.
These cookies are required
These cookies allow us to know which pages are the most and least popular and see how visitors move around the site. All information we collect is anonymous unless you actively provide personal information to us.
If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
These cookies allow a website to remember choices you make (such as your user name, language or the region you're in) and tailor the website to provide enhanced features and content for you.
For example, they can be used to remember certain log-in details, changes you've made to text size, font and other parts of pages that you can customise. They may also be used to provide services you've asked for such as watching a video or commenting on a blog. These cookies may be used to ensure that all our services and communications are relevant to you. The information these cookies collect cannot track your browsing activity on other websites.
Without these cookies, a website cannot remember choices you've previously made or personalise your browsing experience meaning you would have to reset these for every visit. In addition, some functionality may not be available if this category is switched off.
Our websites sometimes integrate with other companies’ sites. For example, we integrate with social networking sites such as Twitter and Facebook, to make it easier for you to share what you have read. These sites place their own cookies on your browser as a result of us including their icons and ‘like’ or ‘share’ buttons on our sites.
The CNSGP (state scheme for GP clinical negligence) has been running for three months and has been well received by the profession. There have inevitably been questions from GPs about the exact scope of the scheme; doctors are keen to know which activities are covered and which aren’t. Mostly this has been a process of clarification and explanation of the new environment created by the scheme’s introduction.
Unfortunately, this month has seen a policy change from the DHSC (Department of Health and Social Care) and NHSR (NHS Resolution) who now administer the scheme in England. The range of negotiations in the run up to the scheme’s launch was broad and detailed, with both the BMA and the RCGP (Royal College of GPs) seeking certainty around many finer aspects of the scheme’s coverage.
One small but important part of this was the question of coverage for travel vaccinations performed in general practice. Some vaccines are delivered as part of GP NHS services and are therefore covered without question. However, the status of chargeable travel vaccination services was an area of keen focus and the decision was made by DHSC that these would also benefit from being within the scope of CNSGP. That was the basis upon which the BMA and other organisations briefed the profession when the scheme was launched.
Just over a month ago we were made aware of a change in advice on the NHSR website that reversed this policy and indicated that chargeable travel vaccinations would no longer be covered under CNSGP. We immediately took this up with DHSC and robustly set out our concerns over this development. Supported by the RCGP we informed DHSC that this policy change could result in some practices ceasing to offer chargeable travel vaccinations and malaria chemoprophylaxis or delivering pass-through costs to patients that could reduce the number of travellers accessing these services. The public health implications are obvious.
We also raised the pressing and serious matter of the retrospective loss of cover for practices who had operated in good faith on the basis of the original advice, that these services were within the scope of CNSGP. Following urgent negotiations, DHSC and NHSR have issued a statement which says that practices will not be disadvantaged retrospectively but they will cease to benefit from this cover from the end of July. This is on the grounds that chargeable vaccines are not an NHS service and are therefore not in scope of CNSGP.
While we welcome the reversal of the retrospective removal of cover we remain concerned that chargeable travel vaccinations and the provision of malaria chemoprophylaxis prescriptions will cease to be covered by CNSGP at the end of this month. We strongly advise practices to review their indemnity arrangements for all of their staff, and especially for practice nurses who traditionally deliver the majority of travel clinic care. We have warned DHSC that some practices may find the potential increase in the cost of private cover for their nurses prohibitive and may therefore cease to provide these services.
It is important to note that simple travel advice remains within the scope of CNSGP but the provision of the chargeable vaccination or prescriptions for malaria chemoprophylaxis require adequate private cover.
The Royal College of Nursing has now announced that their nurse indemnity cover will include chargeable travel vaccinations, and we are in discussions with the Medical Defence Organisations about the potential cost of this cover. While we continue to make it clear to DHSC that there must be no further such revisions to the scheme it is nonetheless vital that every practice is aware of this change and reviews its policies accordingly.
Mark Sanford-Wood is deputy chair of the BMA GPs committee
Thank you for the information and guidance. A few added comments from personal experience as a GP and a Private Travel Clinic Medical Director.
If the nurses work autonomously as a 'nurse led' service then independent nurse insurance is readily available and affordable.
If however there is Dr input (advice and guidance) then you are in the realm of requiring MD cover. The guidance from MDOs (Medical Defence Organisations) is confusing and the quotes vary hugely. Some wish to base their premium on your total income from the vaccinations not acknowledging that the bulk of the clinical work is nurse led and already insured. Another piece of advise is that you will not be able to get cover from an alternative MDO who is not your present MDO as they are averse to sharing risk (it appears that if there is a claim involving shared liability the organisations are more concerned about inter MDO fighting over proportionate liability). I fear patient care and travel services delivered by GP will suffer due to uncertainty and lack of insurance cover.
Dr Rene Skule (personal view)
Your share is the great knowledge I have gathered, you are an important person I admire, thank you https://candycrushsoda.co
Book your Manali Trip with Kullu Manali Travel Time. We are a leading travel agency in Shimla. We are specialized to offer Tour packages for Kullu Manali. Kullu Manali Travel Time offer you affordable packages for your holiday trip. Here you get multiple packages such as: kullu manali tour packages, shimla manali packages and much more.
mybkexperience.com is the site created by Burger King which is one of the noticeable cheap food chains that have some expertise in giving delectable burger.