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Update 20 October 2017:
Since the announcement by Jeremy Hunt last week about a state backed indemnity scheme, there have been several statements made about planned changes to indemnity/insurance products by some providers. We remind all salaried and locum doctors to read the terms and conditions of any indemnity or insurance carefully. Ensure you are satisfied that the level and nature of cover is sufficient for your circumstances and your practice. If your indemnity cover is provided by your employer, please make sure you are also clear on any changes they make. We have re-circulated the below blog by Sessional Deputy Chair, Krishan Aggarwal from August 2016 which helps explain the differences.
Why do I need Indemnity?
What does Indemnity cover?
How is Insurance different to Indemnity?
What about Private Providers who offer “indemnity”?
What about Crown Indemnity?
Is one MDO cheaper than another?
How do I change MDO?
What is The Indemnity Support Scheme?
Concerns with The Indemnity Support Scheme.
Whatever happens...you can be assured that the Sessional GPC Subcommittee will do everything to be part of these negotiations and not let Sessionals be forgotten.
Krishan Aggarwal is deputy chair of the GPC Sessional GPs Subcommittee.
Follow him on Twitter @krishanx
Indemnity risk and therefore cost has traditionally been been differentiated between locums versus other doctors and also between “In hours” work and OOHs.
However general practice has changed so much that new varieties of work such as extended hours, walk in centre work (WIC), and prime minister challenge fund (PMCF) work have challenged traditional risk assumptions based purely on the time the care is offered. So for example WIC work is classed as high risk like OOH work because one can’t access the full medical record, however PMCF work which can often be after 6pm or at weekends can be counted as scheduled care because the dr has access to the full GP medical record. There is now the concept of “scheduled” and “unscheduled” care.
If the availability of access to the full medical record is such a fundamental determinant of risk then it should/might be possible to argue that locums who work in normal day time general practice should be on the same indemnity risk/cost level as any other GP working in the same practice even if they don’t have a long term relationship with the patient. After all with the move to MCPs, and larger providers will there really be any long term continuity between doctors and patients if list sizes of 300000 are served by practices of 20+ GPs ?
There are already salaried posts which work across several practices providing “locum” type backfill for federations and these don't pay the higher indemnity rate which locums pay despite being unfamiliar with patients or practices systems in the same was as freelance locums.
There is a suggestion that rising indemnity claims reflect rising workload (i.e. number of cases seen). Locums typically can control their workload much better than salaried or principal GPs (this is why so many of us are making the transition to locum work) so one might argue that this would mean their indemnity should not be rising.
It is time to move away from indemnity risk and cost being based on prejudices against locums to being based on actual evidence of risk. Locums are subject to the same appraisal and revalidation system as any other doctor.
We also need much clearer transparency about pricing indemnity for portfolio roles. IF you do a mixture of salaried and locum work it is possible to get several different answers from the same MDO about exactly what one is covered to do.
Its time GPC challenged discrepancy in the indemnity rates between GP locums and other GPs,
Does your company wor in Ireland too? If you offer this service, how much does it cost?
Thank you in advane for the answer.
Dr Izaskun Tellitu
can we get back dated indemnity.
Unfortunately the cover from The MDO is discretionary and therefore you are not guaranteed cover. Furthermore any decision they make is final and there is no body that they are answerable to
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