Changes to GP membership in England and Wales

 

FROM 1st April 2019, all GPs working in England and Wales now have access to indemnity for their GMS, PMS or APMS contractual duties provided by the Clinical Negligence Scheme for General Practice (CNSGP) for English GPs or the General Medical Practice Indemnity (GMPI) for Welsh GPs.

All MDDUS GP members working in England and Wales were sent a letter in mid-March regarding the changes to our GP grade of membership and detailing our new General Practice Protection (GPP) product. This new grade of membership will supplement the aforementioned state indemnity and will ensure continued access to the expert advice, support and representation currently enjoyed as MDDUS members.

All members affected by the state indemnity schemes have been transitioned onto the GPP product, and those due a pro-rata refund will now have received this. Most members will have seen from the pro-rata calculation that the cost of the MDDUS GPP product is significantly less than their previous grade of membership and members will continue to enjoy these lower rates when their annual renewal falls due.

Maintaining your MDDUS membership at renewal is vital to protect your professional interests in areas not covered by CNSGP and GMPI, as these schemes will not provide indemnity for any work that you undertake outside your NHS contract.

The BMA has highlighted the essential future role of medical defence organisations (MDOs). It advises: "The scope of the state-backed scheme is to cover the cost of clinical negligence for NHS services. The MDOs will continue to play an important role in providing legal advice, representation for GMC hearings and also for the rare occasion where a criminal case occurs. Similar to hospital colleagues, it will be essential to maintain such medical indemnity.”

Our GPP product will provide you with access to expert advice and representation for the following:

• Complaints
• Ethical/professional advice
• GMC investigations
• Performer list/disciplinary investigation
• Coroner’s inquests/fatal accident inquires (FAIs)
• Criminal matters (related to medical practice).

Both CNSGP and GMPI have significant indemnity exclusions. The GPP product automatically includes indemnity for up to £10,000 annual earnings per GP, for non-NHS work on practice-registered patients, as set out below (the £10,000 limit applies whether or not the income is received personally or by the practice):

• Report writing (for NHS patients but non GMS/PMS work), e.g. for court purposes
• Occupational health reports
• Private certificates, e.g. fitness to attend court/sit exams etc.
• Statutory notification forms, e.g. notifiable infectious diseases etc.
• DVLA medicals
• Sports medicals, e.g. racing, diving, parachuting, etc.
• Adoption/fostering medicals
• Passport countersignatures
• Private prescriptions
• Life insurance reports and medicals
• Travel insurance – reports and claim form completion
• Event medicine – crowd doctor work at music, sports events, gala days, etc
• All cremation form completion
• All deprivation of liberty safeguards (DOLS) reports
• Access to indemnity for chargeable travel vaccines/immunisations.

If earnings from this work exceed £10,000 we can of course offer a revised quotation based on personal circumstances.

For GP partners, the GPP product also provides indemnity for your share of liability arising from nurses, healthcare assistants and similar staff employed by you to perform the non-NHS work described above. Please ensure that you include your share of fees generated by such staff when you calculate your expected annual earnings. Again, we will be happy to provide a revised quotation for any GP whose earnings from this work will exceed £10,000 per annum.

We can also extend your membership to include access to indemnity for a range of medical work outside of your practice setting, including private GP work, occupational health, sports medicine, cosmetic medicine and work as a forensic medical examiner.

You should also note that standard inclusions within the pre-CNSGP/GMPI grade may now have been removed. It is important to verify that you have ongoing indemnity for additional work you perform, such as medico-legal report writing and non-invasive cosmetic treatments, such as Botox and other non-permanent fillers. In addition, members should now declare all GP sessions worked to MDDUS in order for us to calculate the appropriate fee, including out of hours and sessions covered by other providers or schemes.

Membership Services is open Monday to Friday (8am – 6pm) should you have any questions about membership. Phone 0333 043 0000.

Stephen Kelly is head of Membership Services at MDDUS