a. To agree the draft guidance on insurance and indemnity for patients and the public at Annex A (paragraph 15 and Annex A).

Transcription

1 2 May 2012 Continued Practice Revalidation and Registration Board 3 To consider Insurance and indemnity Issue 1. Providing guidance on insurance and indemnity in line with recommendations of an independent review published in Recommendations 2. a. To agree the draft guidance on insurance and indemnity for patients and the public at Annex A (paragraph 15 and Annex A). b. To agree the draft guidance for doctors on insurance and indemnity and Good Samaritan acts at Annex B (paragraph 16 and Annex B). Further information 3. If you require further information about this paper, please contact us by gmc@gmc-uk.org or tel

2 Background 4. At present, there are no express statutory requirements or provisions dealing with professional indemnity arrangements for registered medical practitioners or those seeking registration with the GMC. There is no compulsory statutory requirement for any doctor to be a member of a medical defence organisation or to have professional indemnity or insurance arrangements. 5. However, since 1997, Good Medical Practice (GMP) has placed a professional duty on doctors to have such arrangements in place. Paragraph 34 of GMP provides that a doctor must take out adequate insurance or professional indemnity cover for any part of your practice not covered by an employer s indemnity scheme, in your patients interests as well as your own. 6. In the autumn of 2009, Mr Finlay Scott (previously Chief Executive of the GMC) was commissioned by the Department of Health (England) to examine and to offer recommendations on whether making insurance and indemnity a condition of registration is the most cost effective and proportionate means of achieving the policy objective that all registered healthcare professionals must have insurance or indemnity cover. He prepared and submitted his report to ministers in the summer of He made it clear that his report to ministers was a personal report although he was assisted by members of a review group. The GMC was represented on that group. 7. The report concluded that making insurance or indemnity a statutory condition of registration is the most cost effective and proportionate way of achieving the underlying policy objective. The report recommends that there should be a review of all existing legislation in this area and that the relevant legislation should be harmonised across healthcare professional regulators. It also recommends that within such a harmonised framework, it should be for each healthcare professional regulator to decide how best to exercise its powers. 8. The four health departments responded to the report with a joint statement welcoming the report and accepting the recommendations. The Department of Health (England) then wrote to regulators in February 2011 asking that, until such legislative changes can be introduced, we give early thought to recommendations 11 and 18 from the report. 9. Recommendations 11 and 18 of the Scott report reads as follows: In consultation with insurers and indemnifiers, healthcare professional regulators should consider the case for communicating to patients, clients and the public, for example through regulators websites, the value of insurance and indemnity, when they can assume it is in place, when they may need to check and how they would do so. 2

3 Healthcare professional regulators should explain to registrants that Good Samaritan acts fall outside the requirement to have insurance or indemnity as a condition of registration; and should provide guidance to registrants on good neighbour acts. 10. Members first considered this issue at the Board meeting in November At that meeting, members were provided with copies of the Scott report together with the letter from the Department of Health (England) requesting that we consider taking forward Recommendations 11 and 18 of that report. Members also considered draft guidance for patients (in line with the proposals set out in Recommendation 11) and guidance for doctors (in line with the proposals set out in Recommendation 18). 11. At that meeting, members recognised the challenges in drafting guidance of this nature, particularly for patients and the public. In particular, Suzanne McCarthy provided some detailed written comments in advance of the meeting, pointing out the importance of getting the balance right in providing guidance of this nature to patients. While most patients are unlikely to access this type of guidance on our website, Suzanne and other members also pointed out that raising patients fears about potential problems and the availability of redress, when the vast majority of doctors are covered by their employers or their contracts, would be unfortunate. 12. Members also suggested that the guidance to patients and the public should make clear that GPs are self employed and should therefore describe how insurance and indemnity arrangements apply in general practice as opposed to secondary care. Members felt that the key point to highlight to patients in any guidance was that any risk of being treated by an uninsured doctor was most likely to arise where that doctors was working wholly independently in the private sector. 13. In relation to the guidance to doctors on Good Samaritan acts, members suggested that we should avoid making reference to particular medical defence organisations and should attempt to define when doctors might expected to be covered by employer schemes and when they should consider seeking independent cover. Discussion 14. We have taken these views on board and redrafted guidance for both patients and the public, and for doctors, to respond to the recommendations in the Scott report. Guidance for patients and the public 15. The draft guidance for patients and the public is attached at Annex A. We have tried to incorporate the following points: 3

4 a. In the majority of cases, patients will be receiving medical advice from someone who has appropriate insurance or indemnity cover, because doctors working within the NHS or employed by an independent healthcare provider will have insurance. b. The main area where doctors may not be covered is where they are self-employed or undertaking work outside of the terms of their employment. c. If a patient is unsure whether or not the doctor who is treating them has adequate and appropriate insurance and indemnity cover, they should ask to see current insurance or indemnity documentation. Recommendation: To agree the draft guidance on insurance and indemnity for patients and the public at Annex A. Guidance of doctors 16. The draft guidance for doctors on insurance and indemnity and Good Samaritan acts in attached at Annex B. We have tried to incorporate the following points: a. a description of the cover that doctors received when employed in the NHS or independent sector b. a description of the position for GPs c. a description of the circumstances where private arrangements with an insurance or indemnity provider might need to be made d. an explanation that Good Samaritan acts they fall outside any requirement for insurance and indemnity cover. Recommendation: To agree the draft guidance for doctors on insurance and indemnity and Good Samaritan acts at Annex B. Resource implications 17. There are no resource implications arising directly from the recommendations in this paper. Equality 18. There are no equality and diversity implications arising from the publication of this guidance which simply clarifies the duty set out in paragraph 34 of Good Medical Practice. 4

5 Communications 19. We are intending to publish this guidance on our website but would welcome members views on whether the guidance should be publicised more widely. 5