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Professor Helen Stokes-Lampard: Soaring indemnity costs must be addressed

Indemnity costs are getting in the way of GPs doing their jobs and the system needs urgent reform, writes Professor Helen Stokes-Lampard.

Soaring costs of medical indemnity are one of the biggest challenges facing GPs right now. GPonline today reports that over a quarter of GPs have seen costs rise by more than 20% over the last year while yesterday it revealed that three in five GPs have cut the number of sessions they work or turned down sessions because of indemnity costs.

This all comes at a time our profession continues to be under-resourced and under-staffed.

Every GP has the right to provide comprehensive care to their patients, safe in the knowledge that they are fully protected by their insurance. 

What I don't think people realise is that NHS GPs, unlike hospital doctors, must meet insurance costs themselves for their NHS work – they are already far too high to be sustainable, and with the recent change to the discount rate, they are set to get significantly worse.

We understand that medical defence organisations (MDOs) are not for profit and that these price rises reflect the increasing culture of seeking compensation, and our current judicial system but it is GPs who are finding ourselves stuck in the middle with substantial financial burdens that are a great source of anxiety.

And in the long run, this isn't good for the NHS or patient care, as GPs will understandably, increasingly opt out of delivering the services that bump up indemnity costs most, such as out of hours work.

Spiralling costs

No individual GP should have to shoulder the spiralling cost of higher indemnity bills for their NHS work, nor should GP practices be forced to divert money into plugging this shortfall when it should be ploughed directly into frontline patient care.

Our profession is under intense workforce and research pressures, and we are already struggling to recruit new GPs, and retain existing ones. Extortionate indemnity costs are simply an incentive not to join or remain in the workforce.

Research commissioned by the college as part of our Annual Assessment of NHS England’s GP Forward View last month, found that 81% of members who said running a GP practice was unsustainable (57%) cited indemnity costs as the reason.

It’s an issue the RCGP is taking incredibly seriously, and we are working tirelessly behind the scenes with our colleagues at the BMA, NHS England, MDOs, and the DH to find a swift and effective resolution that benefits everyone.

There needs to be clarity on DH plans soon. We need to get to a stage where GPs are not faced with the prospect of having to pay massively higher bills on an annual basis.

It was one of our six steps for safer general practice that we announced ahead of the general election in May, and it was a pivotal ask when we were advising NHS England on what the GP Forward View should look like.

We need long-term solutions

We are seeing some progress and we welcomed the winter indemnity scheme as a short-term measure to offset rising costs. But we need long-term, sustainable solutions – particularly given the change to the discount rate, which is seeing costs soaring.

The DH has given us all strong assurances that GPs will be protected from these increases – but speaking to GPs around the country, particularly newly qualified GPs, they feel vulnerable and uncertain. Things aren't moving fast enough; GPs renewals for medical defence organisations are hitting doormats now.

We need urgent reform of a system that is becoming increasingly unsustainable and is getting in the way of GPs doing their jobs.

  • Professor Stokes-Lampard is chair of the RCGP

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