Indemnity Costs Causing English / Scottish Divice

Evidence suggests that many doctors working in England are crossing the border to Scotland after identifying that indemnity costs are significantly less than is the case in England.

Indeed, in many cases this aspect of a doctor’s existence can be one-third of the cost of the equivalent in England.

Many senior doctors have switched to agency work following a long career in English general practice, owing to the fact that working south of the border simply makes no financial sense.

This is apparently largely due to weaknesses in the existing indemnity system, according to individuals working within the healthcare system.

Some individuals have even faced indemnity quotes of over 500% higher when moving from Scotland to England, and it seems that this is resulting in a significant ‘brain drain’ between the two British nations.

With pressure already bearing down on NHS workforces in England, it seems clear that this undesirable phenomenon will have a further negative impact on the health service.

There seems to be a multitude of reasons for doctors to consider quitting the health service in England at present, and the fact that the rates for annual cover increased by 25% last year alone is seemingly another one to add to a significant pile.

NHS England has already stated in its General Practice Forward View that it would tackle rising indemnity fees, having launched a risk sharing pilot for out-of-hours last year.

But it seems that this process has not been successful, and has indeed barely had any impact whatsoever on the situation in England.

Commenting on the issue, NHS Northumberland CCG chief clinical officer Dr Alistair Blair suggested that the indemnity issue is effectively penalising practices all over England.

“It’s about £7,000 to £8,000 for a full time ten-session GP [in Northumberland], and it’s £2,000 to £3,000 in Scotland. Those are big differences – £5,000 a year penalty to work in England rather than Scotland. Recently, several GPs have retired and looked at doing locum work… Unfortunately they’re now saying “I know I’ve worked in England all my days but it makes no financial sense for me to work in England now, so I’m working in Scotland only.”

A spokesperson on behalf of the Medical and Dental Defence Union of Scotland suggested that GPs practising in England are simply far more likely to require to file a claim related to this issue than their counterparts north of the border.

“GPs practising in England are up to three times more likely to have a claim than one practising in Scotland… not only are the number of claims higher in England, the value of these claims are also greater. It is important to note that the distinction being made is between two different areas of legal jurisdiction, rather than a matter of simple geography.”

Nonetheless, it seems clear that this is another issue that NHS England must tackle sooner rather than later.


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