Medical Defence Organisations in Indemnity Refusal

A prominent MP suggests that NHS England must intervene over the refusal of Medical Defence Organisations (MDOs) to offer indemnity to practice nurses working in hubs at weekends at GP Access Fund seven-day pilots.

Dr Patrick Geraghty, who was involved in a pilot in Leeds West, has indicated his approach to several medical organisations regarding indemnity for practice nurses was completely futile.

None of these organisations were willing to cooperate with such enquiries.

Consequently, Leeds West, where Garrity works currently, is unable to employ any practice nurses at present.

Commenting on the issue, Dr Geraghty noted that there is considerable room for improvement with this issue, and that it seems ultimately to be a failure of imagination.

“They don’t seem to have got their heads around hub working and nurses. So at the moment it is mainly being doctor-run, with healthcare assistants as well because they are covered by the doctors’ indemnity. And I don’t think this is just applicable to us, I think it’s a universal problem”.

It is believed that the reason for indemnity refusal is related to concerns that practice nurses may also work with patients from other practices.

But Geraghty believes that the way the hubs have been implemented ensures that this will never be an issue.

“This isn’t an out-of-hours service – this is extended access – so we all have access to the computer systems of all of the 15 practices. So we are working within their system as if we were a locum or a partner in the practices”.

Despite the issue having been raised with major executives in the health service, there has been a reluctance to address the problem.

Garrity believes that NHS England must put pressure on MDOs to alter their approach to this issue, or for the organisation itself to provide indemnity cover for nurses.

Meanwhile, other prominent individuals essentially concurred with the opinion of Geraghty

Dr Nick Clements, head of risk and underwriting policy at MPS, indicated that there is no reason that the practice nurses couldn’t be offered indemnity arrangements.

“We can offer a number of indemnity options for nurses working in general practice, and we can discuss bespoke arrangements for hubs with multidisciplinary teams each operating in different ways – there is no one size fits all indemnity solution”.

And Dr Sharmala Moodley, MDU deputy head of underwriting, also believes that there is no practical nor legal reason why practice nurses should be denied this vital healthcare provision.

“Well over 10,000 nurses are MDU members, the majority working in primary care. However, we can usually extend the benefits of MDU membership to nurses planning to take on additional roles outside the practice. This will sometimes attract an additional subscription depending on the nature of the arrangements and the specific role taken on”.

NHS England has yet to be forthcoming with any practical response to this issue, but it is clear that some form of action is required imminently.

There are approximately 15,000 practice nurses are currently occupied in the English health service system.


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