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Posted 22 March 2019
by Endurance Arthur

How are claims against general practitioners (GPs) paid for?

Stethoscope

Until 31st March 2019, if negligent treatment from a GP causes injury to a patient, the GP must rely on insurance paid for by membership of a medical defence organisation to handle any claim by the patient. There are several medical defence organisations, for example, The Medical Defence Union (MDU), Medical Protection Society (MPS) and the Medical and Dental Defence Union (MDDUS). The medical defence organisation helps the GP to defend and ultimately pay for any claim for damages.

From 1st April 2019 a new system comes into force, the Clinical Negligence Scheme for General Practice (the scheme). NHS Resolution, which already meets claims against hospital trusts, will now meet claims against GPs.

Why is the scheme a good idea?

Getting insurance cover has become more expensive year on year and this has caused many GPs to reduce their hours, to reduce the cost of their cover. This applies especially to out-of-hours care, which is particularly expensive for GPs to insure.

How does the scheme help GP medical services?

The scheme aims to provide a more stable and affordable system for providing insurance cover for general practice which will improve access to GP medical services by for example:

  • Improving recruitment and retention of GPs
  • Enabling GPs to provide patients with more care including out of hours care
  • Meeting needs of GP practices
  • Offering taxpayers value for money
  • Relieving the administrative and financial burden for general practice

The scheme covers GPs and other healthcare professionals, such as the practice nurses, pharmacists, locums and administrative staff.

Will the scheme help patients?

The scheme will be helpful to people bringing claims for damages after substandard GP care in many ways. Here are some:

  • Under the system before 1 April 2019 if a patient brings a claim against several GPs because, for example, they saw several GPs who each contributed to the delay in referring the patient for urgent care, each of the GPs may have a different defence organisation. The different defence organisations may not agree on how liability should be apportioned between them or what approach to take. This can cause delay in handling the claim and can make achieving a settlement more expensive and difficult. Under the new scheme the difference in approach, difficulty and delay should be avoided.
  • If a GP or locum is employed by the GP practice, the GP partners will be liable to meet claims against them. If GP or locum is self-employed the GP partners may not. Under the new scheme that uncertainty as to who a claim should be brought against should be avoided.
  • In the highest value claims where for example a patient will need care for the rest of his or her life because of negligence, the award is often split between annual payments for life and a lump sum payment. Unlike NHS trusts, Defence associations cannot give security for any periodical payments. The new scheme will enable people to obtain periodical payments in appropriate cases in claims against GPs.
  • Sometimes it is difficult to trace GPs who have retired and find out who their defence organisation was. Under the new scheme, provided the GP negligence took place after 1 April 2019, that difficulty should be avoided.

What negligent acts will be covered under the scheme?

The scheme covers liabilities incurred after 1st April 2019 which arise from acts or omissions by GPs or people working in a general practice setting. The actions must be connected to the diagnosis, care or treatment of a patient and must result in personal injury or loss to a patient.

What will not be covered under the scheme?

The scheme will not cover other liabilities associated with GP practice such as employment issues or breach of contract claims against the surgery. It will also not cover any non-NHS work, representation at inquests, GMC hearings or disciplinary investigations involving the GP.

How do I bring a claim against my GP?

At Tozers we have a highly experienced clinical negligence legal team who will advise you on the best course of action in a sympathetic and professional way. If you would like to discuss making a claim, please contact one of our experienced lawyers for initial advice free of charge.

Want to know more?

Request a call back or ask us a question using our quick-contact form.
Alternatively you can call us on 01392 207020.

About the author

Endurance Arthur

Partner and Solicitor

Partner and solicitor in the medical negligence department and a member of the Law Society's Clinical Negligence Panel