One of the changes that the new GP contract framework brings is that NHS Resolution will provide indemnity cover for GPs henceforth. Given indemnity provision is a real cost to partnerships, this should be a good thing and will release not insubstantial amounts of money. However, the devil is always in the detail in these things and we examine some of the details here. First question is ‘what is NHS Resolution?’. It is part of the Department of Health but operates at arm’s length and was formerly NHS Litigation Authority which gives a clue about why it was created. It has operated as the negligence claims authority since 1995 and has dealt with well over 150,000 claims in that time. Whether it has done so effectively is probably neither here nor there when GPs look at it as a provider. The question is ‘am I covered?’.

So, a quick consideration of what we know. First the good news; there is no limit on coverage under the scheme and no excess so there will be no need for ‘top up’ coverage. It covers situations where the person against whom a claim is made has died, is bankrupt or insolvent, or where a practice has been wound up – provided that the claim fell within the scope of CNSGP at the time of the alleged negligence. The majority of GP staff are covered (including sessional GPs) for the majority of services, treatments and procedures that they perform on a day to day basis. The exceptions are as follows:

• Where an eligible person has made an admission of liability without Resolution’s agreement;
• Where court proceedings have not been referred to Resolution;
• Where a condition imposed by Resolution has not been complied with; or
• Where the eligible person has failed to assist Resolution in managing the claim.

None of these sounds ridiculous but the last two are a bit subjective. It seems unlikely that they would be used as grounds for excluding coverage, but GPs can expect to have various hoops to jump through as part of any claim. Follow the rules, say nothing and make sure your staff do the same would appear to be the default position. As regards staff and types of treatment exclusions, a PCN Clinical Director is not covered (but then again, this is not a role that should involve treatment of patients) but effectively all other staff are covered providing they are carrying out activities in connection with the delivery of primary medical services or ancillary health services under a GMS, PMS or APMS contract. As regards treatment and services, occupational health injections are excluded unless staff members are practice patients, as are travel vaccinations where the patient is required to pay and some reports (for example safeguarding reports). Obviously all private services are not covered.

It is a pretty good deal and will take some of the financial pressures off GPs. It is being paid for via a one-off sum that is part of the new contract calculation so there is no ‘free lunch’ but cashflow should improve as a result and this can be turned to other things. One obvious caveat is that the cover is not for public liabilities, buildings or other business liabilities. GPs will continue to need separate cover for all of these things. Nor does it cover representation in front of professional bodies (like the GMC). The scheme does tie GPs increasingly in to the NHS bureaucracy and some GPs may not like this but that is the price of what is pretty comprehensive cover. If asked to decide to take it or leave it, it would be an odd decision indeed not to say take it!