The COVID-19 outbreak has presented unprecedented challenges for general practice in relation to the delivery of care.  We have received a number of questions about indemnity cover arising from changes to personnel and the way that care is delivered during the emergency.  We have compiled guidance and some FAQs to assist healthcare practitioners and managers in general practice navigate their way around the key issues. 

Clinical Negligence Scheme for General Practice (CNSGP)

CNSGP cover is linked to the form of contract that the services are provided under. CNSGP covers activities which are commissioned under a Primary Care Contract (PCC)—a GMS, PMS or APMS contract or as enhanced primary care elements under Schedule 2L of the NHS Standard Contract. ‘Primary Care Contract’ also includes a direct sub-contract to a PCC.

If the services are not being provided under a PCC they may still be covered as an Ancillary Health Service (AHS). Further detail on the criteria can be found on NHS Resolution’s website.

In either case, all those carrying out activities in connection with the provision of NHS services for general practice under a PCC will be covered under CNSGP for clinical negligence liabilities. This includes GPs, locums, nurses, HCAs and any other professional or support staff.

Read NHS Resolution’s guidance and Q and A on indemnity during COVID-19 and its joint letter with the Department of Health and Social Care and NHS England and NHS Improvement.

FAQs

If I am asked to carry out a role that is different from my usual role, will I be covered under CNSGP?

Cover will be available, provided the service is being delivered under a PCC or as an AHS.

If I am undertaking consultations remotely, either by phone, iPad or video, will I be covered under CNSGP?

The nature and location of the consultation does not affect whether cover is in place, provided the consultation forms part of a service being delivered under a PCC or as an AHS.

If I am seconded to work in my local NHS Trust hospital will I be covered?

If the service is being provided by the hospital under a PCC, CNSGP cover will be available.  If the service is a secondary care service (e.g. working in the emergency department), you are likely to be covered for clinical negligence liabilities by the Trust’s membership of the Clinical Negligence Scheme for Trusts (CNST).  In any event, s.11 Coronavirus Act 2020 provides for cover to be available for clinical negligence liabilities arising from NHS activities carried out for the purposes of dealing with, or because of, the coronavirus outbreak, where there is no existing indemnity arrangement in place. These arrangements are complementary to existing arrangements and do not replace them.  Where NHS Trusts are hosting special healthcare arrangements such as the Nightingale Hospitals, NHS Resolution have confirmed that clinical negligence liabilities will be covered by CNST.

As a retired GP, if I come back to work to assist with the fight against COVID-19, what are the indemnity arrangements?

The specific indemnity arrangements will depend upon the work you are returning to do.  If you are returning to work as a GP in a primary care setting delivering care under a PCC or as an AHS, CNSGP cover will be available. If you are working in an NHS Trust hospital, please refer to the FAQ above.

I am a final year medical student volunteering to provide backfill cover in a GP practice. Am I covered by CNSGP?

If you are delivering services under a PCC or as an AHS you will be covered by CNSGP.  Section 11 Coronavirus Act 2020 would also provide cover if no other arrangements are in place.

Is CNSGP cover available if I am asked to carry out triage for NHS 111?

If the NHS 111 services are provided by general practice, you will be covered if they are provided under a PCC.  If not, they will be covered as an AHS if the provider’s main activity is to provide primary medical services.

NHS 111 services outside of general practice would normally be covered under CNST, provided the main contract holder is a member. Section 11 Coronavirus Act 2020, would also provide cover if no other arrangements are in place.

If we set up a workforce sharing agreement where GPs and other staff may be required to work at neighbouring GP premises in order to provide a service to deal with COVID-19, will this be covered under CNSGP?

Provided the work being undertaken at any of the practices is under a PCC or as an AHS, cover will be in place.  It is the form of contract, rather than the location or the individuals undertaking the work, which determines whether cover is available under CNSGP.

How Capsticks can help

Capsticks is an NHS Resolution panel firm with a dedicated team of lawyers that has experience of handling claims against GPs, as well as regulatory investigations and disciplinary investigations. We also have a dedicated team of lawyers providing advice on all aspects of general practice, including indemnity issues.

For further information about the contents of this insight please contact Majid Hassan, Ed Mellor or any of your contacts at Capsticks about how we can help.