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Medical Indemnity Cover For GPs Working With Acute and Community Trusts

There are an increasing number of GPs taking up posts with Acute and Community NHS trusts. A lot of this is in relation to ‘improving GP access’ initiatives. One of the benefits of being on a trust contract is that there is the offer of indemnity cover while working for that organisation.

It is imperative that you are clear what cover is being offered to you and what is written into your contract of employment.

The Clinical Negligence Scheme for Trusts (CNST) provides indemnity to NHS bodies for clinical negligence claims. It does not provide cover to GPs working outside of their trust contract.

Ultimately the onus is on the individual to ensure that they have adequate cover through their MDO, and a clear understanding of what cover is afforded by the hospital scheme. Our understanding is that the hospital scheme is very much aimed at addressing the interests of the NHS trust and we would always advocate doctors discussing with their MDO to ensure that they have adequate cover and support above and beyond the hospital scheme.

The BMA has an excellent summary with links at;


On 1 January 1990 health authorities took over financial responsibility for negligence attributable to medical and dental staff of the hospital and community health services. The arrangements, which have since been extended to NHS trusts, apply throughout the UK.

As a result, it should no longer be a contractual requirement for NHS employed doctors to hold indemnity insurance, i.e. membership of a defence society, for work undertaken as part of their employment contract.

However, the requirement that all doctors hold adequate and appropriate indemnity cover is a responsibility enshrined in the GMC's 'Good medical practice', and as of 16 July 2014 this became a legal requirement under the Health Care and Associated Professions (Indemnity Arrangements) Order 2014.

Therefore it is vital that doctors understand what their contracted NHS duties are, and arrange separate indemnity cover for any work they do outside the scope of the employing authority or trust indemnity scheme.

Doctors are strongly advised to brief themselves on the extent of the employing authority or trust indemnity scheme ('the indemnity scheme') by reading this guidance and Health Service Guidelines HSG(96)48, NHS Indemnity: Arrangements for Handling Clinical Negligence Claims Against NHS Staff. In addition, our full guidance below contains information on the activities that should be covered by your employing authority or trust indemnity scheme and those that separate indemnity should be arranged for.

Doctors should contact their medical defence society or other insurer for advice on the type of cover they require, depending on both the services they need and the nature of the work they undertake.

Both the BMA and the health departments advise all doctors employed by the NHS to retain defence body membership or take out other personal indemnity insurance. They should also ensure that the cover they opt for is adequate for the activities they undertake.

Doctors who are thinking of changing their defence union should consider the wider implications of such a transfer, for example which union will provide cover for past events.’

Full details of the NHS medical indemnity are here : NHS medical indemnity

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Updated on 08 March 2018 549 views