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Wednesday 28 September 2016
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GPC criticises RCN indemnity withdrawal

The Deputy Chair of the GPC has slammed the Royal College of Nursing (RCN) for leaving general practices "in a state of confusion" as it announced a "surprise" move to withdraw indemnity for its practice nurse members.

In a confirmation statement to MiP regarding the change, Kate Howie, Chair of the RCN Practice Nurse Association, said the withdrawal of indemnity to practice nurses has been made to allow the organisation to control costs and ensure membership rates remain affordable for all.

She said that while the frequency of claims are low they can prove "very costly" – thought to be around £5m.

RCN indemnity cover for practice nurses is set to expire from January next year.

Dr Richard Vautrey of the GPC told MiP that while he understands the RCN's decision and even went so far as to say it was "inevitable", he described it as "unfortunate".

He also said it was "unhelpful" the organisation chose not to engage in clear liaisons with medical defence organisations (MDOs) so that the "full implications of the changes could have been made known to practices before it made an announcement."

"This shock move has left general practices in a state of confusion, which could have been prevented," he said.

A statement from the Medical Protection Society (MPS) was provided to MiP in a bid to clarify the responsibilities of GPs under the policy change.

"It does not extend to their vicarious liability for the acts and omissions of employed practice clinical staff working autonomously, such as practice nurses.

"GP members have the benefit of indemnity for their personal liabilities arising from their own acts and omissions and also for their vicarious liability for the acts and omissions of employed non-clinical staff, such as receptionists," said Dr Stephanie Bown, Director of Policy and Communications for MPS.

"It does not extend to their vicarious liability for the acts and omissions of employed practice clinical staff working autonomously, such as practice nurses.

"GPs must ensure that all employed clinical staff have their own indemnity arrangements in place. This may be provided as part of a practice package or through individual membership."

It is feared that under the new RCN membership terms many practice nurses may be discouraged from working in an advanced capacity, with general practices reluctant to add to their mounting costs.

Dr Vautrey does not believe this will be the case but has expressed concern over who defines what is an "extended role" for a practice nurse. He has called upon MDOs to deliver clear guidance to mitigate any future problems in this area.

Controversially, practices will also become free to ask practice nurses to pay for indemnity coverage out of their own pocket once the RCN cover expires.

Dr Vautrey advised practices to be "sensible" when deciding whether to take this road but refused to comment on whether it would be a move the GPC would endorse or oppose.

A spokesperson from the MPS told MiP media reports have "exaggerated the implications of this move for general practices" – a sentiment Dr Vautrey shares.

"Some reports have claimed general practices will see a sharp increase in defence premiums – there is no justification for that to happen," he said.

"It is unlikely that the RCN's withdrawal of indemnity for practice nurses will impact many practices – if at all."