The Royal College of Nursing was forced this week to defend a decision to withdraw its indemnity cover for nurses working in general practice.
RCN leaders came under repeated fire for the decision, which takes effect on January 1 next year, at Wednesday’s annual general meeting in London.
Indemnity cover pays for the costs of clinical negligence cases, and the decision will mean that clinical negligence costs will fall on employers, as they do elsewhere in the NHS.
At the moment GP practices will be covered by medical defence organisations. However those bodies are currently able to recover some costs from the RCN where an RCN member was at fault. The college is to change the terms of its indemnity scheme to stop that happening.
Stacey Hunter, RCN honorary treasurer, told the meeting that although there are only around 40 or 50 cases a year relating to nurses in general practice, the costs are “unacceptably” high, requiring the college to carry £5m in cash to cover litigation costs.
She said GP practices are legally required to have indemnity insurance to cover all employees. “Employers don’t have a choice, and we will be working hard for anyone whose employer doesn’t understand.”
Ms Hunter emphasised that the RCN valued its practice nurses, and added: “These costs should not be on your college – it’s about putting responsibility where it should be.”
But many RCN members were unconvinced. One speaker said it was an “own goal for the RCN,” warning that practice nurses could leave the college as a matter of principle.
Ursula Gallagher, regional member of the RCN London board, warned that passing the costs on to GP practices might cause some to limit the scope of the services they deliver. She added that the change could have knock-on effects for nurse-owned social enterprises providing NHS services.
General secretary Peter Carter accused GPs of “cost shunting” and pledged that “no nurse would be disadvantaged” by the new arrangements.
RCN president Andrea Spyropoulos said the only other option was to charge nurses working in general practice more for RCN membership. “I’m not going to ask nurses to cover medics. [GPs] don’t like it, but I don’t care.”
A spokesman for the British Medical Association, whose GP committe represents employers in general practice, would not comment on whether the change was positive, or whether the new financial liabilities would result in services being cut back.
He said: “The RCN let the BMA know they were making this change and we have acted accordingly. The BMA has advised GPs and their practice managers to check their practice’s insurance policy to make sure that their nurses are covered.”