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Indemnity may be made compulsory for nurses

All nurses and midwives would be required to have clinical insurance cover before they can register to practise under latest government proposals, Nursing Times has learnt.

This could result in a system where they have to pay for their own insurance in the same way as doctors currently have to.

Nursing Times understands that a draft consultation document on proposals to introduce compulsory professional indemnity for nurses and midwives was due to be published last week.

However, the government has postponed the launch of the document following a meeting between health secretary Alan Johnson and key stakeholders including the RCM, RCN and Unison – at which concerns were raised over the plans.

Most NHS staff currently have ‘vicarious’ indemnity through their NHS employers – with the exception of so-called ‘Samaritan acts’ of care delivered outside their work setting.

But unions are thought be concerned that the new proposals could lead to a fundamental shift in the NHS’ stance on the issue of liability in clinical negligence cases, with the onus being placed on individual nurses to ensure they have indemnity cover.

Dr Stephanie Bown, a medico-legal adviser with the Medical Protection Society, confirmed that any proposals to introduce compulsory indemnity as a pre-requisite of registration for nurses, would be heading in the same direction as doctors and dentists, who must have their own personal medical indemnity in order to be registered.

Professional organisations, including Unison and the RCN, currently provide their members with ‘contingent’ or ‘fall back’ cover. But Nursing Times understands that this form of indemnity alone would no longer be considered sufficient under the proposals for nurses to register to practise.

In addition to what could be a considerable extra cost to nurses – indemnity for an independent nurse can currently cost as much as £500 a year – stakeholders fear there could also be an associated risk of individual liability encouraging more claims. They are thought to be very concerned that the current proposals could open the floodgates to claims against individual nurses.

Unions are also thought to be worried that stricter rules on indemnity could act as a disincentive to nurses engaging in more advanced and innovative practice because of the perceived higher risk.

However, compulsory indemnity for the profession has long been a goal of government, with former health secretary Patricia Hewitt announcing – as long ago as 2006 – that professional indemnity for all NHS staff was a government ‘aspiration’.

The government’s consultation is thought to have originated from concerns about independent midwives practising without insurance cover. 

An increase in the number of initiatives such as social enterprise schemes, where nurses and midwives provide services for the NHS but as independent organisations, may have hastened the need for tighter rules on indemnity.

Although the government has introduced legislation to allow such arms-length bodies providing NHS services to take part in NHS indemnity schemes, not all want to.

As Nursing Times went to press, neither Unison, the RCM or the RCN wished to comment on the proposals.

A spokesperson for the NMC said: ‘We are aware that it is the long-term intention of the Department of Health to make professional indemnity insurance a requirement of registration for all healthcare professionals, including nurses and midwives.

‘The NMC will not be commenting further until we have had the opportunity over the next few months to discuss any issues arising from any future consultation with the Department of Health and our stakeholders including the professional bodies and trades unions,’ he added.

Readers' comments (8)

  • We don't earn enough money to be forking out for insurance cover, which would then go up every year. I can see it now, posters all over the wards encouraging the public to sue nurses for petty incidents like forgetting to clean a hairbrush after use, etc etc.
    I have been a nurse for 32 years and I can gladly say I am happy to be near the end of my career and not just starting out!

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  • In may areas of the UK the levels of highly skilled trained nurses are at a critical level reliant on bank and agency staff to plug the gaps. The introduction of compulsory indemnity adds another barrier to recruitment and retention in a profession that already precariously hangs in the balance. Nurses do not get paid the same as Doctors and Dentists and simply wont be able to afford this, on top of annual registration and monthly union fees. It is another sad indictment that we are moving to private healthcare away from free for all NHS. The government are simply covering their backs and not thinking of the individuals struggling to cope in the recession now, let alone with another £500 plus to find annually.

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  • If we have similar indemnity as doctors then we should have similar pay

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  • If we have similar indemnity as doctors then we should have similar pay

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  • I too am sick and tired of the derisory pay that we as professionals recieve, especially when the government charge us the taxpayer for 2nd and 3rd homes and give themselves pay awards far above the public sector who they seem to blame for everything that happens. This year again any payrise will not be above the inflation rate and all household bills have increased fourfold. Just how does the government expect us to pay out for insurance when we barely have enough to live on now? As comments above we need to retain staff not have none? We run on crisis management all the time. I think the government all require admission to mental institutions for their insanity, stupidity, lack of insight and once again unworkable ideas.

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  • What something else to pay for, what with union fees,registration,car parking and now our dining room has taken away the staff subsidy on meals we may as well sign on for benifits as we would be better off. I am glad I too I am at the end of my nursing career and not the start. This is no longer a career I would encourage friends and family to enter.

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  • I wholehearteldy agree with the other comments.
    I also have nursed for 32 years and have had to put up with changes that have cost me.
    As many of my collegues I am put in life or dealth situations every day for only £5000 more per annum than a factory worker.
    This ridiculous idea will put people off coming into this profession. Role on retirment - or will they rob me off that too!

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  • I am saddened and appalled that the government truly feel it is acceptable to penalise nurses yet again. The nursing profession is continually being hammered financially from all directions, we have to smile and appear grateful for the demisary pay increase we receive year after year. We have continually inflating costs to register as a nurse and of course union costs. The vast majority of nurses undertake study days in their own time often having to foot the bill also, so that they feel confident that they can continue to practise safley, oh and be able to legally re register as a nurse. We work late after the end of the shift receiving no overtime payment and rarley being able to take the time back. We change shifts at the drop of a hat to help out the NHS, and usually at a cost to ourselves and/or family and financially. This has to STOP, and every nurse must be united to ensure the government do not keep taking advantage of our good nature. I have a potential 33 further years in this career, and at this rate ill be lucky if i last 3 years. No other profession would put up with this, and its time we stood up and not shut up. Society and the government need to know that enough is enough! If you want these standards you have to pay for it, and not expect nurses to yet again bail out the government!

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