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.