CNSGP - What Locum and Out of Hours GPs need to know17/06/19
Due to increasing pressures on primary healthcare services, the requirement for out of hours clinics and reliance on locum doctors has become increasingly necessary. It is understandable that, for services which fall outside of the traditional model, there are questions as to whether, and in what circumstances, those providing care in these capacities are covered in these capacities under the new Clinical Negligence Scheme for General Practitioners ( CNSGP ). With this article, we hope to provide an overview of the position.
CNSGP covers clinical negligence liabilities arising in general practice in relation to incidents that occur on or after 1 April 2019.
CNSGP will provide a fully comprehensive indemnity for all claims within its scope and all employees of the organisation contracted to deliver the care commissioned under:
- A Primary Care Contract (GMS, PMS or APMS contract or as enhanced primary care elements under Schedule 2L of the NHS Standard Contract) or its direct sub-contract; or
- As an ancilliary health service, as defined under the scheme rules
It is the contract, not the nature of the role or location which is important to establishing whether cover is provided. A useful starting point for establishing whether cover is provided under CNSGP can be found with the overview document provided by those administrating the scheme: https://resolution.nhs.uk/scheme-documents/scheme-scope/
Out of hours clinics
If the out of hours work is carried out pursuant to a Primary Care Contract, or as an ancillary health service, then this activity will be covered by CNSGP. Whilst you would need to check the individual contract, most out of hours care is provided under an APMS contract.
The out of hours period is from 6:30pm to 8am on weekdays and all day 24 hours at weekends and on bank holidays.
Out of hours services and care for the purposes of CNSGP may include:
- GPs working in Emergency departments or urgent care centres (including minor injury units or walk-in centres);
- teams of healthcare professionals working in primary care centres, Emergency departments, minor injury units, urgent care centres or NHS walk-in centres;
- healthcare professionals (other than doctors) making home visits after a detailed clinical assessment; and
- ambulance services moving patients to places where they can be seen by a doctor or nurse to reduce the need for home visits.
As with out of hours work, locums who are engaged by a provider to provide or undertake services under a primary care contract, or as an ancilliary health service, will be covered by CNSGP.
The employment status of the locum is not a matter that determines whether the activities they carry out are covered by CNSGP. Locums not employed by a provider, but who are otherwise engaged or permitted by a provider to carry out activities covered by CNSGP, will be covered when carrying out those activities.
Additional Cover Required
There are events which may occur whilst providing out of hours or locum care which will not be covered by CNSGP and it is essential that adequate separate indemnity is maintained in respect of those events. This will include (but is not limited to) regulatory investigations, disciplinary investigations, inquests and private work. Of course, care provided outside of a primary care contract and that which is not an ancillary health service, will likely require additional cover.
We recommend that GPs familiarise themselves with the helpful guidance that has been set out on NHS Resolution’s website, which is regularly updated. This can be found at: https://resolution.nhs.uk/services/claims-management/clinical-schemes/clinical-negligence-scheme-for-general-practice/
Capsticks has a dedicated team that has experience of handling claims against GPs, as well as inquests, regulatory investigations and disciplinary investigations. We also provide a range of business services to the wider GP sector. For further information, please contact Majid Hassan, Joanna Bower or Amy Perry.