Clinical Negligence Scheme for General Practice, England
Are you aware of the Clinical Negligence Scheme for General Practice (CNSGP)? The scheme was introduced on 1st April 2019 by NHS Resolution and operates a new state indemnity scheme for general practice within England.
The aim of the scheme is to cover any liabilities in clinical negligence that arose from general practice on or after 1st April 2019. Fully comprehensive indemnity is provided by the scheme for all claims that fall within its scope.
Under the scheme, each provider of primary medical services in the NHS are covered, including those that provide out of hours services. All individuals working within NHS primary medical services are covered, including salaried GPs, locums, students and trainees, nurses, clinical pharmacists, agency workers and other practice staff. Along with primary NHS services, all other services that are provided by general practice are also covered - those activities carried out by or for a primary NHS medical service provider. These services are referred to as ‘ancillary health services’ in the regulations of CNSGP.
There are many aspects of the service that are not relevant to the scheme, such as the status of the person carrying out the activity, the place at which the activity was carried out, the form of the entity responsible for the provision of the service in question and the individual circumstances of the patient; the only thing of relevance is whether the service provided was classed as a NHS primary medical service, and if it were not, whether it was NHS primary services provided by general practice (a provider whose principal aim is to provide primary NHS medical services). Therefore, different organisations are covered under the scheme for those activities they carry out that fall within the scope of the scheme.
Any clinical negligence that arises as a result of a breach of duty or care owed by a GP contractor or GP sub-contractor to a patient regarding the provision of primary medical services are covered under the scheme, where:
•An act or omission by the GP contractor/sub-contactor (or any employee or other individual engaged by them) results in the patient suffering either personal injury or loss
•The act/omission is relating to the diagnosis of an illness or the provision of care or treatment to the patient, and
•That the act or omission took place on or after 1st April 2019
Any clinical negligence liability is also covered by the scheme if the activity consisted of or was in connection with the provision of primary medical services under:
•General medical services (GMS)
•Personal medical services (PMS)
•Alternative provider medical services (APMS) contract, or
•APMS contract under schedule 2L of NHS Standard Contracts
However, if the activity was not delivered under any of the above, it may still be covered under the scheme if all answers are affirmative to the following questions:
•Was the activity one that consisted of or was in connection with the provision of NHS services?
•Were the NHS services carried out by or for a provider whose principal activity is to provide primary NHS medical services, or a sub-contractor arrangement with such a provider?
•Was the activity connected to the diagnosis of, care or treatment of a patient?
If a claim is received after 1st April 2019 but relates to treatment/care/diagnosis provided prior to this date, then this will not be covered under the scheme. These claims will instead need to be reported to the relevant medical defence organisation (MDO) or other indemnity provider.
For Those Working in General Practice
If you are working as a healthcare professional in general practice you may be wondering if you are required to notify NHS Resolution if conditions are imposed on your licence to practice. At present, there are no requirements for NHS resolution to be notified of this, however, you may be asked to provide the information if you are involved in a claim that has been notified to NHS Resolution. The details will be requested to enable NHS Resolution to manage the claim effectively on your behalf, under the scheme rules. If details are provided that have not been requested, then a response will be issued by NHS Resolution informing these are not required and any information will be deleted. If your MDO or any other indemnifier requests you to report any such instances, then you should continue to do this.
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Medical negligence is an overall term used to describe errors, accidents or sub- standard care by medical staff or hospitals.
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