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Since 2019, GPs providing NHS services in England and Wales have been automatically covered against clinical negligence claims by state-backed indemnity schemes. However, from December 2020, locum GPs working in Wales have been required to sign up to the Locum Hub Wales staff ‘bank’ to access the scheme.

While the introduction of this new requirement has been controversial, the Welsh government reports positive feedback from GP practices and locums using the system.

Requirements to access the state-backed indemnity scheme for locum GPs in Wales

GPs working in Wales receive indemnity through a General Medical Practice Indemnity (GMPI) scheme. This is managed by the Legal and Risk Services team at the NHS Wales Shared Services Partnership (NWSSP). Cover applies to claims arising from incidents occurring on or after 1 April 2019, when the scheme was introduced. The BMA provides further information about what the scheme covers.

If you are a GP locum working for a GP practice in Wales, you have to be listed on the All Wales Locum Register (AWLR) to access this state-backed indemnity scheme. To be included on the AWLR, you must be a qualified General Medical Practitioner on a Medical Performers List in Wales.

From December 2020, an additional requirement to qualify for cover is that your locum GP shifts are booked or recorded through Locum Hub Wales (LHW).

NWSSP provides GMPI guidelines along with a list of FAQs. If you want to access the GMPI scheme, contact the Employment Services Division of NWSSP for advice on the application process (contact details here).

Locum Hub Wales

At a time when rising workload pressures and a shortage of GPs in primary care are leading to increased reliance on use of locums across the UK, tools are needed to manage the locum workforce. LHW was designed to be a free, online tool making it easier for locums to find work and for practices in Wales to fill their shifts.

But registering with LHW has now become a requirement if you want to benefit from GMPI as a GP locum working in Wales. To qualify, you must complete a locum profile on LHW and enter information about each locum shift you provide.

GPs and the BMA’s GP Committee for Wales have lodged ‘strong concerns’ about the new requirement, particularly that the system is unnecessarily burdensome and open to administrative error, so that locums may not be able to prove they had indemnity cover and become liable for clinical negligence costs.

Some GPs have been worried about a negative financial impact on both locums and GP practices in Wales. Locums in Wales are reportedly raising fees to pay for additional indemnity cover due to a lack of confidence in the system and some are even avoiding working in Wales.

However, a Welsh Government spokesperson said: “Since the release of the full functionality of Locum Hub Wales, NWSSP has received positive feedback from both practices and locums using the system, including noting an increase in choice within their area.”

Opting out

If you decide not to sign up to AWLR and LHW, you will be responsible  for  arranging  your  own clinical  negligence  indemnity  cover  for  any  locum  shifts  worked  in Wales in general practice. You will also need to notify the Health Board, NWSSP Employment Services and the GP practice that you have arranged your own indemnity cover.

Ensuring adequate indemnity for work not covered by the state-backed scheme

GMC advises considering whether you need to take out additional professional insurance or indemnity for work that is not covered by the state-backed scheme and to access personal regulatory and medico-legal support and advice.

Activities and services not covered by GMPI include non-NHS or private work, chargeable services such as medicals, reports and statements, inquests, regulatory and disciplinary proceedings, employment and contractual disputes, and non-clinical liabilities.

If you are a GP locum in Wales and unsure whether your current indemnity arrangements are adequate and appropriate, please contact us for advice at Medical Defense Society.