The announcement from Chair of the GPC, Dr Chaand Nagpaul around sickness cover reimbursement for GPs has raised many issues regarding locum insurance cover.
The law of unintended consequences springs to mind when reviewing the changes to the GP contract, and we know it is early days.
It's great that NHS England is providing additional financial support to our hard-pressed GPs with an additional £238m going into the GP contract in 2017/18.
With £1734.18 pw being paid to practices for up to 6 months after 2 weeks' sickness absence, most doctors working less than about 7 sessions a week could find their locum costs being met – unless you're in an area of England where locum costs are particularly high.
Although we are still waiting for detail it is clear that the sometimes considerable sums that prudent practices were spending on locum insurance will fall, as practices reevaluate their need for insurance.
However, I urge GPs to consider their circumstances carefully. This doesn't mean that the need for locum insurance falls to zero and practices which cancel their locum insurance face a number of risks:
- In areas where locums are very costly – and I've heard of locums charging £1000 per day in some places – the sickness absence reimbursement of up to £1734.18 per week isn't going to cover the entire cost of a GP's absence.
- Reimbursement halves after 6 months' sickness absence. £867 doesn't make a big dent in locum costs to cover for a full-time GP.
- Reimbursement covers sickness absence of doctors only. The new proposals provide no cover for staff.
- Reimbursement covers doctors’ sickness absence only. It doesn't cover jury service, suspension from practice, revalidation leave, or compassionate leave. It doesn't meet funeral costs after accidental death. It doesn't meet private physiotherapy costs and a whole host of other things which typically fall within today's locum insurance policies.
On this latter point, our underwriters paid more claims for jury service in 2016 than I have ever known in 13 years running locum insurance businesses. Over 70% of our clients in 2016 chose to buy a policy which included these additional benefits.
So ditching your locum insurance and putting yourself in the hands of NHS England won't necessarily be the panacea you hoped it would be.
Unless you have insurance in place you will still be putting your hand in your pocket to meet locum costs.
I am confident that underwriters will rise to the challenge and will offer insurance to plug the gaps which NHS England's well-meaning intervention has caused. And, hopefully, should the NHS England funding be withdrawn once its cost to the public purse is deemed unacceptable, the skilled and proficient specialist providers will not have left the market.
Lynda Cox, Principal
Practice Cover
The opinions presented in this statement are solely those of the author on behalf of Practice Cover Limited and they do not constitute individual advice. Practice Cover is a trading name of Practice Cover Limited and is authorised and regulated by the Financial Conduct Authority.
