The General Osteopathic Council (GOsC) recently reported that it removed an osteopath for failing to obtain and maintain professional indemnity insurance.  What’s the relevance of indemnity cover to fitness to practise?

A condition of registration – The Health Care and Associated Professions (Indemnity Arrangements) Order 2014

Parliament passed legislation in 2013, which came into effect on 1 August 2015. The Health Care and Associated Professions (Indemnity Arrangements) Order 2014 introduced a statutory requirement to “have in force in relation to him an indemnity arrangement which provides appropriate cover for practising as such.”

“Indemnity arrangement” means:

1. a policy of insurance;
2. an arrangement for the purposes of indemnifying a person;
3. a combination of the two.

“Appropriate cover” means cover against liabilities that may be incurred in practising as such which is appropriate, having regard to the nature and extent of the risks of practising as such.

The 2014 Order allows healthcare regulators to make rules and regulations setting out its own requirements in relation to the information to be provided to the Registrar or requirements to notify the relevant Registrar when cover ceases to have effect.

In practice, healthcare professionals are required to signed a declaration to confirm they have the appropriate indemnity arrangements in place (or will have it in place once they begin practising).  This happens at initial registration and on renewal/revalidation.

Indemnity Cover

From the above, there is a requirement to ensure that healthcare professionals:

1. have professional indemnity cover; and
2. the indemnity cover in place is appropriate to your practice.

In most cases, indemnity cover is covered by an employer if you are employed.  However, many healthcare professionals are not directly employed.  Indemnity cover can also be through:

• a membership of a professional body;
• directly from an insurer; or 
• a combination of the above.

Indemnity cover and fitness to practise

Healthcare regulators would consider fitness to practise action if they believe that the above requirements have not been met.  For example, if a registrant:

• makes a false declaration that they have professional indemnity cover in place;
• registers or renews their registration but cancels their indemnity cover and fails to put alternative cover in place; or
• has professional indemnity cover which is inappropriate for their practice. 

It is worth noting that the requirement to have appropriate indemnity cover in place applies to all aspects of practice including voluntary work but not for breaks in practice.  For a break in practice, you will need to you must ensure arrangements are in place when you restart your practice.

Protecting your registration

Fitness to practise action in relation to indemnity cover, although less common, is often seen as a particularly serious.  It is therefore important for healthcare professionals to take care to ensure their indemnity cover is sufficiently comprehensive and in place at all times they are practising.

Here are a few things healthcare professionals can do to protect their registration:

• If you are employed and are in any doubt, you should always ask what is covered by your employer’s indemnity arrangements.
• You should make sure that you understand the terms of your insurance policy and declare any relevant information to your insurer.
• If you undertake both employed and self-employed work you need to make sure that you have professional indemnity arrangements in place which cover all of your practice.
• If your practice or circumstances change, you need to consider whether you might need to change the cover you have in place or arrange additional cover.
• Make sure that you have the correct minimum cover to meet your regulators’ registration requirements.  £5 million indemnity covers is usually the minimum requirement but you must check with your own Registrar.

Further guidance:

• General Medical Council (GMC) – https://www.gmc-uk.org/-/media/documents/DC9428_Insurance_and_Indemnity_Guidance_for_CEs.pdf_67637098.pdf