Expert advice

COVID-19 and professional indemnity: what nurses need to know

Ensuring nurses on the temporary register have indemnity in every sense of the word

 Illustration shows a female figure holding an umbrella to shield herself, with white lines being deflected by the umbrella. 
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More than 10,000 former nurses, midwives and eligible overseas registrants have joined the Nursing and Midwifery Council (NMC) temporary register since it opened at the end of March in response to COVID-19.

These rapidly recruited staff may have questions about the arrangements for their assignments, as may nurses on the main register who are redeployed or change working environments as a consequence of the emergency.

What protection is available if something goes wrong?

Some staff may wonder what protections are in place if something goes wrong. This is where professional indemnity becomes relevant.

Professional indemnity is sometimes used to describe two different types of ‘insurance’ cover. This can be confusing, because they are quite different.

Cover when a patient makes a claim for clinical negligence

The first and most common use of the term ‘indemnity’ describes the cover that pays out if a patient makes a claim for clinical negligence against a practitioner.

If their case is successful, the patient receives compensation for their injury and their legal costs are met.

All registered healthcare professionals are required to have an indemnity arrangement that provides appropriate clinical negligence cover for their practice. Nurses must declare that they have such cover when they join the NMC register or when they revalidate.

All practitioners providing care through NHS trusts or state-funded GP services, whether employed or self-employed (as locum or bank staff) are automatically covered by state-backed indemnity schemes, the Clinical Negligence Scheme for Trusts or Clinical Negligence Scheme for GP services. This means these practitioners do not need any other cover for clinical negligence claims for that work.

The Clinical Negligence Scheme for Coronavirus

Staff on the new register may also be assigned to non-NHS employers, perhaps as backfill. If that is the case, their clinical negligence cover will be provided by their new employer.

Additionally, the Department of Health and Social Care has introduced the Clinical Negligence Scheme for Coronavirus via the Coronavirus Act 2020. This scheme may never be used, because all practitioners on the new register will be covered by the existing arrangements or by local employers.

The aim of the new scheme is to fill any unforeseen gaps in indemnity cover and provide reassurance to staff supporting the coronavirus response. The scheme also covers volunteers assisting in the response.

Practitioners should not need any other clinical negligence indemnity for their pandemic work.

Schemes like the RCN indemnity scheme also provide cover for members who are self-employed doing non-NHS work, and those who volunteer in other settings or those who step forward as Good Samaritans to help in an emergency outside of work.

Cover for legal support after a workplace difficulty

The second use of the term ‘professional indemnity’ is for legal support following a workplace difficulty. Many consider this a misuse of the term.

The support usually includes representation at an NMC hearing or an inquest, criminal law assistance for workplace allegations, and representation for disputes or disciplinary issues with employers. Unions such as the RCN provide this to all their members as a benefit of membership. Some medical defence organisation cover also includes this service.

It is highly advisable to have this type of professional indemnity, but healthcare regulators such as the NMC do not require practitioners to do so. Many nurses do not have this type of cover and purchase legal support if they are reported to the NMC or called to give evidence at an inquest – or even represent themselves. However, legal costs can be high, and those without representation tend to have worse outcomes in their cases.

RCN retired members who join the temporary register

The RCN has decided to allow retired members who join the temporary register to remain in its retired membership category, which has a lower subscription fee. The college has also agreed to allow new or past members to join in that category, provided they are only joining to work on the temporary register.

These members may require assistance with all the workplace issues that can arise, such as NMC referrals, inquests and disputes with employers. They can then be reassured that they have ‘professional indemnity’ cover in all senses of the word and are fully supported.

View our COVID-19 resource centre

Picture of Roz Hooper, RCN head of legal (regulatory)Roz Hooper is RCN head of legal (regulatory)



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