RCN Statement on Indemnity Insurance

As a result of changes in the way that general practices are run, mainly through the new GMS contract, the RCN is receiving a number of enquiries from nurses regarding the RCN’s indemnity insurance scheme being appropriate for nurses entering partnership with GPs.
Any nurse who becomes a partner in a general practice immediately assumes legal accountability for the actions of both of the following :

Obviously this arrangement increases the risks of claims and to insure against those risks the nurse partner would need to take out insurance cover for the position they now hold within the ‘business' . 
The RCN's insurers have declined to extend the protection afforded an individual member under the policy, to cover her ‘business in these circumstances. This also means that the member is not covered personally when working in the ‘business’. This exclusion also applies to nurses who choose to be a fixed share salary partner or an employed salaried partner.
Although this decision seems harsh, there is logic and rationale behind it. If the nurse has to take out cover for her vicarious (or joint) liability (i.e. business cover), then that cover will inevitably extend protection to his/her own professional practice whilst working in the business.  In addition, if he/she was also personally covered by the RCN, and caused injury through his/her own clinical negligence, there may be a dispute between the RCN insurer and the business insurer about who would pick up the costs. Thus, business policies often exclude cover for the insured if there is another policy of insurance in existence for the same risk.
The RCN's insurers will continue to cover the nurse employer in relation to any practice she undertakes outside of the business/general practice (e.g. undertaking the odd bank shift at the local hospital to keep her hand in; the charitable act of the 'good Samaritan', etc). 
In reality, there will inevitably be insurance cover for the business in relation to clinical negligence claims, and the new nurse partner should ensure that that insurance policy covers her own practice in the business.  If not, they should identify an insurance broker that can provide them with personal liability insurance for their practice whilst working in the business.  This is usually approximately £400. This additional cover is a business expense (along with other insurance cover, such as for 'employer's liability', cars, equipment, premises etc), and can therefore be offset against the income of the practice for tax purposes, rather than having to be paid for by the individual nurse partner. 
We hope that this explains the situation and the reasoning behind the RCN current indemnity insurance system. We obviously hope that nurses believe that RCN membership has a number of benefits, of which, indemnity insurance protection is only part of the package, and that this will not inhibit their continuing membership of the RCN. For example, members who are nurse partners and employers of others would still be entitled to the usual range of general professional and employment relations advice and support, and legal representation in appropriate circumstances, before the NMC for example, should they need it. 

Lynn Young, Prinary Care Advisor,

RCN Professional Nursing Dept                                                    

Chris Cox , RCN Legal Department                                            

Katrina Maclaine Nurse Practitioner Adviser
RCN Professional Nursing Department                                                                                October 2005