Indemnity regulation reform
We recommend that the Government should, as a matter of urgency, reform the current regulation of indemnity products for healthcare professionals in light of the serious shortcomings identified by this Inquiry and introduce a nationwide safety net to ensure patients are not disadvantaged.
- A voluntary Code of Practice for discretionary indemnity was launched by the Medical Defence Union, Medical Protection Society, and Medical and Dental Defence Union of Scotland on 6 January 2025 (Lords Written Statement HLWS789, July 2025).
- The Department of Health and Social Care stated in July 2025 that it had commissioned an independent evaluation of the voluntary Code of Practice (Lords Written Statement HLWS789, July 2025).
- The Department of Health and Social Care published a survey report in 2024 regarding healthcare professionals' indemnity arrangements to inform future policy options (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
How was this evidence gathered?
Response
Accepted in Part
Response
Accepted in PartAccepted in principle. Medical defence organisations launched a voluntary Code of Practice for discretionary indemnity on 6 January 2025. DHSC commissioned an independent evaluation of the Code. Government continues to consider further policy options to reform clinical negligence cover, including addressing cover for criminal acts. The Code is voluntary, not the mandatory 'nationwide safety net' the Inquiry recommended. (Sources: Written Ministerial Statement HCWS318, March 2024; Lords Written Statement HLWS789, 8 July 2025)
Progress Timeline
The voluntary Code of Practice was launched by the Medical Defence Union, Medical Protection Society, and Medical and Dental Defence Union of Scotland on 6 January 2025, establishing seven core principles. Lords Written Statement HLWS789 (8 July 2025, Baroness Merron): DHSC has commissioned an independent evaluation of the Code to assess its impact. Government continues to consider additional policy reforms including addressing cover for criminal acts. The Code remains voluntary and does not constitute the mandatory nationwide safety net recommended by the inquiry.
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: In progress. In March 2024 the Government announced the MDOs' intention to implement a sector led Code of Practice by the end of 2024 which would act as a safeguard to make the system more transparent as highlighted in the Government's December 2022 update to the Paterson Inquiry. The Code will be evaluated following implementation to determine its effectiveness. The Department of Health and Social Care also published the report of an independent survey commissioned to understand healthcare professionals' indemnity arrangements. Based on the feedback of the survey and wide-ranging stakeholder feedback, DHSC is also looking at how to improve healthcare professionals' knowledge of their clinical negligence cover and its importance for patients.
Written Ministerial Statement HCWS318 (7 March 2024, Minister Will Quince): Medical defence organisations proposed to implement a sector-led Code of Practice for discretionary indemnity cover by end of 2024. The Code would establish principles for corporate governance, fair member treatment, scope of benefits, decision-making, and complaints review, to provide greater transparency around discretionary indemnity. Government announced it would keep wider policy reform options under consideration.