Healthcare indemnity regulation
13 items
2 sources
Serious shortcomings identified in the regulation of indemnity products for healthcare professionals, leading to patient disadvantage.
Cross-Source Insight
Healthcare indemnity regulation has been flagged across 2 independent accountability sources:
4 inquiry recs
9 PFD reports
This issue has been identified by multiple independent accountability bodies, suggesting it is a recurring systemic concern.
Inquiry Recommendations (4)
BRIS-100 — Mandate ethics committee approval for all new untried invasive clinical procedures
Recommendation: Before any new and hitherto untried invasive clinical procedure can be undertaken for the first time, the clinician involved should have to satisfy the relevant local research ethics committee that the procedure is justified and it is in the patient’s …
Unknown
10 — Indemnity regulation reform
Recommendation: 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 …
Gov response: Accepted 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 …
Accepted in Part
In progress
13 — Independent sector provider responsibility
Recommendation: We recommend that the government addresses, as a matter of urgency, this gap in responsibility and liability.
Gov response: Accepted in principle. Government acknowledges gap in legal responsibility when consultants work under practising privileges. CQC strengthened requirements for independent providers to have robust governance over consultants. Consideration being given to whether legislative change needed. …
Accepted in Part
No update 2+ yrs
15 — Independent sector NHS contract qualification
Recommendation: We recommend that if the government accepts any of the recommendations set out above, it should make arrangements to ensure that these are to be applicable across the whole of the independent sector's workload, where relevant, and not only to …
Gov response: Not accepted but kept under review. Government concerned about proportionality and unintended consequences. NHS Standard Contract already requires providers to meet certain standards. CQC registration applies to all providers regardless of funding source. Government monitoring …
Response Unclear
No update 2+ yrs
PFD Reports (9)
Joan Read Prevention of future deaths report
Concerns: A single consultant lacking cross-cover for geriatric perioperative care creates a risk of urgent test results being missed during periods of absence.
Pending
Chamali Bibi
Concerns: Concerns exist regarding the expertise and frequency of PAO surgeries, as many surgeons perform very few procedures annually without adequate oversight or recognition of the procedure's specialized nature.
Responded
Susan Pollitt
Concerns: The absence of national regulation, clear training frameworks, and comprehensive competency assessments for Physician Associates creates significant patient safety risks and widespread role confusion.
Responded
Michael Walton
Concerns: Supply chain issues led to a sub-optimal cannula being used, which dislodged and contributed to the patient's death. Surgeons were restricted in their choice of appropriate medical equipment.
Responded
Brian Rochell
Concerns: Concerns about an individual's professional practice were not referred to the relevant professional body in a timely manner. This delay in addressing competence issues poses a risk to future patients.
Overdue
Peter O’Donnell
Concerns: Private hospital care had no clear consultant review agreements, inadequate junior doctor oversight/training, absent patient transfer protocols, and failed to report nurse misconduct, creating systemic safety risks.
Responded
Benjamin Orrill
Concerns: The lack of a regulatory body for advanced nurse practitioners, leading to inconsistent appraisal, revalidation, and potential unsupervised practice, poses a significant risk to patient safety.
Responded
Rio Andrew
Concerns: The regulation of private medical companies at events is inadequate, creating false security and leaving event medical provision, including "ambulance technicians," largely unregulated, with insufficient checks on mentor suitability for trainees.
Responded
Derek Brierley
Concerns: The suprapubic procedure was performed by a consultant after a long hiatus with inadequate preparation, likely incorrect insertion, and a lack of Trust guidelines for competence and training.
Response: The Trust has re-drafted and shared a pathway for managing urinary retention, making supra-pubic aspiration a first-line intervention. They have initiated a training program for staff on catheter insertion, requiring …
Responded