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GPC criticises RCN indemnity withdrawal

The Deputy Chair of the GPC has slammed the Royal College of Nursing (RCN) for leaving general practices "in a state of confusion" as it announced a "surprise" move to withdraw indemnity for its practice nurse members.

 
In a confirmation statement to NiP regarding the change, Kate Howie, Chair of the RCN Practice Nurse Association, said the withdrawal of indemnity to practice nurses has been made to allows the organisation to control costs and ensure membership rates remain affordable for all.
 
She said while the frequency of claims are low; they can prove "very costly" - thought to be around £5m.
 
RCN indemnity cover for practice nurses is set to expire from January next year.
 
Dr Richard Vautrey of the GPC told NiP that while he understands the RCN's decision and even went so far as to say it was "inevitable", he described it as "unfortunate".
 
He also said it was "unhelpful" the organisation chose not to engage in clear liasions with Medical Defence Organisations (MDOs) so that the "full implications of the changes could have been made known to practices before it made an announcement."
 
"This shock move has left general practices in a state of confusion, which could have been prevented," he said.
 
A statement from the Medical Protection Society (MPS) was provided to NiP in a bid to clarify the responsibilities of GPs under the policy change.
 
"It does not extend to their vicarious liability for the acts and omissions of employed practice clinical staff working autonomously, such as practice nurses.
 
"GP members have the benefit of indemnity for their personal liabilities arising from their own acts and omissions and also for their vicarious liability for the acts and omissions of employed non-clinical staff, such as receptionists," said Dr Stephanie Bown, Director of Policy and Communications for MPS.
 
"It does not extend to their vicarious liability for the acts and omissions of employed practice clinical staff working autonomously, such as practice nurses.
 
"GPs must ensure that all employed clinical staff have their own indemnity arrangements in place. This may be provided as part of a practice package or through individual membership.
 
It is feared, under the new RCN membership terms, many practice nurses may be discouraged from working in an advanced capacity, with general practices reluctant to add to their mounting costs.
 
Dr Vautrey does not believe this will be the case but has expressed concern over who defines what is an 'extended role' for a practice nurse. He has called upon MDOs to deliver clear guidance to mitigate any future problems in this area.
 
Controversially, practices will also become free to ask practice nurses to pay for indemnity coverage out of their own pocket once the RCN cover expires.
 
Dr Vautrey advised practices to be "sensible" when deciding whether to take this road but refused to comment on whether it would be a move the GPC would endorse or oppose.
 
A spokesperson from the MPS told NiP media reports have "exaggerated the implications of this move for general practices" - a sentiment Dr Vautrey shares.
 
"Some reports have claimed general practices will see a sharp increase in defence premiums - there is no justification for that to happen," he said.
 
"It is unlikely that the RCN's withdrawal of indemnity for practice nurses will impact many practices - if at all."
 
 
 
 
We asked you if you will be discouraged from advanced practice in light of the RCN's policy change. 
Your comments (terms and conditions apply): 
 
“Have to admit the only thing I get for my money is a magazine full of job adverts and a diary. Now this is happening, I will be leaving the RCN and finding someone who will cover me in my extended role as a practice nurse.” - Carol Patterson, Bury St Edmunds
 
“I would like to add my comment to those expressed below. Indemnity is the main reason I have maintained my membership with the RCN, especially as I too, work in an advanced role and am an independent non-medical prescriber. After over 33 years, looks like I'll be turning to Unison too.... and many thanks to Andrea for researching that.” - Frances Boomer, Overseas command
 
“Yes, after 28 years membership I will be moving to another organisation; this is shameful treatment of professionals - many of whom work in isolation in autonomous roles and who NEED their support.” - Name and address withheld
 
“I am currently doing an independent nurse prescribing course and I now feel "what is the point?" I'm extending my role as a practice nurse to benefit patients and I am disgusted by the failure of the RCN to support me. I have been a member of RCN for 25 years now and I don't think I will be renewing my subscription either.” - Helen, Northern Ireland
 
“I have left the RCN after almost 40 years. When I became a partner my indemnity from the RCN ceased, I continued to pay my fees but this is the final straw. Why should general practice nurses be excluded without at the very least some financial compensation? We pay MPS for all clinical staff but there may be some PNs who may not be so fortunate, MPS is usually based on the sessions worked. The previous question about locum sessions is very valid.” - Andrea Richardson
 
“How about those of us who are heading up community organisations, working with the homeless and working in general practice and have complex roles?
My organisation's employer liability and professional indemnity insurance demands that I have my own PI insurance whilst undertaking clinical work. Having been a member for more than 30 years, I am amazed that there has been no communication or consultation about this. I'm glad I found out today by accident so that I can prepare for January and a change in Union.” - Stephanie O'Leary, London
 
"This is yet another disaster, no one recognises the input P/N's make to general practice, everyone always let us down, we have never had good pay etc and now this will be leaving RCN" - Jaz Bains, West Midlands
 
"I would like to add my comment to those expressed below. Indemnity is the main reason I have maintained my membership with the RCN, especially as I too, work in an advanced role and am an independent non-medical prescriber. After over 33 years, looks like I'll be turning to Unison too....and many thanks to Andrea for researching that" - Frances Boomer, Overseas Command
 
"Yes after 28 years membership I will be moving to another organisation. This is shameful treatment of professionals - many of whom work in isolation in autonomous roles and who NEED their support" - Name and address supplied
 
"I am currently doing the independent nurse prescribing course and I now feel 'what is the point?'.  Im extending my role as a practice nurse to benefit patients and I am disgusted by the failure of the RCN to support me. I have been a member of RCN for 25 years now and I don't think I will be renewing my subscription either" - Helen, Northern Ireland
 
"I have left  the  RCN after  almost 40 years. When I  became a partner my indemnity from the RCN ceased I continued to pay my fees but this is the final straw, why should  General Practice Nurses be excluded without at the very least some financial compensation?  We pay MPS for all clinical staff but  there may be some PNs who may not be so fortunate as MPS is usually  based on the sessions worked. The previous question about Locum sessions is very valid" - Anna Richardson
 
"How about those of us who are heading up community organisations, working with the homeless and working in general practice and have complex roles? My organisations employer liability and professional indemnity insurance demands that I have my own PI insurance whilst undertaking clinical work. Having been a member for more than 30 years, I am amazed that there has been no communication or consultation about this.  I'm glad I found out today by accident so that I can prepare for January and a change in Union" - Stephanie O'Leary, London
 
"I'm lucky to be covered by my GPs but I think I will be looking to cancel my RCN membership, I don't think they are of any practical use to Practice Nurses" - Cath Nolan, NE England
 
"I am considering leaving the RCN after being a member for over 30 years. Yet again they have let Practice Nurses down completely" - Lorraine Shwenn, Hull
 
"Yes absolutely,the top reason for paying my RCN registration fee was the indemnity for practice nurses.I will not pay my 2012 registration fee. The RCN has made a bad decision for its future" - Carl Curtis, Southwark NHS
 
"I will be cancelling my RCN membership and finding an organisation that will provide appropriate cover and a guarantee that they will look after my interests" - Gillian Cash, Isle of Man
 
"Not unless I had difficulty securing some other cover because my salary is considerably lower than my GP colleagues! I must say that I am absolutely disgusted at not only the decision but the fact that as an organisation they did not inform us.I will definitely cancel my membership and worry about the legal responsibilities of an organisation like the RCN who bail when the going gets tough. Look out all of the other nurses working in more advanced roles because if your job costs the RCN too much money you too may face the chop! It then becomes such a joke to read the RCN magazine claiming to promote CPD and nurse education!" - Lesley Williamson, Northumberland
 
"I have been an RCN member for 35 years but will be leaving in January. In the letter sent to me it states that I would be covered by the GP through vicarious liability. Reading the above this is not true. How many nurses will believe the letter and not be covered? A very scary thought indeed." - Ruth Wright, Kent
 
"As usual RCN support seems to be non existent to practice nurses and I will definitely not be renewing my membership next year." - Carol Disley, Lincolnshire
 
"I am considering leaving the RCN after being a member for over 30 years. Yet again they have let Practice Nurses down completely." - Lorraine Schwenn, Hull
 
"I am now concerned that I will not be adequately covered for my prescribing practice, which significantly enhances my role, particularly as Diabetes Clinical Lead for our surgery." - Margaret Stubbs, Portsmouth
 
"Yes, absolutely. The top reason for paying my RCN registration fee was the indemnity for practice nurses. I will not pay my 2012 registration fee, the RCN has made a bad decision for its future." - Carl Curtis, London
 
"What about the practice nurses who offer locum cover in their free time?" - Name and address withheld
 
"What a disgraceful act by the RCN. So much for nurse support." - Name and address withheld
 
"I will be cancelling my RCN membership and finding an organisation that will provide appropriate cover and a guarantee that they will look after my interests." - Gillian Cash, Isle of Man
 
"Like many others I will be looking for an alternative. I feel very badly let down by the RCN Again, it seems Practice Nursing and Nurses are left out on a limb by the very organisation that says it works for nurses - seemingly only some!" - Margaret Briggs, Stirlingshire
 
"I am disappointed in this move by the RCN. I may well withdraw my membership as this was a key reason for being a member. The least the RCN can do is to reduce the subscription for practice nurses, as they will be offering us less. I am concerned re my prescribing role as the Diabetes clinical lead in the practice." - Margaret Stubbs, Portsmouth
 
" The main reason I belong to the RCN is for the indemnity cover. If Practice Nurses will not have that then there seems little point in belonging or at least paying as much as other members." - Lynn McCarthy, Saffron Walden
 
"No, but I will withdraw my RCN membership, cancel my subscription to their journals and find an organisation that will cover me." - Michelle James, Northumberland
 
"What is the point of being a member of the RCN? I have been a practice nurse for years, also luckily a member of the MDU whilst working in General Practice. I think we need more than a free diary?" - Amanda, Cambridge
 
"I will not be discouraged from advanced practice having worked long and hard to up-skill, but will be forced to cancel my subscription to RCN in preference to a union that will offer the support I need to continue." - Noelle Collingwood, Suffolk
 
"Not unless I had difficulty securing some other cover because my salary is considerably lower than my GP colleagues! I am currently at university studying for the prescribing course in order to enhance the patients' care. This on top of all of my other work and home commitments I must say that I am absolutely disgusted at not only the decision but the fact that as an organisation they did not inform us. I will definitely cancel my membership and worry at the legal responsibilities of an organisation like the RCN who bail when the going gets tough. Look out all of the other nurses working in more advanced roles because if your job costs the RCN too much money you too may face the chop! It then becomes such a joke to read the RCN magazine claiming to promote CPD and nurse education!" - Lesley Williamson, Northumberland
 
"I have three comments on this:
 
Firstly I agree with Christine Forgan's view that the RCN lacks understanding of General Practice work.
 
Secondly, the RCN fails to use nursing evidence to support Practice Nurses. For example, it is known (e.g. survey by Education for Health, 2007) that around half of PNs feel they are not adequately trained for aspects of their work.
 
Although some areas have excellent collaborative training between PCTs and local universities - such as that outlined by Ann Moger at the PNA Conference two years ago, June 2009. At that conference PN's raised their dilemmas of GP's reluctance to support attendance at training modules but the response of the RCN Adviser was to 'leave the practice for the sake of their health'.  Two years on, this year's PNA Conference was cancelled due to poor uptake - is anyone surprised?
 
Thirdly I'm not surprised to have been informed by letter, with no prior membership consultation.  Nor with the RCN's lack of engagement with MDO's.  The RCN has a very 'patchy' track record of national multi-professional engagement, as raised by members at the RCN AGM in London last month." - Catherine Gleeson, West Yorkshire
 
"The RCN has lost yet another practice nurse member this week. They have been of limited and questionable benefit to me in my 14 years as a paying member. I have joined Unison." - Lin McDonald, East Sussex
 
"No, but as the only real benefit of belonging to the RCN was the liability cover, the solution is obvious: leave the RCN ASAP." - Mike Horsburgh, Cornwall
 
"I am leaving the RCN after 30 years because of this, as are my other nursing colleagues in this practice." - Michelle Quinton, Hampshire
 
"Many years ago I cancelled my RCN membership as I had no faith in its understanding of General Practice or its care of General Practice Nurses. I joined the MDU, which offers very good and comprehensive cover for Practice Nurses.  Having read the poor, and purely financial, reasoning behind the RCN's decision re Practice Nurse cover, I see my initial worries were well founded.  I encourage all PNs to leave the RCN and join an organisation that understands General Practice.  As with all insurance policies one hopes never to use it but if one needs to, it is good to know that you have a professional body that will have no hesitation in supporting you" - Christine Forgan, Lothian
 
"I will not be discouraged from practicing at an advanced level but I am seriously considering cancelling my RCN membership" - Lynne Gray, Skelmersdale
 
"Yes, I think it is disgraceful" - Allison Jackson, Highland
 
"I would want to be absolutely certain I am covered for actions taken in the course of my job. If it turns out that I am not covered I would not undertake duties for which I am not covered" - Fiona Wallace, Scotland
 
"Yes I will be discouraged.  I will withdraw my RCN membership if this goes ahead - as will many of my colleagues. I am profoundly disappointed with the RCN" - Elgar, Winchester
 
"I am disappointed with this decision to withdraw indemnity for practice nurses. Why should they be penalised when they pay the same RCN rates as all other RGN nurses? Practice nurses are again being disadvantaged as they were not allowed to contribute to the NHS pension. I was a practice nurse for many years and my pension is reduced because as I was employed by GPs I was not part of the NHS-- the patients that are treated in GP surgeries are all in the NHS.How many practice nurses think that their GP's will pay for MDU cover--shame on the RCN to consider this as this will leave PN's open to litigation. GP's will not support this and therefore PN's will refuse to perfom certain procedures. Nurse Practitioners will have to really consider their responsibilities"- Mo Lewis, Wales
 
"No but I may have to consider cancelling my RCN policy and move to an organisation that will cover me. I think it is unreasonable that this is happening to practice nurses and am sure another solution could be created so that Practice Nurses will be covered by the RCN and not forrced to leave the organisation. I have had no response to the plight of locum Practice Nurses. are we still covered by the RCN?" - Brenda Simmonds, Surrey
 
"I will no longer be a member of the RCN" - Mary, Cambridge
 
"I have left the RCN and joined Unison who will cover us in General Practice.I have worked long and hard to be able to work as advanced Practice Nurse and do not want to stop" - Andrea McIlwee, Birmingham