RCN withdraws indemnity cover from employed nurses and aesthetic practice

The RCN’s indemnity scheme covering members against clinical negligence claims is about to change again. From 1 July 2014, it will exclude work undertaken as part of a contract of employment, and it will exclude aesthetic practice. The RCN says the vast majority of its members will not be affected by this change, and reiterates that it will continue to provide workplace and NMC support and representation.

The RCN says that all employers – the NHS (including for bank or agency work), GP practices, independent sector, out-of-hours providers and so on – “have vicarious responsibility for the actions of their staff” and should cover the costs of any claims of clinical negligence. Its says RCN cover is not needed to cover employed members for work undertaken as part of their contract of employment as their employer is liable, so it is closing what it calls a loophole by making some “small, technical changes”. Education placements, good Samaritan or charitable nursing work and voluntary work are still covered.

According to the RCN, some employers have been attempting to shift their costs onto the RCN, “even insisting that their staff have personal indemnity cover”. The NHS does not do this, and nor can GP practices since the rules were changed in 2011, amidst some controversy, but some out-of-hours providers and other organisations are still trying to do so.

Most self-employed members are covered by the scheme but should check their specific circumstances, as there are some exclusions. In addition, from 1 July 2014, aesthetic practice will no longer be covered by the RCN, as there is a high risk of claims.

Chief Executive and General Secretary of the RCN, Dr Peter Carter, said: “Most members won’t notice a change at all, but this ensures that the responsibility for claims rests with those who should be paying – namely the employer – so that we can focus on protecting, representing and supporting members in other work-related and professional legal areas. This means that neither our members nor the RCN will pay the price for underperforming employers.”

Unison says it is examining the rationale behind the decision but that its indemnity insurance stays in place for now. Christina McAnea, Unison Head of Health, said, “It should, however, be crystal clear that employers are responsible for ensuring that their staff are covered.”

The issue of indemnity, particularly for nurses in extended roles given recent legal changes, was discussed at the November ANP conference. The NMC is still preparing its final information about the new legislation that makes indemnity insurance compulsory for all healthcare professionals but is clear that nurses working for the NHS already have appropriate arrangements; that nurses working for other employers should be covered by their employer’s scheme – but should check the detail; and that self-employed nurses will need their own cover. In its draft information, the NMC says it cannot offer advice on what level of cover is appropriate.

Dr Barbara Stuttle CBE, ANP Chair, said, “The changes highlight the fact that responsibility for indemnity for employed nurses acting within the terms of their contract lies with their employers. Nurses working in advanced or extended roles such as prescribing should check that their job description states that their role includes prescribing, and that their employer’s indemnity covers these roles. Both employed and self-employed nurses must check they are covered – ignorance will be no excuse!”