NHS England is looking at how to bring down financial barriers deterring GPs from taking on out of hours work, participating in new care models and expanding primary care, HSJ has learned.

The organisation’s primary care directorate is working with the NHS Litigation Authority and medical defence organisations to look at the rising costs of medical indemnity for GPs, a letter from NHS England to new care model vanguard sites sent earlier this month said.

The letter, seen by HSJ, also said the Medical Defence Union has asked Priya Singh, executive director of the Medical Protection Society, to review how indemnity requirements would be affected by NHS England’s new care models programme.

Most NHS doctors are covered by the hospital and community health services indemnity scheme, also known as crown indemnity, for any work carried out under their NHS contracts, but this does not apply to GPs.

GPs and professional leaders have repeatedly raised concerns about increasing costs of indemnity. Richard Vautrey, deputy chair of the British Medical Association’s GP committee, told HSJ that for many GPs it was “more costly to do [an out of hours] session that the income they may generate”.

He warned that the situation was “simply unsustainable”. Indemnity costs had “increasingly put off doctors from doing out of hours sessions” and was creating a barrier for practices wanting to work together. 

There “needs to be a way of reducing the burden on individual practitioners”, Dr Vautrey added. “The bottom line is the costs of indemnity need to be paid for not by GPs.”

He suggested the government could cover the costs, or GPs could be entitled to crown indemnity “if work is increasingly moving from hospitals to the community” and they are doing “increasingly more complex work”.

An NHS England spokesman said: “We understand the impact of indemnity costs on general practitioners and it is a priority issue for us to resolve.

“As part of this, we are keen to work with medical defence organisations to help them understand and plan for how professionals will work under the new and emerging models of care.”