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HEE block indemnity arrangements for medical specialty trainees

Health Education England (HEE) works in partnership with Medical Defence Organisations (MDOs) to ensure postgraduate doctors in GP training and those training in certain other medical specialties have comprehensive indemnity arrangements throughout their training.

Eligible specialties:

General Practice

Public Health

Palliative medicine

Occupational medicine

Community, sexual and reproductive medicine

Genito-urinary medicine

Sports and exercise medicine

Aviation and space medicine

Medical Protection have been appointed to provide membership for trainees in the following regions/deaneries.

Midlands:

  • East Midlands
  • West Midlands

South East:

  • Kent, Surrey and Sussex
  • Thames Valley
  • Wessex

North East and Yorkshire:

  • North East
  • Yorkshire and Humber

North West:

  • Mersey
  • North Western

What this means for members

If you are eligible for Medical Protection membership through a HEE block indemnity arrangement, HEE will ask your permission to provide us with your contact details before your training starts so we can get in touch with further information.

Current Medical Protection members

If you are currently a member and HEE inform us you are now eligible for a membership through a block indemnity arrangement, you don't need to take any action. We will update your membership and send you further information about this nearer the time. 

Joining Medical Protection

If you are due to begin specialty training in 2023, you can apply online from eight weeks before your training starts. We’ll write to you with further information about how to apply. 

 

Leaving Medical Protection

If another MDO has been appointed to manage the block indemnity arrangement for your deanery you may wish to end your Medical Protection membership. We will be sorry to see you go but will make this as easy as possible. Please call on 0800 952 0441 to let us know and we’ll close your membership and provide any refund due to you.  

We recommend you remain in membership with us until your new MDO membership is confirmed. This will ensure there are no gaps in your protection.

 

Membership benefits

Your HEE block indemnity arrangement provides you with all the comprehensive membership benefits that medical specialty trainees need, including:

  • access to medicolegal advice and expert legal representation, including 24/7 in an emergency
  • indemnity for work undertaken during your ST training which is not indemnified by either the Clinical Negligence Scheme for Trusts or the Clinical Negligence Scheme for General Practice
  • a wide range of additional support, including our member journal Casebook, essential risk prevention skills training and access to an independent counselling service.

You can find further details in the information we send you and in the FAQs below.

Private work outside your training

HEE block indemnity arrangements don’t include access to indemnity and medicolegal support for private work undertaken outside your ST training for an employer other than the NHS.

However Medical Protection is pleased to offer you free additional membership for private work where your gross annual earnings are £10,000 or less. If you earn more than £10,000 annually from private work, an additional membership fee will apply. Your additional membership may be subject to underwriting approval and some exclusions.

You can find further details in the information we send you and in the FAQs below.

 

Is membership through HEE guaranteed?

Yes if, as a medical specialty trainee in an eligible specialty and region, you are covered by the terms of our agreement with HEE. You won’t be refused membership due to your claims history, new claims notified to us during this period of membership, or if you have had GMC suspension and are subsequently reinstated with conditions.

What is the scope of indemnity protection during training?

Trainees have the right to request indemnity for clinical negligence claims arising from clinical and non-clinical activities which are not indemnified by either the Clinical Negligence Scheme for Trusts or the Clinical Negligence Scheme for General Practice, including out-of-hours work, where:

  • training placements are part of a trainee’s official training programme rotation at approved centres
  • the trainee is appropriately supervised throughout this element of their rotation
  • the trainees only undertake procedures and tasks they are suitably trained, qualified and competent to carry out

This could include, but is not limited to, providing palliative care within a care home, supporting consultants with a procedure not available under the NHS and carrying out ‘category 2’ or ‘fee-paying work’ in the course of their NHS employment.

Trainees also have the right to request indemnity and assistance in relation to Good Samaritan Acts worldwide as a benefit of Medical Protection membership.

Medical Protection indemnity provides access to end-to-end claims management and meets all the financial costs of the claims we manage. There are no limits on the number of claims members can make and no caps on the amount we will pay out. It is offered on an occurrence basis meaning you can seek assistance with any adverse incident that took place during the period of membership, even if the claim is brought several years later.

Does membership include indemnity for work undertaken outside ST training?

HEE block indemnity arrangements don’t include access to indemnity and medicolegal support for work undertaken outside ST training. However, we are pleased to offer you this additional protection as outlined below.

NHS-indemnified work. This is included in your standard HEE membership and you don’t need to inform us of this work. However, if you work for a service that has been commissioned from a private provider to care for NHS patients, please be aware that your work may not be NHS-indemnified. In this scenario we recommend you check your contract and, if it requires you to arrange your own indemnity, then treat this as private practice (see below).

Non indemnified private practice. We will provide free membership where your gross annual earnings are £10,000 or less. If your gross annual earnings are over £10,000 you will be asked to pay an additional annual subscription of £1,100 per annum.

Please ensure you add any non-indemnified practice to your membership even if your earnings from this are less than £10,000 and you are entitled to free membership, so we can ensure you are fully protected.

There are some exclusions to the work you can undertake. You cannot be the clinician in overall charge of the clinical care of the patient and your earnings cannot be derived from any of the following activities:

  • air ambulance/repatriation
  • bariatric surgery
  • benefits work
  • circumcisions
  • complementary medicine
  • cosmetic/aesthetic medicine (other than Botox, or other non-permanent fillers and superficial chemical peels)
  • general practice
  • health screening (other than DVLA medicals)
  • medical nonclinical work (eg appraiser, coroner, tribunal officer, responsible officer)
  • medicolegal work
  • neurosurgery
  • obstetrics
  • occupational medicine
  • ophthalmology (including refractive laser surgery)
  • oral and maxillo-facial surgery
  • plastic surgery, reconstructive and aesthetic surgery
  • slimming clinics
  • sports club doctor
  • spinal procedures/surgery
  • pregnancy termination

What medicolegal support does Medical Protection provide?

As well as access to indemnity for clinical negligence claims which are outside the scope of the CNST and the CNSGP, you need complementary protection for the range of medicolegal issues that can arise during your training.  

Medical Protection membership includes:

  • Access to our medicolegal adviceline, including emergency support 24/7.
  • The right to request advice and legal representation for coroner, disciplinary and regulatory proceedings and criminal investigations related to professional practice. This can include, but is not limited to, GMC fitness to practice investigations, representations at Medical Practitioner Tribunal Service and in high court appeals, help to prepare a case for a disciplinary hearing, support preparing a case and representation in a coroner’s court.
  • The right to request assistance with complaints to the GMC arising from personal or professional conduct or health issues from the first stages of the investigation through to the end.
  • Expert help responding to and resolving complaints.
  • A team dedicated to dealing with unwanted media attention in relation to a case or claim, including preparing statements and responding to the media.

As with claims indemnity, medicolegal protection and support is offered on an occurrence basis to provide reassurance that you are protected throughout your career, provided you were in membership at the time the incident occurred.

What are the additional benefits of Medical Protection membership?

Essential skills training

Indemnity and medicolegal support address problems as they arise, but it is important that trainees have the knowledge to practise safely and with confidence a wide variety of settings and circumstances.

We provide a comprehensive, member-focused risk prevention programme including workshops, online courses and webinars with accredited CPD to help you develop your communication and risk management skills, and risk management resources including our Casebook journal.

Wellbeing support

We want to support you through your Specialty Training and interactions with patients and that includes helping you address any mental health concerns. We include a wellbeing service in our core membership offer, including free and confidential counselling provided by our independent partner, ICAS. Any trainee suffering work-related anxiety or stress, or who is involved in a case or claim, can access this service.

Can trainees join while on a period of statutory leave eg maternity leave?

Yes. We would encourage you to join us straight away using the application portal and then call us on 0800 952 0441 so we can update your membership status. This means you can continue to access Medical Protection resources, courses, advice and medicolegal support during your statutory leave and are protected for Good Samaritan Acts.

Can trainees join if they have an open case or claim with another indemnity provider?

Yes. If you join Medical Protection and you have a current open case, incident or matter, or one which comes to light from a period when you were not in Medical Protection membership, you should continue to seek assistance from your previous provider in respect of this. However, you can contact our medicolegal team and ask for guidance on how to approach this, should you require any additional support. The majority of indemnity organisations operate on an occurrence basis which means even if you have left a previous provider you are entitled to seek assistance in relation to a case, incident or matter that occurred while you were a member.

Are trainees eligible for membership if they undertake training in another region as part of an Out of Programme Training (OOPT) agreement?

Yes. If Medical Protection has been appointed to provide membership for your permanent region/deanery, this will continue if you undertake training in another region as part of an Out of Programme Training (OOPT) agreement. This includes rotation in Scottish and Welsh settings. Please let us know if you go OOP so we can keep your membership record up to date.

Will membership renew automatically?

When you join Medical Protection, or we transfer you to an HEE block indemnity arrangement, your annual renewal date will be the same month as your expected date for completion of training. This may mean your first membership period is less than 12 months but it will then be automatically renewed.

We will continue to renew your membership annually for the duration of your training. We ask that you let us know about any changes to your training or personal circumstances during this time, such as taking a break from your training or going OOPT.

Once your training is complete, we’ll let you know about your options for remaining in membership as a newly qualified GP, hospital doctor or consultant.

Understanding your membership

Please take time to read the guide to your responsibilities as a member and examples of those circumstances in which we are unlikely to be able to help with a request for assistance.
 

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