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What is the Existing Liabilities Scheme?

In April 2019, the Clinical Negligence Scheme for General Practice (CNSGP) for England and the General Medical Practice Indemnity (GMPI) scheme for Wales were introduced to provide general practice staff with indemnity cover for claims related to the provision of NHS primary medical services from 1 April 2019 onwards.

We have since reached an agreement with the Department for Health and Social Care in England, and the Welsh Government, for them to assume responsibility for eligible claims against primary care members which relate to the provision of NHS primary medical services where the adverse incident date was before 1 April 2019.

These claims will be managed through the Existing Liabilities Scheme for General Practice (ELSGP) in England and the Existing Liabilities Scheme (ELS) in Wales.

Why has an Existing Liabilities Scheme for General Practice been introduced for England and the Existing Liabilities Scheme for Wales?

The transfer of the responsibility for providing indemnity for historical clinical negligence liabilities to DHSC under the ELSGP in England, and to the Welsh Government under the ELS in Wales, means that Medical Protection members working in general practice in England and Wales can turn to a government backed indemnity scheme for help with a clinical negligence claim related to the provision of NHS primary medical services, regardless of when the adverse incident it relates to occurred. 

You can read more about this in the announcements we made on our website at the time the agreements on the ELSGP in England and ELS in Wales were reached.

What claims do the ELSGP in England and ELS in Wales cover?

The ELSGP in England and the ELS in Wales provide indemnity cover for clinical negligence claims (arising from the provision of NHS primary medical services) made against current and former GP members of medical defence organisations (MDOs) with whom the Welsh Government and DHSC has reached an agreement. This is in respect of liabilities incurred before 1 April 2019 within scope of the schemes. The schemes provide indemnity mainly for clinical negligence claims arising from the provision of NHS primary medical services (and in some circumstances, other ancillary NHS services provided by general practice). This, therefore, does not include medicolegal support in relation to matters such as GMC referrals, ombudsman investigations and coroners' inquests.

Do I need to pay for ‘run-off cover’ to use the ELSGP in England and ELS in Wales?

No. The Department for Health and Social Care said in 2019 that some GPs and others working in general practice might need to purchase ‘run off cover’ in order to be able to seek assistance with a historical claim from the ELSGP. But this does not apply to Medical Protection members. You have already paid subscriptions that reflect the risk that is likely to arise from your practice and there is no need for you to make additional payments.

What is NHS Resolution?

NHS Resolution is a Special Health Authority with responsibility for administering NHS state indemnity schemes for DHSC in relation to clinical negligence claims against the NHS in England. Their purpose is to provide expertise to the NHS on resolving concerns fairly, sharing learning for improvement and preserving resources for patient care. NHS Resolution have handled clinical negligence claims on behalf of NHS organisations and independent sector providers of NHS care in England since 1995, and on behalf of beneficiaries of state-based indemnity for general practice since April 2019.

What is NHS Wales Shared Services Partnership (NWSSP) – Legal and Risk Services?

Established by the Welsh Government in 1996, the NWSSP Legal and Risk Services is a team of in-house lawyers employed within the NHS Wales. They provide legal advice and representation for all health bodies in Wales and have specialist experience, knowledge and understanding of the legal, administrative and policy issues that affect the operation of the NHS in Wales.

Will my claim be transferred?

We have reviewed all clinical negligence claims and potential claims for members working in general practice in England and Wales and identified those which fall within the scope of the ELSGP in England or the ELS in Wales.

If you have told us about a possible claim related to the provision of NHS primary medical services where the adverse incident occurred before 1 April 2019, or we are currently managing a claim of this type on your behalf, from 1 April 2021 NHS Resolution in England or NHS Wales Shared Services Partnership Legal and Risk Services in Wales, will assume responsibility for managing that claim. 

If you think your claim or potential claim is affected, you don’t need to take any action now. We will write to you to explain the process before we begin transferring details of your claim or potential claim.

Why is my claim being transferred?

The transfer of claims to be considered under the ELSGP in England or the ELS in Wales by the 1 April 2021 forms part of the Existing Liabilities Scheme agreement Medical Protection reached with the Department for Health and Social Care in England in 2019 and with the Welsh government. In both cases, this allows general practice members access to state backed indemnity for claims related to NHS primary medical services regardless of when liability for the claim arose.

How will you ensure the details of my claim are shared securely?

The transfer of information about your claim or potential claim is being undertaken in accordance with our responsibilities under the General Data Protection Regulation and the Data Protection Act 2018.

You can find further details of how NHS Resolution in England and NHS Wales Shared Services Partnership Legal and Risk Services (NWSSP – L&R) in Wales will manage data transferred to them in their online privacy notices:

When is my claim being transferred?

From 1 February 2021, we started the process of transferring claims and potential claims within scope of the ELS in Wales to NHS Wales Shared Services Partnership Legal and Risk Services in February (NQSSP – L&R).

From 1 March 2021 we will also begin transferring claims and potential claims within scope of the ELSGP in England to NHS Resolution.

We will write to affected members with further information about the process. All claims and potential claims will be transferred by 1 April 2021. Once the transfer is complete, NHS Resolution or NWSSP – L&R will be in touch to confirm that, from 1 April 2021, they will be responsible for management of your claim or potential claim unless you have been advised otherwise in our letter to you.

Who should I contact if I need to speak to someone about my ongoing claim?

Once you have received confirmation from NHS Resolution or NHS Wales Shared Services Partnership Legal and Risk Services that they have assumed responsibility for managing your claim, you should contact them directly if you need to discuss your claim or potential claim.

NHS Resolution Claims team.
Tel: 0207 811 6212. Email: ELSGPnotifications@resolution.nhs.uk

NHS Wales Shared Services Partnership Legal and Risk Services Claims Helpline. Tel: 029 2090 5454. Email: ELS@wales.nhs.uk

Until then, Medical Protection will continue to be responsible for your claim or potential claim.

If it is a current claim, please speak to your Claim Manager. If it is a potential claim, please contact the Claims Assessment Team on 0800 953 8334.

Who should I contact if I need to speak to someone about a claim that has already been settled/closed?

If a claim is considered closed, this will not be transferred to NHS Resolution or NHS Wales Shared Services Partnership Legal and Risk Services. You can continue to contact Medical Protection if you need to discuss this claim.

Will the solicitors Medical Protection has instructed still act on my behalf?

Where Medical Protection has instructed solicitors on your behalf, they should remain in place but will take instructions from NHS Resolution or NHS Wales Shared Services Partnership Legal and Risk Services in consultation with you once the case has been transferred.

I have a medicolegal case and an ongoing claim related to the same incident. Are they both being transferred?

Only eligible clinical negligence claims are being transferred to the ELSGP in England or the ELS in Wales. ELSGP in England and ELS in Wales provide indemnity cover for clinical negligence claims arising from the provision of NHS primary medical services (and, in some circumstances other ancillary NHS services provided by the general practice). Medical Protection will remain responsible for claims and cases not covered by the ELSGP or the ELS, including medicolegal cases such as GMC referrals, ombudsman investigations, performers' list actions, coroners' inquests and criminal investigations related to professional practice. We will work closely with both NHS Resolution and NWSSP – L&R to ensure your interests are fully protected where medicolegal and clinical negligence cases run alongside each other.

What is the position if a patient making a claim lives in Wales but the care was provided by a GP in England (or vice versa)?

NHS primary medical services (under Part 4 NHS Act 2006) provided by a GP in England to a resident of Wales will be covered under ELSGP for liabilities within scope of the scheme. Similarly, the General Medical Practitioner Indemnity (GMPI) scheme in Wales will cover primary medical services provided by a Welsh GP practice to a resident of England.

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