All dentists that are on the National Performer List are required to have professional indemnity under the NHS Performer List Regulations 2013.
The General Dental Council also has a requirement for all registered dentists and this is defined in the GDC Standards:
Standard 1.8 of Standards for the Dental Team states:
‘You must have appropriate arrangements in place for patients to seek compensation if they suffer harm’
All dental professionals must, by law, have an indemnity arrangement or insurance policy in place. This is so that any patient who suffers harm can recover any money they might be entitled to through compensation, in the event of a successful claim.
The following types of indemnity or insurance are recognised by the GDC:
Dental defence organisation membership – either your own membership or as part of your employer’s membership;
Professional indemnity insurance held by you or your employer (including indemnity insurance provided by your professional association);
NHS indemnity.
However in recent times we have seen the cost of indemnity rise and the reason quite simply is, litigation has skyrocketed, but rather than costs being passed onto those most at risk, the rising costs have been crudely apportioned across the profession, with some clinicians with decades of experience seeing thousands of pounds being added to their fees, despite having a clean record.
This has led to dentists shopping around to find an affordable alternative to their current indemnity.
The types of indemnity currently available are:
Dental Defence Organisations – Mutual societies
Insurance-based indemnity – Offered by commercial insurance organisations and some DDO’s
Dental Defence Organisations
Traditionally, the dental defence organisation has provided their members with indemnity on a discretionary basis, meaning that there is no legal contract between the indemnifier and the dental professional. Should the dental professional find themselves in a position where they require assistance, it is at the discretion of the DDO's board or council whether to assist or not. Each case is considered when the request is made.
In circumstances, albeit rare, that discretionary assistance is refused the dental professional may find them faced with having to fund their defence and any compensation award themselves. Equally concerning is where that leaves patients who have been negligently harmed; they might not be able to seek the compensation they may be entitled to, which goes against the GDC's ethical guidance, Standards for dental professionals.
Support and advice should be available as a matter of course with a DDO.
Insurance-based Indemnity
An indemnity policy is a legal contract to provide assistance in the event of a claim, subject only to the terms and conditions of the policy.
The cost of insurance will vary according to the length of time you have been qualified and the type of treatments / specialty you provide in your practice.
Insurance-based indemnity are contractual cover, and has the following types available:
Claims made indemnity
Claims occurrence indemnity
Contractual insurance cover provides a legally enforceable contract between the dentist and their insurer. Among the many requirements of contractual cover are that clients are treated fairly and insurers have the funds to meet claims, if necessary.
Claims made indemnity means that you are only covered when the dentist is currently insured and the claim is made during that current period of insurance. This requires ‘Run Off Cover’ to be taken when the dentist stops practising.
Claims occurrence indemnity means that you are covered no matter when the claim is made as long as you were insured when the occurrence happened. This means that you do not need run off cover.
Whatever type of professional indemnity you choose you need to ensure that it has sufficient cover, that the cover will apply to all of your activities and that it will provide support for you when a claim is made. This last part is important, as your indemnity should provide support with your claim and any representation that is necessary for litigation or professional conduct issues relating to the claim.
Ensure that you carefully read and understand the terms of your cover.
Currently when applying to join the National Performer List you will be required to demonstrate that your insurance based indemnity has a minimum of £5 million cover and that your Run Off Cover, should it be necessary, is for a minimum of 3 years.
Membership of a DDO will be assumed that those minimum levels are in place.
When engaging a locum dentist it is the responsibility of the provider/contract holder to ensure that the locum has appropriate indemnity to cover them for the type and period of work they are being engaged for, and that would include satisfactory Run Off Cover.
If you have any questions don’t hesitate to contact me about indemnity and the performer list requirements.
David Bradley BDS
Dental Adviser
NHSE Lancs and S Cumbria
David.bradley12@nhs.net