Why you need an MDO

As a junior doctor, you may believe that NHS indemnity provides all the help and support you need should you run into professional difficulties. But what about all the things it won’t help you with?

  • Date: 29 January 2019

HOSPITAL doctors often assume that NHS indemnity provides all they will ever need in terms of professional advice and support, with many not giving a second thought to the idea of joining a medical defence organisation (MDO).

It can come as a shock to discover that there are a number of key exclusions to NHS cover, leaving some unsuspecting clinicians having to pay hefty legal bills out of their own pocket.

Hospital doctors must ask themselves how they would cope without advice, support or legal representation in the event of a General Medical Council (GMC) referral, disciplinary hearing, coroner’s inquest or fatal accident inquiry. And would they be in a position to fund such assistance personally?

It’s true that you will be indemnified by the NHS for the work you do within your NHS contract, but there are a number of key areas where your NHS cover will not assist you.

These are issues for which a medical defence organisation can provide unlimited assistance:

  • 24/7 medico-legal advice.
  • General Medical Council referrals – without access to assistance, you will have to pay for your own advice and representation.
  • Disciplinary hearings – NHS indemnity does not provide advice or support in relation to any disciplinary issues.
  • Coroner’s inquests/fatal accident inquiries – NHS indemnity offers no guidance or representation on how to conduct yourself at these hearings.
  • Private work – it is a GMC requirement that you secure access to indemnity for work not included within your NHS contract.
  • Good Samaritan cover – membership of a medical defence organisation will provide you with access to worldwide indemnity for Good Samaritan acts.

As a member of a medical defence organisation, hospital doctors have access to a number of key benefits which are further explained in these commonly asked questions.

I work for the NHS. Why do I require MDO membership when I already have NHS indemnity?

As a hospital doctor you will be indemnified by NHS indemnity for work undertaken within your NHS contract. If, however, you are involved in disciplinary issues, GMC referrals, fatal accident inquiries or coroner’s inquests you would not receive any assistance unless you have secured membership with an MDO. Such situations can seriously impact upon your career and could ultimately result in you being struck off. It is therefore crucial that you have access to support and guidance from experienced medico-legal advisers.

I undertake private work, will the NHS cover me for that?

The GMC requires you to secure adequate and appropriate indemnity for any private practice undertaken beyond your NHS contract. As a result you must ensure that you have the necessary cover in place.

If I am referred to the GMC will the NHS offer me assistance?

No. The NHS will not assist you if you are involved in a GMC matter. Remember that the GMC has the power to suspend, place restrictions on your practice, issue you with a warning and ultimately erase you from the register. With such potentially severe consequences there are a range of advantages of having representation and assistance from an MDO whose focus will be to ensure that your case is dealt with fairly and efficiently and that you are properly represented.

What are the advantages of having assistance from an MDO at a fatal accident inquiry or coroner’s inquest?

Any criticisms made at an inquest/inquiry can lead to a GMC or a criminal matter being raised against you. With such high stakes it is important to have the support and guidance of a medico-legal adviser with the experience and insight to advise you on how to conduct yourself at such a formal and daunting process. MDOs which employ and retain some of the UK’s leading medico-legal solicitors can instruct the best legal representation, which will be made available to members free of charge.

Does my membership provide me with assistance regardless of where I work in the UK?

This is an important point to check with your MDO. Assistance should be offered regardless of where you work in the UK (there may be some exceptions such as the Channel Islands, the Isle of Man, Gibraltar and the Falkland Islands). Even if an MDO does not normally operate membership outside the UK, it is likely it will indemnify members for Good Samaritan acts anywhere in the world which are not covered by any other indemnity or insurance arrangement.

What is the difference between occurrence-based and claims-made products?

Before joining an MDO it is important to clarify the type of product they offer. With an occurrence-based product, members can apply for assistance with claims or complaints arising from incidents that occurred from the period while you were a member, even if you have left membership when the claim/complaint arises. In contrast, claims-made products only guarantee protection if you are insured, both when the incident occurred and when the claim/complaint is made. The crucial importance of this lies in the fact that acts of medical malpractice often do not occur and then materialise in a claim/complaint within a short period of time. There can be several months or even years between the events that give rise to a claim/complaint and the claim/complaint being made.

For more information visit www.mddus.com

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Read more from this issue of FYi

FYi is published twice a year and distributed to MDDUS members in Foundation Year 1 and Foundation Year 2 training programmes and final year medical students throughout the UK. It provides a mix of articles on risk, medico-legal and regulatory matters as well as general features and profiles of interest to trainee doctors. Browse all current and back issues below.
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