Indemnity cover

Indemnity cover makes sure that if a patient is harmed through a professional's negligence, they can recover the compensation they are entitled to. It can come from an employer's scheme, from membership of a professional body, trade union or medical defence organisation, or from an insurance policy bought directly.

In the UK it is a legal requirement. The HCPC says legislation introduced in July 2014 requires all its registrants, other than social workers in England, to have an arrangement in place as a condition of registration. The GMC describes adequate and appropriate cover as a statutory requirement for doctors, and the NMC says nurses, midwives and nursing associates are legally required to have it in order to practise.

Cover must match the nature and extent of the risks of your own practice. The HCPC lists factors such as the areas you work in, the people you care for and the risks involved. If your scope of practice changes, for example when you start private work, you should check that your cover still applies. The GMC can check a doctor's cover and can remove a licence to practise if a doctor does not have adequate cover or does not provide the information it asks for.

The HCPC adds that some professional bodies and trade unions include indemnity in their membership or offer it for an additional fee, and that you should contact your insurer when your scope of practice changes.

• NHS trusts: NHS Resolution runs the Clinical Negligence Scheme for Trusts (CNST), which covers clinical negligence claims for incidents on or after 1 April 1995 in member organisations.
• General practice in England: since 1 April 2019 the Clinical Negligence Scheme for General Practice (CNSGP) has covered NHS services in general practice, including GPs, locums, trainees and practice nurses. It is centrally funded, so individuals do not pay to benefit.
• Ireland: the Medical Council says employers require registered doctors to hold professional indemnity insurance, and every doctor must have adequate cover before practising.

These schemes relate to NHS services. The GMC notes that cover needs differ for NHS work, private practice, locum work and medico-legal work, so check each kind of work separately.

1. Ask your employer in writing whether its scheme covers your role and duties.
2. If you are self-employed or work privately, arrange your own cover through a professional body, union or insurer.
3. Declare your cover when you register and, for nurses, at each revalidation. The NMC does not ask for evidence, only a declaration.
4. Recheck when you change job, add private work or extend your scope.

• Assuming NHS cover extends to private sessions or overseas telehealth.
• Starting work as a locum before cover is confirmed.
• Letting a defence organisation membership lapse between jobs.