Indemnity for OH professionals

All registered healthcare professionals in the UK must have an insurance or indemnity arrangement in place in order to practise, as from 17 July 2014.

This is as a result of the EU cross-border healthcare directive (2011/24/EU), which is implemented in the UK by The Health Care and Associated Professions (Indemnity Arrangements) Order 2014, SI 2014/1887.

NHS employees are covered in any event by the NHS Indemnity (sometimes called Crown Indemnity) provided by the NHS Litigation Authority in England. However this does not cover practice outside the NHS, nor does it cover healthcare professionals working in GP practices. In any event, many doctors and nurses also rely on their medical defence organisation or union membership – eg for indemnity cover for voluntary or private work, or support for disciplinary cases. See for example BMA advice for doctors , including further links at the bottom of that page.

Otherwise practitioners should check that their employers (if they are employed) have appropriate insurance or indemnity arrangements, and arrange personal cover if need be.

As regards nurses, the RCN changed its indemnity from 1 July 2014 so that it no longer covers employed RCN members, only self-employed nurses. Also the RCN indemnity no longer covers ‘aesthetic practice’. See

OH is generally considered a low-risk specialty, and subscriptions should reflect that.

Personal vs vicarious liability

Employers are ‘vicariously’ liable’ for employees. Eg. the NHS, an OH company, or a company otherwise directly employing OH staff is liable for negligence of its OH employees in the course of their employment. But legally the individual is also personally liable for his or her negligence – both to the claimant, and also to the individual’s employer in the unlikely event that the employer seeks to recover damages paid out to the claimant.

The legislation does not require cover for personal liability, only that appropriate arrangements are in place for the person’s practice. So employer’s cover for their vicarious liability can satisfy the legislation.

Whether the employed practitioner also wants personal cover is a matter for them. One important point is that a claimant will not usually claim against an uninsured employed individual, as opposed to the employer who (though insurance) has the funds to pay any damages. Also the employer’s insurance/indemnity arrangements may cover the practitioner’s personal liability. The OH practitioner should check if that is the case. He or she should also check what is the employer’s (or insurer’s) policy as regards claiming a contribution from the relevant employee towards any damages paid to a claimant. On this latter point, as regards the NHS, employers guidance on the NHS Indemnity says:

‘6. Where the principles outlined in paragraph 5 apply [for example negligence by an employee in the course of employment], NHS bodies should accept full financial liability where negligent harm has occurred. They should not seek to recover their costs either in part or in full from the health care professional concerned or from any indemnities they may have…’ Indemnity.pdf

Journal link

Indemnity for OH professionals, by Rebecca Ghani, Occupational Health at Work 2014; 11(1):16-22.