The facts about indemnity and medical defence organisations for IMGs

Understanding what indemnity is and why you need to join a medical defence organisation (MDO) as a doctor in the UK. By Rob Hendry, Medical Director of Medical Protection. 

It’s always beneficial to get a breadth of experience in the medical world. If you’ve trained outside the UK but are now coming here to work, we have some useful information to help you get off to the best start possible. Here are some vital tips about making sure you have the right indemnity and professional support to protect yourself and your career in the UK.

Why indemnity is so important

Practising medicine in the UK can be extremely rewarding but it also brings with it a high level of professional accountability. Having the right medical indemnity and protection in case you are sued, complained about or investigated offers great peace of mind.

What the law says about indemnity

In the UK, doctors are legally required to have appropriate medical indemnity or insurance in case a patient makes a claim for compensation.

The General Medical Council (GMC) has the power to remove your license to practise in the UK if you haven’t protected yourself with adequate and appropriate indemnity or can’t provide evidence of it when asked. They can also refuse to grant you a license if they aren’t satisfied that you’ll have appropriate indemnity or insurance by the time you start practising in the UK.

What is NHS indemnity?

As an NHS employee, you are usually indemnified through an NHS indemnity scheme but there can be some exceptions; for example, if you work as a locum for an organisation which is contracted to provide NHS staff.

NHS indemnity covers clinical negligence claims made against hospital doctors and those working in general practice, arising from duties listed in their NHS contract.

NHS Resolution is the organisation that has financial responsibility for the clinical negligence claims brought against healthcare professionals in England, and there are equivalent organisations in Scotland, Northern Ireland and Wales.

The GMC has a useful guide to insurance, indemnity and medicolegal support on their website.

Work that falls outside of your NHS role

Many doctors take on duties that aren’t primarily concerned with prevention, diagnosis and treatment of NHS patients. Below are some examples of these activities – none of which are covered by NHS indemnity. If you plan to undertake any of these, you’ll need additional indemnity or insurance to run alongside your NHS protection:

• Any private practice work you take on alongside your NHS role
• Any ‘category 2’ work you undertake in hospitals, such as cremation forms and examinations/reports on patients for use in courts or by insurance companies and the Department for Work and Pensions
• Any ‘fee-paying’ or ‘chargeable’ services undertaken while in general practice, such as private travel vaccines, insurance reports or HGV medicals
• Any clinical trials not covered under legislation
• Any instances where you assist in a public medical emergency (such as a road traffic accident) or carry out other ‘Good Samaritan’ acts

Other situations not covered by NHS indemnity

NHS indemnity ensures that patients have access to compensation if clinical negligence has been proven. It’s not designed to protect the individual interests of doctors. Because of this, many professional challenges which you could encounter are not covered by NHS indemnity. These issues can have potentially serious and career-limiting consequences, and include:

• Dealing with complaints, perhaps involving the Ombudsman
• Giving evidence to Coroner’s inquests or fatal accident inquiries
• Being referred for investigation by the GMC
• Employer disciplinary proceedings
• Police investigations and criminal prosecutions

Where medical defence comes in

Medical defence organisations (MDOs) are mutual, non-profit making organisations, owned by their members.

For an annual subscription fee, they provide access to legal advice and representation should a medicolegal problem arise from clinical practice. This can include investigations, inquiries, complaints and criminal proceedings, as well as clinical negligence claims which fall outside of the scope of NHS indemnity. MDOs are also a valuable source of personal medicolegal advice and support with professional development and risk management.

Why medical professionals join an MDO If you only undertake NHS contracted work, there is no legal obligation to seek additional medical defence cover. Despite this, most doctors consider it essential to do so, and the reason for this is simple – the risks can be huge. As a doctor, it’s realistic to assume you will face some kind of medicolegal problem during your career. Without the support of an MDO you may have to deal with an adverse incident alone. This could put your career, reputation, financial security and even your liberty at risk.

The risks of not joining an MDO

If a complaint or allegation is made against you, it can lead to sanctions, suspension, loss of earnings and reputational damage. It can also be incredibly upsetting emotionally.

While it’s possible for you to deal with medicolegal situations yourself, this can be more stressful, costly and time consuming. It can also result in a less favourable outcome than having a MDO fighting for you.

Reasons to choose Medical Protection

As an MDO, Medical Protection support more than 95,000 doctors working in the UK. We help members respond to inquiries, investigations, complaints, claims, criminal and disciplinary proceedings. This might include drafting a response, compiling evidence and arranging legal representation, as well as explaining and supporting you through the process.

Our dedicated team of experts include doctors and lawyers who understand how the medicolegal system works and the challenges doctors like you can face.

We produce a wide range of resources to help doctors working at every level and speciality to continue their professional development, including factsheets, case reports and our Casebook journal.

We’re also the leading provider of communication and risk management support amongst We also offer a wide range of courses, online learning modules and webinars to help you practise safely and avoid medicolegal problems from arising in the first place. All are included in the cost of your membership.

You can explore all the benefits of membership here.

To discuss your indemnity and protection requirements and get a personal membership quote once you are ready start work in the UK contact our IMG Relationship Manager.

About the author

Rob Hendry is Medical Director at Medical Protection, working with members around the world. He has a particular interest in supporting doctors who move between different countries and has championed Medical Protection’s Diversity and Inclusion strategy.