NHS Education for Scotland

Indemnity Insurance

Indemnity Insurance

As the Health Board is vicariously liable for the practice of its employees, in most cases proceedings are initially brought against the Health Board rather than an individual staff member. NHS Scotland and Integrated Joint Boards are members of the Clinical Negligence & Other Risks Indemnity Scheme (CNORIS) https://clo.scot.nhs.uk/our-services/cnoris.aspx. Refer to Scottish government guidance http://www.sehd.scot.nhs.uk/dl/DL(2015)23.pdf

However, if it can be demonstrated that the Advanced Nurse Practitioner has acted outwith the described parameters and responsibilities of their role and acted outwith their contract of employment then legal action may be taken against the individual practitioner.  The Health Board may also initiate disciplinary procedures against the Advanced Nurse Practitioner which may lead to dismissal, referral to the NMC or both.

It is, therefore, vital that when an Advanced Practitioner role is initially established, there is a clear understanding between the employer and the Advanced Practitioner of the parameters, responsibilities and accountability structures associated with the development and that the role is covered by the employers' vicarious liability insurance.  Employers vicarious liability will cover agreed activities within the workplace but does not usually extend to activities outwith the contract of employment and does not include independent practice.

The UK Government requires all healthcare professionals to hold an appropriate indemnity arrangement.

The NMC state

“When you practise as a nurse or midwife you must have an appropriate indemnity arrangement in place. The large majority of nurses and midwives will already meet the new requirement and will not need to take any further action. You meet the requirements where:

  • you work exclusively for the NHS, as you will already have an appropriate indemnity arrangement;
  • you work in an employed environment in the independent sector where your employer provides you with indemnity cover; or
  • you undertake self-employed work and have made your own professional indemnity arrangements.

If you are an employee in the NHS or independent sector,

It is for these cases outwith the contract of employment that professional indemnity insurance is recommended.  The NMC also states that it is the individual practitioners' responsibility to establish their insurance status and take appropriate action.

Many advanced practitioners will already have professional indemnity insurance as part of their membership of professional organisations such as the Royal College of Nursing (RCN) or Unison.  The increasing demands of the clinical environment and the potential for negligence claims is recognised but the RCN do not perceive advanced nurse practitioners to be any more susceptible to negligence claims than any other nurse (RCN, 2010, p6).