The government's new state-backed indemnity scheme for GPs in England and Wales changes the indemnity arrangements for thousands of healthcare professionals. Below we answer some of the most common questions we've received about how the scheme will work and how members will be affected.

What does state-backed indemnity provide?

State-backed indemnity started on 1 April 2019, and only provides indemnity for clinical negligence claims arising from primary care work under an NHS England or Wales contract.

What's included in standard MDU membership?

The main benefits of MDU membership include:

  • support with GMC fitness to practise investigations
  • indemnity for work not covered by the NHS indemnity scheme (such as writing reports or any private clinical work)
  • representation at disciplinary investigations
  • help preparing responses to patient complaints
  • help with criminal investigations arising from clinical practice
  • representation at the coroner's court
  • 24-hour access to award-winning medico-legal advice
  • 24-hour access to press and media helpline
  • indemnity for Good Samaritan acts worldwide.

As well as this, standard MDU membership includes access to indemnity for a lot of everyday GP work that is not included in the state scheme.

Included activities are:

  • providing medical reports, including for:
    • insurance purposes
    • driving, aviation and sea farer roles
    • sports (or other activity) participants
    • armed forces
    • patient's employers
    • disability assessment
    • adoption medicals
    • benefit certification
    • housing applications
    • Office of the Public Guardian
    • firearm licensing
    • court exemption
    • solicitors (regarding patients registered at the practice)
  • providing witness statements for the police or Criminal Injuries Compensation Board
  • safeguarding work/MAPPA meeting attendance
  • assessment of testamentary capacity
  • providing travel services (advice/vaccinations etc.) to practice patients
  • signing medical certificates of cause of death and cremation forms (including pacemaker removal)
  • academic, research and lecturing activities including the supervision of students
  • clinical and non-clinical audit
  • involvement in training courses (beyond training own NHS staff), such as first aid or resuscitation courses
  • responsible officer and appraisal work
  • acting as Care Quality Commission (CQC) registered manager
  • health screening work
  • acting as an examiner
  • GMC assessor for PLAB or for FTP performance assessments
  • medical appeal tribunals
  • mental health review tribunals.

It's not a legal requirement to continue with MDO membership, but you will need it to access any of the above after the state scheme is introduced.

Remember that a single incident can give rise to a number of different adverse outcomes, a phenomenon known as multiple jeopardy. A GP facing a claim might well also have to contend with disciplinary investigations, a GMC investigation, a police investigation, intrusion from the media and more - either separately or all at once. You wouldn't get any support with these if you relied on state-backed indemnity alone.

How does state-backed indemnity impact my MDU subscription?

Your subscription will significantly reduce after 1 April 2019, as the state scheme will cover clinical negligence claims arising from work you do under an NHS contract in England and Wales. We'll write to members to explain the impact on their membership before their next renewal.

Will I get a refund?

MDU members have already benefited from significant savings on their subscriptions as a result of transitional benefits membership.

State indemnity was introduced for claims arising from care provided from 1 April 2019. However, no state arrangement is yet in place to support MDU members with claims relating to care provided before that date. Because of this, we are not currently in a position to provide partial refunds of subscriptions for that year.

Our intention is to provide partial refunds to members who had a substantial part of their transitional benefits membership year still to run when the state scheme was introduced, and who converted to the new form of membership.

We will contact members as soon as this situation changes.

I'm on transitional benefits. Does that mean I'll need to buy run-off cover (extended benefit rights)?

You will only need to buy run-off cover if:

  • you leave the MDU before the state scheme is introduced
  • the state scheme is introduced without picking up historic liabilities and you leave the MDU before the normal retirement age for your NHS pension scheme.

If neither of these situations apply, there would be no need to buy run-off from us.

Mind the gap

There's a significant difference between what the new state-backed scheme can provide and the established and award-winning support offered by MDU membership. With the MDU on your side, you can practise with confidence knowing that you'll have access to expert guidance, support and defence, whatever happens during your career.

For more information on the state-backed indemnity scheme and how the MDU will can continue to help members after it's introduced, visit

This article was correct at publication on 11/03/2019. It 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.