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.

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.

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.

MDU members have already benefited from significant savings on their subscriptions as a result of transitional benefits membership. State backed-indemnity was introduced for claims arising from care provided from 1 April 2019. However, no state arrangement has yet been agreed for claims relating to care provided before that date.

The MDU is still in discussions with the English and Welsh Governments about arrangements for existing liabilities of GP members for claims arising from incidents before 1 April 2019. Neither Government has proposed a solution that would make good on the promise to protect GPs from the rising cost of claims, but the MDU remains committed to reaching a solution that is acceptable for all our members. When there is any further information we will update members.

Unfortunately until an arrangement has been agreed we will not be able to provide a refund.

You will only need to buy extended benefit rights 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 extended benefit rights from us.