Substantial increase in out-of-hours premiums

May 2011

The claims experience of MPS Group companies involved in indemnifying primary care providers has deteriorated significantly over the last few years. Of particular concern is that analysis shows that out-of-hours and unscheduled/urgent care have a much higher overall claim frequency and a far greater propensity to large claims arising from catastrophic injury than is the case in core hours primary care.

Of the largest claims settlements, which typically involve catastrophic injury following alleged clinical negligence, a disproportionate number have involved care given out-of-hours which itself only constitutes a small percentage of all consultations. This is particularly significant as it is the value of the large losses that have experienced some of the highest claims inflation; claims that settled for £3m–£4m a few years ago may settle for £6m today.

In MPS itself the claims cost per GP undertaking significant out-of-hours work is much heavier than those with minimal out-of-hours exposure and this year subscriptions charged to OOH GPs will be significantly more than that payable by a full time GP principal.

Historically MPS Risk Solutions has to some extent been shielded from this exposure with the claims made against provider organisations in many instances eventually being attributable to a doctor. For this reason we have not increased underlying risk premiums for several years.

This is no longer the case and the current premium levels are unsustainable. OOH providers are evolving service models which are not as reliant on GPs and instead are using employed nurses and other health professionals for which the organisation has vicarious liability. This has had the effect of significantly increasing our exposure against the background of deteriorating experience.

Update from March 2012

Premiums charged to OOHs Service Providers will this year see a 12% rise, reflecting a continuing deterioration in claims experience across the MPS Group of companies.

Analysis continues to show that out-of-hours and unscheduled/urgent care has a much higher overall claim frequency and a much greater inclination to large claims arising from catastrophic injury, compared to core hours primary care.

Historically MPS Risk Solutions has to some extent been shielded from this exposure with the claims made against provider organisations in many instances eventually being attributable to a doctor. For this reason, many years had gone by where we did not increase underlying risk premiums.
 
OOH providers are evolving service models that are not as reliant on GPs and, instead, are using employed nurses and other health professionals for which the organisation has vicarious liability. This has had the effect of significantly increasing our exposure against the background of deteriorating experience.