Focus on providing outstanding patient care without the distraction of litigation or reputational damage.
Specialist contractual indemnity for clinical organisations – guaranteed cover and peace of mind for your hospital, your team and your patients. No more discretionary refusal when you need legal support the most.
“I am pleased to recommend Themis to my colleagues; they provide indemnity which is contractual as opposed to discretionary cover so you can be assured you will have comprehensive protection. The team at Themis have many years’ experience in medical defence and are always accessible to provide advice and support.”
Negligence claims are on the rise, with the most common claims typically arising from misdiagnosis, negligent surgery and incorrect treatment. If a claim were made against your practice or employees, are you confident you have the right protection in place? If a claim is incorrectly settled, it can ruin your organisation’s reputation and increase future indemnity premiums. At THEMIS, we pride ourselves on providing true peace of mind for your hospital, your team and your patients. We offer complete defence solutions, coupled with exceptional customer service, so your teams can focus on providing great patient care without the worry and distraction of litigation risks.
*https://www.statista.com/statistics/893770/number-of-claims-reported-to-nhs-england-by-type/
Unlike discretionary policies, our contractual insurance provides certainty – you know exactly what’s covered and when it pays out. We’re regulated by the Financial Conduct Authority (FCA) - this means we have to be transparent with our policies. Our underwriters are also regulated by the PRA – this means you can be confident your THEMIS policy has the funds available to pay out any claims made.
In addition to having a dedicated contact within our client care team to discuss your policy needs, your team are granted access to our day-to-day medico-legal helpline to help deal with common issues that arise (such as complaints, regulatory issues, etc.). We also offer your clinical staff access to our clinical governance team who offer expert advice to assist with specialised treatment questions that may arise (such as referral suitability opinions).
Driven by AI and our deep knowledge of medical risk, our underwriting process enables us to set competitive premiums that identify and promote best practices. This means we are both reducing the risk of claims and supporting you in driving up clinical standards.
If you ever need to make a claim, you will have the leading experts in your corner from the first moment – including legal counsel from top medical defence firms, our highly experienced in-house claims team and the independent investigatory experts at TMLEP. We never outsource to a third-party claims handler.
We offer different types and levels of cover and always tailor our policies to meet your needs exactly.
As a policyholder, you will also benefit from a range of expert tools and resources from Themis and our wider network of specialists.
Discretionary medical indemnity means just that — it is discretionary and down to your provider to decide whether to cover you or not. That means that there is no guarantee that the cover will pay out when you need it to.
Discretionary indemnity and a providers insurance products are not regulated to provide insurance by the FCA or the PRA. This means the provider is under no legal obligation to detail the specifics of the cover and there is no knowing whether the providers have the resources to cover new claims. Indemnity offered by The MDU, The MPS and The MDDUS — collectively known as medical defence organisations (MDOs) — typically falls into this category. Most clinicians don’t realise that this type of indemnity has zero contractual guarantees of assistance in the event of a claim.
Contractual medical indemnity is guaranteed cover, dependent on the terms in your policy.
If you are a clinician working in the private sector, you will want to know that there is no risk of a claim being turned down. Contractual cover is regulated by the FCA and details the specifics of the cover you’re purchasing.
Learn more in our guide - Your guide to medical malpractice indemnity/What clinicians need to know when purchasing medical malpractice cover
Many clinicians don’t realise that they have discretional, unregulated indemnity provided by UK MDOs in place. Where discretion was exercised by leading MDOs, medical professionals were left personally liable to meet claims. Here are just a few examples. Have you got the correct cover in place?
Clinician A was originally introduced to their MDO at medical school. At no time when explaining their services (or at subsequent subscription renewals) can Clinician A recall the MDO explaining discretionary cover. Clinician A remained with their MDO for around 20 years, with subscription fees exceeding £100,000.
When an unexpected regulatory investigation was launched, it caught the attention of the press and claimant law firms. Clinician A looked to their MDO to assist with the regulatory issues and clinical negligence claims, and also enquired as to whether assistance could be provided in relation to the public media attention.
Clinician A was informed that their MDO was exercising their right to withdraw their protection, on discretionary grounds. For both the regulatory issue and the defence of clinical negligence claims, Clinician A was left to fund his own representation. They were personally liable for claims in excess of £350,000.
Given the lack of immediate support, the matter was allowed to progress extensively and has caused almost irreversible reputational damage.
Clincian B signed up to discretionary indemnity at medical school. The MDO they signed with was so well known and used by all their colleagues, that they never questioned the effectiveness of the cover. Indemnity fees were taken each year by direct debit and Clinician B assumed they had adequate cover.
Following a referral request form that documented clear symptoms and a suspected diagnosis, Clinician B saw and investigated a patient according to the usual procedure.
A claim was later brought against Clinician B for failing to notice a tumour in an area unrelated to the symptoms or suspected diagnosis.
Clinician B contacted their MDO who refused the claim on discretionary indemnity grounds.
Clinician B had never made a claim in the past, and to date, had paid thousands of pounds in membership fees.
Clinician B was left to fund their defence privately, with the claim valued in the region of £250,000.
Most healthcare professionals don’t fully understand the indemnity they have in place, or who manages their defence in the event of a claim. Most want to pay their premium and hopefully never have to use it. Unfortunately though, we know that things can and do go wrong. Where cover or a defence fails, medical professionals can be left with a damaged reputation and may be personally liable to meet claims.
Have you got the correct cover in place?
Claimant 1 had undergone a successful mitral valve repair surgery by an experienced surgeon. Unfortunately, the patient had suffered an iatrogenic atrial-septal defect perioperatively. It was discovered that this was a new iatrogenic atrial-septal defect as the preoperative echocardiograms excluded this defect as being present. The immediate post-operative trans-oesophageal echocardiogram (TOE) fell short of the standards expected as it lacked the detail required following this type of surgery. As a result of this missed diagnosis, the claimant’s right-sided heart strain caused symptoms of breathlessness, oedema, weight gain and a feeling of drowning. Symptoms were present for over a year.
Claimant 2 had presented to the ambulance service with a history suggestive of cauda equina syndrome incomplete. The A&E clinician suspected CES but withdrew this suspicion and referred the patient to Orthopaedics for review. There was a three-hour delay for the claimant to be seen and referred for an MRI scan. Further delays in image reviews and additional scans compounded the situation. It was not until two days later, following the initial presentation, that the patient was taken to theatre. It was argued that if the patient had received treatment earlier, he would have had a high likelihood of a full recovery.
Claimant 3 was admitted to hospital with shortness of breath, dizziness and chest pains. They had a history of heart disease, shoulder surgery and knee replacement. The patient underwent a blood test, was diagnosed with symptomatic anaemia and was due to be given a blood transfusion. A cannula was placed but was left in place for five days and became infected. The infection spread to the knee replacement and shoulder joint. As a result, this patient had to undergo a knee washout and a shoulder aspiration. A prolonged course of intravenous antibiotics was required for over a month. Poor cannula monitoring and leaving it in situ for longer than recommended, caused additional procedures, a prolonged hospital stay and a stiff knee joint.
It’s important that clinicians keep up-to-date with and are aware of emerging clinical risk trends that could lead to claims.
We make this easy by offering complimentary access to clinical risk alerts, based on advanced claims intelligence provided by our Lead Clinical Partner, TMLEP. Policyholders can stay updated by accessing the latest insights that may impact their practice.
Although typically rare, surgery-related nerve damage can arise from a number of different procedures. The severity of nerve damage can vary greatly, from complete disability to temporary, minor chronic pain.
In order to manage patient expectations, and to defend claims involving nerve damage, generalised consent for chronic nerve pain and/or nerve damage should always be considered.
It is important for gynaecologists to remain informed about the pre-treatment options available for fibroids. Several cases have shown that GnRH analogues should always be considered prior to fibroid removal surgery.
One example is if the fibroids are causing an enlarged or distorted uterus. Clinical and patient discussions regarding the risks and benefits of taking GnRH analogues should occur prior to surgery.
Intestinal obstruction occurs when food and stool cannot move freely along the gut. Various factors can cause intestinal obstruction, including hernias, tumours, abdominal adhesions, volvulus (intestine twisting around itself), and foreign objects. Unless treated promptly, intestinal obstruction can be fatal.
This clinical alert explores why an accurate history and examination are essential for correct investigation and management.
