Specialist contractual indemnity for gynaecologists – 100% guaranteed cover subject to policy terms No more discretionary refusal when you need legal support the most
“Many gynaecologists don’t understand their cover. It’s wise to check that you are covered by specialist, contractual indemnity, before it is too late.”
With the number of negligence claims reported to NHS England on the increase, it’s no surprise that medical indemnity insurance is a statutory requirement for gynaecologists. The most common claims typically arise from misdiagnosis, negligent surgery and incorrect treatment. Navigating the complex landscape of insurance and indemnity can take time. Getting it wrong, however, can put not only your finances at risk but also your reputation. THEMIS take the stress out of searching for the right cover. We offer complete defence solutions for gynaecologists so you can focus on providing great patient care without the worries and distractions of litigation risks.
www.statista.com/statistics/893770/number-of-claims-reported-to-nhs-england-by-type/
We provide specialist contractual indemnity with no discretionary refusal. Our indemnity protects gynaecologists from legal costs and claims that may arise from professional negligence, incidents or allegations of malpractice.
We are regulated by the Financial Conduct Authority (FCA) which means we’re upfront and clear from the start as to what’s covered. Our products are underwritten solely by UK insurers who are regulated by the Prudential Regulatory Authority (PRA). You can take comfort knowing our products have the financial security to meet claims.
Having a complaint lodged against you can be incredibly worrying. We ensure the process is stress-free from the start. Our expert in-house claims handlers and lawyers are approachable, friendly and available when you need them. We’ll never pass you over to third party claims handlers. We’ll be by your side every step of the way.
Driven by artificial intelligence, our unique underwriting process enables us to identify safely practising clinicians and offer competitive premiums. Our quotes are based on the procedures gynaecologists offer and perform rather than solely based on earnings.
Regardless of the type of support you need, our specialist in-house claims handlers and lawyers are always on hand, with a dedicated, single point of contact assigned to policyholders.
It’s vital that gynaecologists understand the differences between discretionary and contractual medical indemnity, with discretionary cover lacking the guaranteed protection of a contract of insurance.
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 its providers are not regulated 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 gynaecologists don’t realise that this type of indemnity has zero contractual guarantees of assistance in the event of a claim.
“Unregulated, discretionary indemnity from MDOs, means the risk to a gynaecologist’s reputation and finances is very real.”
Contractual medical indemnity is guaranteed cover, dependent on the terms in your policy.
If you are a gynaecologist working in the private sector, you will want to know that there is no risk of discretion if you receive a claim. Contractual cover is regulated by the FCA and details the specifics of the cover you’re purchasing.
Learn more in our guide - What gynaecologists need to know when purchasing medical malpractice indemnity
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. For both the regulatory issue and the defence of clinical negligence claims, Clinician A was left to fund their 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 which documented clear symptoms and a suspected diagnosis to investigate, Clinician B saw and investigated a patient according to usual procedure.
A claim was later brought against the 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.
“Doctors typically enter the profession because they’re motivated to help people. Having a complaint made against you can be incredibly stressful. THEMIS make the process simple. Their in-house defence teams are approachable, friendly and always available when you need them.”
Many gynaecologists don’t fully understand the indemnity they have in place, or who manages their defence in the event of a claim.
Where cover or a defence fails, medical professionals can be left personally liable to meet claims or with a damaged reputation. Have you got the correct cover in place?
Claimant 1 had suffered from Heavy Menstrual Bleeding (HMB) for a number of years and had exhausted all medical treatments. Because of the ongoing symptoms and a history of ovarian cancer in the family, Claimant 1 wanted her ovaries removed. While undergoing the procedure, there was a partial-thickness bowel injury that occurred during the dissection of the adhesions on the side of the pelvis. The surgeon had failed to notice that the bowel was involved with these adhesions. There was a failure to protect the bowel and/or identify the injury. As a result, Claimant 1 had a bowel leak, laparotomy, stoma and the need for a reversal procedure.
Claimant 2 was referred to hospital with a suspected ectopic pregnancy. A laparoscopy was discussed as an option and Claimant 2 signed a consent form for this. Her bloods were monitored and scans undertaken. The tests indicated that Claimant 2 did not have an ectopic pregnancy. However, the clinician failed to record and communicate these results. Subsequently, an unnecessary laparoscopy took place. There was no clinical basis for the surgery to go ahead. Although injuries were limited and not long-term, Claimant 2 suffered distress and several weeks of pain.
Claimant 3 was advised to have a sterilisation procedure due to the potential risks of pregnancy following an endometrial ablation procedure. On the day of the procedure, poor documentation, communication and individual error resulted in challenges and intraoperative complications, with consultants failing to consider alternative management (such as inserting further accessory ports and laparoscopic ports). The consent process was found to be substandard and a breach of duty. The risks, failure rate, method, and alternatives (including no surgery) were not properly discussed with Claimant 3. After surgery, Claimant 3 complained of severe unilateral flank pain on the same side a Filshie clip was applied. A urinary tract injury should have been suspected and investigated but this did not occur. This led to a delay in diagnosis and delayed recovery. There was damage to the ureter leading to a nephrostomy bag and for a ureter reimplantation.
Claimant 4 was referred by her GP to a consultant urologist for help with addressing urinary incontinence. The Claimant was leaking 3-4 times a day. Following tests, Claimant 4 was admitted and consented to the use of transobturator tape (TOT). The procedure was uneventful but during follow-up, Claimant 4 mentioned hip, pelvis and groin pain. It was thought unlikely to be related to the TOT. Claimant 4 returned a month later and was referred onwards concerning an ovarian cyst seen on a scan from the previous visit. The cyst had resolved itself and the focus of the groin pain was suspected to be related to the TOT. Claimant 4 decided the pain was too much and opted for the removal of it via surgery. During surgery, the tape was found to be twisted and under tension. The tape was removed. Whilst this is a recognised complication of the procedure, Claimant 4 was not adequately counselled and advised on alternative treatments.
It’s important that gynaecologists 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.
TMLEP has identified an increase in claims against gynaecologists resulting from femoral nerve injuries sustained during abdominal hysterectomies.
Awareness of neurological injury is not widely recognised by gynaecologists in the UK, and it is not discussed in the standard consent form provided by the Royal College of Gynaecologists. Because of this, it is understandable why patient consent forms seldom include this risk.
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.
“THEMIS provide contractual indemnity instead of discretionary cover, meaning I can practice with confidence, knowing I have comprehensive protection in place should the worst happen.”
* All THEMIS policies are tailored to exactly what you need, with all coverage options available for selection when you request a quote from us. If you have any questions please get in touch with us.