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PLI for Pharmacists – FAQs.doc


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									                    Guild of Healthcare Pharmacists

              Professional Liability Insurance Explained

Guild Council regularly reviews its position on policy issues, and the policy
on Professional Liability or PLI is no exception, this being fundamental to
practising as a pharmacist. Guild Council was increasingly aware of some
fairly significant shifts in thinking within our parent organisation, Unite, on
its attitude to criminal prosecutions, and our own learning from individual
case histories helped to clarify the position for us.

There has been growing unease for Unite corporately to be seen to offer
support to members facing criminal prosecution, something that had also
started to be aired in Amicus before the latest merger. While none of the
predecessor organisations (ASTMS, MSF and Amicus) had ever refused
support to a Guild member there was concern over what should and could be
supported and, perhaps more importantly in a democratic trade union where
equity of access to support is fundamental, what should not be supported
with respect to criminal prosecution.

There has throughout, however been a recognition that all healthcare
professionals have increasing clinical responsibilities, and, in the current civil
and increasingly criminal litigious environment are in a particularly difficult
position. This is further compounded for pharmacists in that a dispensing
error is a criminal offence under Section 64 of the Medicines Act 1968. We
have repeatedly brought this to the attention of each successive Head of
Health and through them to the legal department, generating support within
the union to address the issues.

Across the various health professional groupings that make up the Health
Sector within Unite, there had always been differing PLI arrangements. With
the very real question of how to support its members who might face criminal
prosecution as part of their daily duties it was an ideal time to take a fresh

                                        1            GHP, Unite Health Sector, January 2009
look at PLI across all the health professions. The review has been led by Carol
English, supported by the Unite legal team and Unite’s insurance brokers.
Carol will be known to many older GHP members as she led on
administrative support for a number of years, so was already aware of some
of the pharmacy specific issues.

In addition to the major shift described above there were two other main
reasons for the Guild to seek changes to PLI arrangements. The first of these
relates to the development of new roles, particularly prescribing, where some
of the guidance from the Department of Health and others would ‘suggest’
that individual PLI was a requirement. The second was that our members
seemed to be asking for a ‘belt and braces’ approach to PLI, if only for peace
of mind.

While sometimes it may seem advantageous to have a ‘pharmacist specific’
view on life we have often found it even more beneficial to learn from the
experiences of the many other health professions that make up the Health
Sector. Indeed, some of the arrangements within the revised PLI we would
probably never have thought of, such as cover outside the UK. The review
also gave us an opportunity to look again at some areas where the Guild had
identified that there was no support, such as work outside the NHS.

Details of the policy can be found on the Unite website, within the Health
Sector section, and also on the Guild website where we have tried to provide
some answers to Frequently Asked Questions.

In broad outline what is now provided, for an extra 30p a week, is legal
support for criminal prosecutions against a member, as a consequence of their
work as a pharmacist, that is no longer reliant on the parent union, Unite.
While this addresses the Section 64 issue that is specific to pharmacists, it also
picks up potential corporate manslaughter charges, Health & Safety Executive
prosecutions and also things like breaches of the Data Protection Act. The
policy provides public and products liability cover for all employees both
within and outside the NHS including locum work undertaken through an
agency of up to £3 million. As mentioned above it also provides cover for
those working overseas, with the exception of the USA and Canada, and the
contingency civil liability cover of up to £3,000.000 for those doing voluntary
work and a professional who acts as a 'Good Samaritan'.

The cover is for work for which you are competent to undertake and
importantly employed through an employment contract to undertake,
including prescribing. There is a strong recommendation, which has always
been Guild policy advice, that the work you are contracted for should always

                                        2           GHP, Unite Health Sector, January 2009
be described in your job description and supported by appropriate
Trust/Board policies for example on non-medical prescribing

Why so cheap you may ask? The scheme is based on contingent liability in
that it expects there to be employer’s vicarious liability in place. For the NHS
this is absolute, and referenced now on the Unite and Guild websites. The
Royal Pharmaceutical Society of Great Britain (RPSGB) and the
Pharmaceutical Society of Northern Ireland requirements, set out for the
RPSGB in Medicines, Ethics and Practice, also require that this is in place for
community pharmacies. Not withstanding this there is still ‘belt and braces’
cover should vicarious liability fail to materialise, providing the extra peace of

So what has not changed, given all the commentary above?
   - your employer’s responsibility with respect to vicarious liability
   - industrial support in the workplace

          o disciplinary
          o grievance
          o investigations
          o grading and other terms and conditions issues
   -   negotiation rights
          o nationally, including submission to Pay Review Body
          o locally, where Agenda for Change has such provisions
   -   externally
          o support and representation up to Employment Tribunal for
             issues related to your employment
          o support and legal representation on fitness to practice issues up
             to the Disciplinary Committee, and similar structures, of the
             professional regulatory body

Summary recommendation
The Guild recommends that members engaged in work involving patient care
or which might impact on patient care should take out this additional cover to
ensure full legal representation and support.

Guild of Healthcare Pharmacists Council
September 2008.


                                        3           GHP, Unite Health Sector, January 2009
     Professional Liability Insurance: Questions and Answers

Is this not a change in GHP policy?

This is not a change in basic GHP policy in that employees remain covered by
NHS Employers’ Vicarious Liability for work undertaken on behalf of the
employer, so there remains no need for employees to obtain additional PLI.
The position is quite clear in England, Scotland and Wales. Guidance has
been issued which provides a written assurance that employers will not seek
to recover any damages from the employee as a result of a civil claim. The
documents are available on the health sector web site
www.unitetheunion.com under health sector. The position in Northern
Ireland is less clear as there are only verbal assurances.

In addition, membership of Unite, the only recognised Trade Union for NHS
pharmacists, provides workplace representation should any employer seek
redress through disciplinary processes or by other means.

So why have GHP sought a policy?

There was a lot of concern amongst members especially those with multiple
employers, those undertaking new and expanded roles (such as both
supplementary and independent prescribing) as part of their contract and
ambiguity about how requirements by regulators for professional indemnity
arrangements should be met. The option of this policy shows that Unite has
listened and the price of £15 per year reflects the market’s estimation of the
additional risks.

What is covered?

The policy provides cover against legal liability in respect of claims for breach
of professional duty consequent upon any neglect, error or omission in
providing advice, treatment or prescriptions in the course of the business
anywhere in the world except USA/Canada where the person concerned is
competent and qualified to undertake the duties. The policy also covers
duties undertaken outside the course of employment so long as the member is
not carrying them out in a self-employed capacity. These could include for
example unpaid professional work or assisting at a roadside accident.

                                       4           GHP, Unite Health Sector, January 2009
What is covered by membership of GHP if I choose not to take out the

As an individual, you retain the rights that come with Trade Union
membership of Unite - including representation in the workplace for
Disciplinary and Grievance Issues, Sickness procedures, Organisational
Change and internal inquiries. This will continue through to Employment
Tribunals for disputes that cannot be resolved with the employer, continued
representation to the regulator’s disciplinary processes for practice
undertaken during employment, and if working within the NHS the civil
liability arrangements under the appropriate national civil negligence

Collectively, the Guild of Healthcare Pharmacists, through Unite, will
continue to negotiate on pay, and terms and conditions for pharmacists
including submissions to the Pay Review Body. As a member, you will have
a say through democratically constituted ballots.

Do I have to pay the extra £15?

Yes – It is an opt-in policy.

What about other Unite Healthcare Professionals?

A number of professional groups in Unite, such as Theatre Practitioners and
Health Visitors already had additional Professional Liability arrangements
and while GHP led on this area it will be available to all Health Professional
members within the Health Sector including Community Pharmacists and
Pharmacy Technicians.

What are the additional benefits from the policy?

The policy provides public and products liability cover for all employees both
within and outside the NHS including locum work undertaken through an
agency of up to £3 million. In addition, at the request of GHP and based on
existing cases, a number of features have been specifically incorporated and
clarified these include

       1. Cost of legal representation at a coroner’s inquest or inquiry in
          respect of any death.

                                       5           GHP, Unite Health Sector, January 2009
       2. The cost of defence of any criminal proceedings brought or in
          appeal against the Pharmacist for an offence of criminal
       3. Proceedings in any court arising out of any alleged breach of
          statutory duty, (including Corporate Manslaughter).

What if you are a PRESCRIBER - do you have to pay extra?

No. All pharmacists registered and recognised by their employers as
prescribers are covered by the policy. As previously GHP would advise that
all duties are listed in the individual’s job description and policies are in place
to support non-medical prescribing.

Are there criteria for cover?

The policy will automatically cover members both within and outside the
NHS provided they meet the following criteria

   1) They are qualified to undertake the work in question and where
      required have been assessed for that competency by the employing
   2) The member acknowledges their own competence in this area of work
      and is working within their scope of practice.
   3) They adhere to the RPSGB Code of Ethics.
   4) The employer has acknowledged that the work is part of the healthcare
      professional’s role and is within their scope of practice.

What are the limits of the cover?

The cover limits are
                       Public and Products Liability:              £3,000,000
                       Legal Defence Costs:                        £250,000

                                         6           GHP, Unite Health Sector, January 2009

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