Dear PRASIS Member
Please note below our latest news and topics of interest.
As always would also like to extend our thanks to you for your loyalty in remaining a PRASIS member.
With best wishes
The PRASIS Board
Chair:
Ruth Waters
Clinical Board:
James Haeney
Mark Henley
Jim Kirkpatrick
Jeyaram Srinivasan
Ruth Waters
Rob Winterton
Legal Advisor and Board Member:
Nicky Collins
PRASIS Board Secretary:
Helen Roberts
Email: helen.roberts@prasis.org
Mobile: 07930509646
Social Media:
X (formerly Twitter): @PRASIS_UK
Instagram: prasis_uk
CHANGES TO THE CLINICAL BOARD
Ruth Waters has been elected Chair of PRASIS, taking over from Tony Yeaman.
The Board are very grateful to Tony for all of his commitment, hard work and guidance during his fixed two years’ tenure.
James Haeney (Hull) and Rob Winterton (Manchester) have now joined the Clinical Board.
REMINDER OF THE IMPORTANCE OF NOTIFICATION OF ANY ADVERSE EVENTS
Emily Borhan, Medico-legal Adviser to PRASIS and our Brokers MIC (Medical Insurance Consultants) writes:
When you take out your indemnity each year, you sign up to a contractual agreement with a particular insurer. As part of this agreement, you are required to notify any situation, or circumstance, that could give rise to a claim under that policy. It is important that this is done as soon as possible following the event or circumstance to ensure that your position is protected if the matter progresses and to make sure that the position on defence is protected. By telling us sooner rather than later, we can ensure that the complaint is being dealt with appropriately and we can try to limit the risk of it escalating further.
What sort of matter could require notification?
Every situation is different and therefore it is hard to give an exact answer. The advice that we provide is that you must make sure you notify any incident, complaint, or circumstance that has the potential to escalate further. This could be a complaint being handled by the hospital, a patient who has requested further revision surgery due to dissatisfaction or an unintended result, and any legal correspondence that you receive.
When should you notify these matters?
As soon as possible. You should always notify us about the situation as soon as you become aware of it. It may be that we do nothing further with it for some time, but it is nevertheless important it has been noted on your policy.
Will the notifications affect my renewal premium?
By notifying us about a complaint or circumstance, you are protecting your position for any future issue that may arise and trigger the policy. The number of notifications on your policy should not directly affect your premium, and if you are notifying matters on a precautionary basis then this will be noted on the system and acknowledged at the time of your renewal. If there are a number of notifications that require legal assistance, or demonstrate a high-risk profile, then this too will be reviewed at the renewal process.
If you have any questions or are unsure on whether or not a matter should be notified, please contact the medico-legal helpline on 03332408979.
COMPLAINTS HANDLED BY HOSPITALS AND THEIR LAWYERS
Emily Borhan, Medico-legal Adviser to PRASIS and our Brokers MIC (Medical Insurance Consultants) writes:
The nature of the work carried out by plastic surgeons often puts you in a vulnerable position when it comes to the surgical outcomes and the patient expectations. It is quite common for a patient to return to clinic expressing disappointment in the result of surgery, and this can even lead to revision surgery.
The situation becomes more complicated when the patient makes a formal complaint to the hospital. You will often be asked to provide a summary of the treatment you have provided, along with some comments on the matters raised in the complaint. Once you have drafted this, the hospital will use your information to compile a response which they will send to the patient.
If you are faced with this situation, it is important that you notify the medico-legal helpline as soon as possible. This is because your insurer will want to be part of the complaint process, and we will be able to assist you with your summary and comments. It is also important to make sure that the hospital provides you with copies of all the correspondence that they have received, and a copy of the draft letter before it is sent to the patient. Your insurer will want to see this letter before it is sent to ensure that your position is protected. In most situations, the hospital will do their best to resolve the matter, but their interests are not always aligned with that of the surgeon, and it is important that we make sure your position has not been prejudiced in any way.
If you are informed of a complaint via the hospital, please make it clear to them that your insurer will need a copy of all correspondence, and that any draft letters will need pre-authorisation before they are sent.
If you have any questions or have a complaint that needs to be notified, please contact the medico-legal helpline on 03332408979.
PRASIS TRAINEE MEMBERSHIP
We are pleased to report increasing numbers of trainees joining PRASIS over the last year.
Simon Downing, Managing Director of our Brokers MIC (Medical Insurance Consultants) writes:
PRASIS Trainee and NHS Doctors Policy
The PRASIS Trainee policy is proving popular, allowing for assisting in private practice and also covering Good Samaritan Acts, GMC hearings plus many other important areas not often considered.
The policy is aimed at the mid to high ST level of trainees and is competitively priced at this point, with the ability to be converted easily once fully qualified and perhaps starting your own private practice.
It is annually renewable, so keeping us informed of your plans, such as taking a fellowship year abroad (or even if you feel that you no longer need cover), is important to ensure continuous cover. This policy responds to claims when it is active, so if you allow it to lapse without giving the insurer a reason, there may be no cover for you when it is needed. Insurance contracts, unlike the MDO discretionary cover, need to have an element of input from the insured each year to ensure that the cover in place is still appropriate.
Our NHS Doctors policy is similar to the trainee cover in scope, but recognises the differences in responsibility, but also allowing for some private work to be added, even if you don’t have a full private practice established. Working in the NHS provides the umbrella cover of your NHS Trust/Health board (in England, Scotland and Wales), or the Health and Social Care Trust in which you work (in Northern Ireland). This will cover you against negligence claims, but that is far as it goes. It does not assist in GMC investigations, employment disputes or provide Good Samaritan cover, which is why our NHS policy is so popular in providing cover in those extra areas.
Please also note that this cover is contractual, not discretionary as provided by the Medical Defence Organisations (MDO’s)
INDEMNITY AND INDEMNITY PROVIDERS
Simon Downing, Managing Director of our Brokers MIC (Medical Insurance Consultants) writes:
Where should you go for your medical indemnity cover?
The medical malpractice market always seems to be in a state of flux, perhaps more noticeable from the inside. Brokers and providers appear who think they can tap in to the market and offer something new, in reality offer just a simple rehashing of what is already available.
Members can be lulled by these new entrants - some of whom offer the world, others of whom offer (limited time) reduced premiums. Of course we all want to make sure we are getting the best deal we can, we advise caution when considering ‘flip flopping’ between different providers.
Loyalty and insurer knowledge of your practice can serve you well, providing a consistently stable premium. This contrasts with the experience of some who switch insurers for a year only to be faced by a premium which then goes up for no apparent reason, putting them in the position of thinking of switching again, and risking entering a cycle which weakens their insurability.
Longevity of a provider is a good indicator of their understanding of the medical indemnity market, and is aligned with consistency of insurer. A provider/broker constantly getting different insurers behind them usually indicates a worrying picture behind the scenes. This activity may be harder for you to see, which is why it is good to talk to us so we can help you understand our recommendations.
At PRASIS we secure and align with insurers for the long term to ensure members get a comprehensive service, with competitive premiums and solid policy coverage.
Again, please note that we provide contractual policies, backed up by in-house medico-legal support, not the ‘we may or we may not cover you’ discretionary cover offered by the MDO’s.
CYBER COVER
Rocky Ruperto,
UK and International Healthcare Underwriter at CFC Underwriting, writes:
Medical practitioners typically hold large amounts of highly sensitive health-related information about their patients, so it is widely assumed that any primary cyber exposure is a data breach, which goes hand-in-hand with investigation costs, fines and penalties.
Surgeons and medical practices, like any business, are exposed to a range of cyber exposures, including malware attacks. Malware attacks, such as an email infected with a virus or a cyber-criminal accessing your systems and holding your records to ransom, can have a devastating impact on operations, especially in relation to system damage and business interruption costs. Have you considered the cost to your Private Practice and the lost revenue, if you could not access your patient files?
As a market-leading cyber insurance provider, CFC resolves 2,000 cyber claims a year. We have put together the top three reasons on how surgeons can benefit from having cyber insurance.
- Technology systems are critical to operating your day-to-day practice, but their downtime is not covered by standard business interruption insurance
All medical practices rely on computer systems and other technology to conduct their core business, from electronic point of sales software to patient health record storage and management. If these systems are brought down by a hacker, a traditional business interruption policy would likely not respond.
CFC’s cyber insurance can provide cover for loss of income and extra expenses associated with a cyber event, such as those arising from system down-time, inability to access patient records, or rectification costs to replace lost records.
- Complying with breach notification laws costs time and money
Breach notification laws are commonplace across many countries, and generally require medical practices that lose sensitive patient information to provide written notification to those individuals that were affected (or potentially affected!). In the UK, this is regulated by the Information Commissioner’s Office (ICO).
A breach can also attract hefty fines and penalties.
There is also a growing trend towards voluntary notification in order to protect your brand and reputation.
CFC’s cyber policy can provide cover for the costs associated with providing a breach notice, even if it’s not legally required, and can also cover the associated regulatory fines and penalties.
- A good cyber policy provides access to a wide range of incident response services
Responding to a cyber incident requires a range of specialists – from IT forensics firms to specialist public relations agencies – that help deal with the immediate aftermath, as well as the longer-term consequences of a cyber event. Small and medium sized businesses are facing an uphill battle; not only are they increasingly being targeted by cyber criminals but they are also unlikely to have the range of incident response specialists in-house.
CFC’s cyber insurance provides easy access to these services, helping surgeons and medical practices more easily negotiate and navigate these tricky situations.
To find out more about the importance of cyber insurance for medical professions and CFC’s cyber policy, you can sign up to our webinar on Tuesday 12 September 2023 (see below).
PRASIS SPONSORSHIP
PRASIS continues to support our members and our Specialty through selected sponsorships, including:
- An Educational Partnership with BAPRAS for 2023-2024
- BAAPS: Annual Scientific Meeting, London, 28-29 September 2023
- PLASTA: supporting selected Webinars
THE CONFEDERATION FOR BRITISH SURGERY (CBS)
The Confederation for British Surgery is an official trade union, which is able to provide members of the surgical community with support and resources that the specialty associations, colleges and indemnity schemes, such as PRASIS are unable to offer.
For further information, please see:
https://www.cbsgb.co.uk/default.aspx
The PRASIS Board is keen to support this development so has arranged funding to give you free membership for your first two years (one year for trainees). You will need to sign up individually to gain this benefit because of the rules regarding trade union membership.
Please follow the link below to join:
https://www.cbsgb.co.uk/membership_application.aspx
FORTHCOMING WEBINARS
Please note the following webinars till the end of 2023.
- Cyber Issues for Surgeons
Rocky Ruperto et al, CFC Underwriting
Tuesday 12 September 2023
- Harrassment and Bullying
Mohammad Malik (Plastic Surgery Trainee, and Equality & Diversity Lead, PLASTA)
Jeyaram Srinivasan (Clinical Board member, PRASIS)
Tuesday 3 October 2023
- Pensions update (2)
Mark Henley (President, CBS, and Clinical Board Member, PRASIS)
Peter Herniman (Ballards LLP)
Nigel Bourne (Chase De Vere)
Thursday 26 October 2023
- How to keep out of Trouble
Parv Sains (Consultant Surgeon, and Executive Member, CBS)
Emily Borhan (Medico-legal Adviser to PRASIS and MIC)
Thursday 7 December 2023
Please note that all webinars will run from 7pm to (no later than) 8:30pm.
Links for these will be sent out by BAPRAS nearer the time of each webinar.
SUMMARY BENEFITS OF PRASIS
Stability and security should be the overriding considerations which drive a choice of indemnifier, and we believe that our current Underwriters and Broker provide these.
The Insurance market remains challenging with ongoing reduced capacity affecting the ability of those left to take on risks, leading to large increases in premiums for some professional groups and great difficulties in securing any cover at all for others.
PRASIS creates and provides a community for plastic surgeons who have shared core values based on their training and working practices, and for this reason PRASIS members are viewed as a safer group, and therefore an attractive risk for insurance companies.
PRASIS is also unique in having a Clinical Board, all of whom are senior plastic surgeons, and who provide their insights and influence to the wider team.
Members of the Clinical Board are always pleased to provide clinical advice to PRASIS members, and when appropriate to act as advocates for them in their dealings with the Brokers and Underwriters of PRASIS. To do this requires the member’s written consent for disclosure to the Clinical Board Member(s) of the full background information relating to the issue in question - be it a clinical matter, or a matter relating to the member’s policy (eg their premium).
We are here to help members with any enquiries. The quickest way to get through to a Board member is to contact the PRASIS Board Secretary, Helen Roberts: helen.roberts@prasis.org. Mobile: 07930509646. Helen will ensure your query is forwarded to the correct member of the team.
In addition to this and as outlined above PRASIS supports educational activities and opportunities for its members for their benefit in particular, and more widely to benefit the Plastic Surgery community as a whole.
PRASIS is an Introducer Appointed Representative of Medical Insurance Consultants Ltd which is Authorised and Regulated by the Financial Conduct Authority and is entered on the Financial Services Register under reference 309026.