Clinical Negligence Scheme for General Practice (CNSGP)

GP Indemnity Arrangements – Update for 2025

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Since the 2017 announcement of a state-backed indemnity scheme for general practice, significant progress has been made. As of 1 April 2019, the Clinical Negligence Scheme for General Practice (CNSGP) has been operational, providing comprehensive indemnity for clinical negligence liabilities arising from NHS primary medical services and ancillary health services delivered under GP contracts in England. 

For full details, see the NHS Resolution page on CNSGP. 

Scope of CNSGP 

CNSGP covers: 

  • All GPs, including partners, salaried GPs, locums, and trainees 
  • Other clinical staff such as nurses, pharmacists, physician associates, and healthcare assistants 
  • Clinical negligence arising from NHS services under GMS, PMS, or APMS contracts 
  • Ancillary health services provided by general practice 

CNSGP does not cover: 

  • Private or non-NHS work 
  • Non-clinical matters, including: 
    • GMC fitness-to-practise investigations 
    • Inquests or disciplinary hearings 
    • Employment or contract disputes 
    • Incidents occurring before 1 April 2019 

In these situations, GPs should continue to maintain appropriate membership with a medical defence organisation (MDO) or similar indemnity provider. 

Further BMA guidance can be found on their state-backed indemnity page. 

Cover for Incidents Before 1 April 2019: ELSGP 

The Existing Liabilities Scheme for General Practice (ELSGP) was introduced to manage claims arising from incidents that occurred before 1 April 2019. 

  • ELSGP covers GPs who were members of participating MDOs (such as MPS or MDDUS) at the time of the incident.
  • Claims under ELSGP are still handled via those MDOs, who coordinate with NHS Resolution.
  • Not all MDOs are included in the scheme, so individual arrangements may still apply 

More information is available on the NHS Resolution ELSGP FAQs. 

Ongoing Considerations for GPs 

  • All NHS general practice clinical work is now covered under CNSGP.
  • GPs still need additional cover for: 
    • Non-clinical risks (e.g. GMC investigations, inquests)
    • Private work
    • Support with complaints, coroner’s reports, and contractual issues
    • MDO membership continues to provide important legal and advisory services outside the scope of CNSGP