Professional indemnity insurance: is it really worth the cost?As a paramedic, you will often work in a high pressure environment making split second decisions and exposing yourself both to personal risk and professional liability. It is important to ensure thatin trying to save the lives of patients, you are also protected as a regulated healthcare professional accountable to the Health and Care Professions Council (HCPC).I hope that I never need the services of a paramedic but it is reassuring to know that I have a safety net in the form of the ambulance service and that, if I am knocked of my bike while cycling to work, someone will be there to help. As a paramedic, I am certain that, having answered an emergency call, you hope you won’t need the services of a solicitor like me to defend you against a complaint to the HCPC. Unfortunately, complaints can arise even when you have operated within standard protocols and that is why professional indemnity insurance is important.Professional indemnity insurance is your safety net and, in the event of a complaint to the HCPC, your insurer may provide you with the legal support that you require. This kind of support may not be provided by your NHS employer, who would normally only cover you in the event of a clinical negligence claim made by an NHS patient. Indeed, it may have been your employer to raise the concern with the HCPC in the first place. Your union is, of course, a possible source of guidance.Complaints to the HCPC are a serious matter and, at their most serious, can result in a practitioner being removed from the register and unable to work as a paramedic in the future. The investigationand hearing of such complaint is a legal process and the correct support is invaluable. My work in this field has made me acutely aware of the significant difference it can make to healthcare professionals to have legal support and assistance available to them.The first step in the process of a complaint to the HCPC is for it to be referred to the investigating committee, whose function is to determine whether or not the complaint should be referred to theconduct and competence committee for a hearing. The threshold for cases to reach the investigating committee is very low and complaints from members of the public are not screened by any other paramedicprior to the investigating committee stage. As a result, it is entirely possible for complaints that have no real merit to reach the investigating committee and to require a response:The investigating committee College of Paramedics must decide two factors:Whether or not there is a realistic prospect of the conduct and competence committee finding the factual allegations proved, and, if so;Whether there is a realistic prospect of finding that the practitioners current fitnessto practice is impaired.This is known as the ‘realistic prospect test’ and if the answer to both these questions is yes then the case will be referred to the conduct and competence committee for a hearing. In some cases (one way or the other) the answer will be obvious, however, in other cases it will not be so clear cut, even when it may seem to a practitioner that it should be. It is therefore very important to get the right advice at the investigating committee stage.If the response to a complaint is handled correctly, then there is often a good chance that the Investigating Committee will decide to close the complaint with no further action, however, if it is handled badly, the situation can be made worse. Indeed, there are some circumstances in which it will be in the practitioner’s best interests not to respond at all to the complaint at the investigating committee stage. There are a number of factors to consider and much will depend on the nature of the complaint and the chances of successfully avoiding a referral to the conduct and competence committee.When responding to a complaint, careful consideration needs to be given to: Should the factual allegations be admitted or denied?What, if any, additional factual evidence should be obtained?What evidence is there of current fitness to practise?What should and should not be included in the response?What evidence should and should not be disclosed?Are there are any legal points worth making?Receiving expert advice on the legal and evidential issues involved and the best strategy to be adopted is invaluable in dealing with a complaint at the investigating committee stage.The value of legal assistance is even more paramount if a case if referred for a hearing. I am afraid that (despite our best efforts) some cases are referred to the Conduct and competence committee and further legal and evidential issues will rear their heads at that stage. In addition, the value ofa skilled advocate at the hearing simply cannot be underestimated. Legal costs can very quickly mountup and can be prohibitive in the absence of professional indemnity insurance.For the vast majority of responsible and competent paramedics, the idea that they will be involvedin this kind of process is alien and, as one of the ‘good guys’, it is easy to think that ‘it won’t be me’.Unfortunately, the present culture is one where complaints against healthcare professionals are onthe rise and, while it is the minority of poor practitioners who make the headlines, beyond the frontpages, there are many good practitioners who, despite their best efforts, find themselves having to account to their regulator for a one of mistake or an entirely unjustified complaint.I hope that you will never have to deal with a complaint to the HCPC, however, the risk is one that is worth guarding against so that, if you are ‘knocked of your bike’, there is an emergency service you can call on.