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Aipedia: Doctors and medical practices
CNST and CNSGP usually cover clinical negligence in NHS care whatever tools were used, but they do not cover private work, occupational health, data breaches or regulatory hearings. Doctors using AI need personal cover for those gaps.
Part of: AI in doctors and medical practices
In short
NHS Resolution runs the state indemnity schemes: CNST for NHS trusts and CNSGP for NHS general practice from 1 April 2019, with ELSGP covering earlier GP liabilities. They cover NHS clinical negligence, including NHS services delivered by digital platform. They exclude private and non-NHS work, occupational health, data protection breaches, cyber incidents, regulatory and fitness-to-practise matters, and criminal and disciplinary matters. The CNSGP scope table says nothing on AI or software suppliers. Under Rec 24, NHS England and NHS Resolution will continue work on indemnity guidance for AI.
CNST covers clinical negligence claims against NHS trusts for incidents on or after 1 April 1995; all trusts in England are members, and independent providers of NHS care have been able to join since 1 April 2013. It has covered inquest representation since 2013. CNSGP covers NHS general practice from 1 April 2019, and ELSGP covers earlier liabilities. For employed hospital doctors doing NHS work, the trust usually carries the liability under NHS indemnity.
For AI, the key point is that these schemes cover NHS clinical negligence claims regardless of the tool involved, subject to their rules. A missed diagnosis involving decision support, an error in an AI scribe note or an under-triaged online request in NHS general practice will usually be handled by NHS Resolution.
The CNSGP and ELSGP scope table (December 2025) and the NHS Indemnity arrangements set out the main gaps:
| Activity | NHS scheme position | AI example |
|---|---|---|
| Private or non-NHS work | Not covered | AI-assisted private online GP service |
| Occupational health | Not covered | AI-drafted fitness for work report |
| Category 2 work, such as reports for insurers | Not covered | AI-summarised insurance medical report |
| Data protection breaches and third-party cyber incidents | Not covered | Patient data leaked from a scribe or chatbot |
| Regulatory, criminal and disciplinary matters | Not covered | GMC investigation over AI-signed certificates |
| NHS services delivered by digital platform | Covered | NHS online consultation with AI triage |
The GMC noted in April 2019 that state schemes do not cover private work, regulatory and fitness-to-practise matters, criminal and disciplinary matters, or employment disputes. NHS indemnity for employed staff also excludes Good Samaritan acts.
AI blurs boundaries. A practice may use the same tool for NHS and private patients, so the same error could fall partly inside and partly outside CNSGP. A scribe or chatbot data incident is outside the schemes entirely. Regulatory risk also rises: GMP para 73 requires reporting incidents with software, and a doctor who signed AI-generated documents without checking may face a GMC investigation that NHS indemnity will not fund.
Supplier failures are another grey area. NHS England's ambient scribing guidance warns that where no liable party can be found or the supplier does not accept responsibility, liability may default to the trust or primary care provider. For NHS work, the scheme usually still deals with the patient's claim, but any recovery from the supplier depends on the contract, which Rec 28 of the government response is examining. In private work, the doctor or clinic carries that risk directly. See CNSGP and private work and regulatory costs cover.
A salaried GP uses an AI scribe in NHS surgeries and the same tool in evening private sessions at another clinic. A misrecorded allergy in a private consultation leads to harm, and a separate configuration error exposes recordings from both settings. The NHS claim position is clear, but the private claim and the data incident need the GP's and the clinic's own cover, and the GMC asks the GP to explain how they reviewed notes.
Under Rec 24 of the government response, a working group including NHS Resolution will clarify professional responsibilities in AI use but "will not determine or redistribute responsibilities". NHS England and NHS Resolution "will continue to progress guidance on indemnity". Until it appears, assume the existing scheme boundaries apply.
See also does medical indemnity cover AI, AI fit notes and letters, AI in medico-legal reports, private GP indemnity and the doctors AI hub.
Apex arranges indemnity for doctors and clinics for work outside NHS schemes. A broker reviews your cover and how your policy treats AI-assisted private, occupational and medico-legal work.
Usually yes, for clinical negligence in NHS general practice from 1 April 2019, including NHS services delivered by digital platform. The scope table does not mention AI, so the normal rules apply, and data breaches and private work remain outside.
No. NHS indemnity excludes private practice, and CNST covers NHS care. Private patients seen in NHS facilities need your own indemnity, whether or not AI tools were involved.
The government response to the National Commission says NHS England and NHS Resolution will continue to progress guidance on indemnity, and a working group will clarify professional responsibilities. No publication date was given in the response.
Tell us about your practice and the work you do. A broker will review how your current cover treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.
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