FEATURE


THE UNSEEN LIABILITY


Medical malpractice cover in care homes demands urgent attention, suggests Alan Kirkwood, Director of Acrisure UK Broking, Motherwell office (previously WH&R McCartney).


Running a care home is about more than safe accommodation. It’s about delivering medical oversight, daily support and peace of mind for residents and their families. It is a highly regulated sector, operating under intense pressure, with operators doing all they can to stay compliant, retain contracts and protect their reputation.


Yet one risk continues to go unnoticed across many care settings: inadequate medical malpractice insurance. Not because care providers are careless, but because the issue is buried under misunderstanding – both in how policies are structured and how risks are defined. I see this regularly in my role, and it is a growing concern.


Most care home owners do not lie awake worrying about insurance wording. They worry about staff shortages, inspections, paperwork, and whether everyone gets through a shiſt safely. But the uncomfortable truth is that one small mistake on a Medication Administration Record (MAR) can escalate rapidly into a life- changing event and a business-defining claim.


This is not scare tactics. It is how these claims play out in the real world.


THE MISUNDERSTANDING AT THE HEART OF THE ISSUE


Many care home operators believe their public liability cover automatically provides full protection for any medical or treatment- related activity. Typically, they hold policies with a £10m public liability limit and assume this extends to all areas of care, including malpractice.


In reality, medical malpractice is oſten listed separately within the policy and carries its own limit of indemnity, which may be much lower – commonly £5m. The assumption that a single limit applies to everything creates a false sense of security, leaving care providers unknowingly underinsured where it matters most.


This is not simply overconfidence. Insurance schedules and policy documents can be technical, and without specialist advice many operators understandably rely on headline figures rather than the detail.


INCREASING PRESSURE FROM LOCAL AUTHORITIES


This issue is becoming more urgent as local authorities and public sector commissioners tighten contractual requirements. We are seeing more councils demand £10m medical malpractice cover as a condition of care home contracts.


The problem is that many providers do not realise their current policies fall short. They may submit documentation showing £10m liability, unaware that figure only applies to public liability,


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“The uncomfortable truth is that one small mistake on a Medication Administration Record can escalate rapidly into a life- changing event and a business- defining claim.”


To illustrate this, consider a case we have seen within the sector. A medium-sized residential care home was supporting an elderly resident with diabetes, mild dementia and a history of falls. Care plans were in place, medication records existed and staff believed procedures were being followed correctly.


During a busy weekend shiſt, a new agency carer misread the MAR chart. Insulin was administered twice within a short time period. Blood glucose monitoring was not properly recorded. When the resident became drowsy overnight, staff assumed tiredness rather than recognising a warning sign. By morning, the resident was unresponsive and taken to hospital, where severe hypoglycaemia was diagnosed.


The resident survived but suffered a brain injury and permanent loss of independence. The family instructed solicitors, alleging clinical negligence relating to medication administration, monitoring, escalation of deterioration and supervision of


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not malpractice. Procurement teams may also accept these policies at face value, assuming compliance has been met.


This disconnect places providers at risk – not only of claims, but of breaching contract conditions, losing tenders, or being forced to renegotiate terms at short notice.


UNDERSTANDING WHAT MEDICAL MALPRACTICE REALLY INCLUDES


Another reason this issue goes undetected is because malpractice is oſten associated with hospitals rather than care homes. In reality, malpractice in a care setting can arise from everyday scenarios such as incorrect medication administration, failure to monitor residents, delayed escalation of deterioration, or inadequate supervision of clinical needs.


Even where a home believes a claim might fall under general liability, insurers or legal teams may categorise it as malpractice, triggering the separate and oſten lower limit. When something does go wrong, particularly involving injury or death, that distinction becomes critical.


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