What does IHPN's new MPAF refresh mean for independent providers?

Here at IHPN we know that delivering safe, high quality care is the number one priority for independent healthcare providers. And as part of this, there is a real ambition amongst our members to continually improve the care they provide to millions of patients every year.

That’s why in 2019, IHPN, together with former NHS England National Medical Director Sir Bruch Keogh, were proud to launch our Medical Practitioners Assurance Framework (MPAF).

While acknowledging the overwhelmingly safe, high-quality care delivered in the independent healthcare sector, this framework of principles – developed with the NHS, healthcare regulators and Medical Royal Colleges – was designed to help foster a more standardised approach to medical governance in the independent sector and drive even further improvements in safety and quality.

Since its launch, the framework is now firmly embedded in the patient safety and regulatory landscape. The Care Quality Commission uses the framework’s principles in assessing how “well-led” an independent service is. it is now also part of the NHS’ Standard Contract – requiring all independent sector providers that deliver NHS-funded care to adhere to it. Moreover, the Government’s response to the Bishop of Norwich’s inquiry into Ian Paterson noted the “significant work” undertaken by independent providers and individual practitioners to fulfil the Bishop of Norwich’s recommendations, specifically through the implementation of the MPAF.

Of course, much has changed since 2019. Throughout the pandemic there was unprecedented collaboration between the NHS and independent healthcare providers, with the sector now playing a key role in the wider healthcare recovery. Likewise, there have been numerous inquiries (and responses) looking at a whole range of issues across the healthcare safety and governance landscape, from the Bishop of Norwich’s independent inquiry report into Ian Paterson to Baroness Cumberlege’s Independent Medicines and Medical Devices Safety Review (IMMDS).

In addition, there have been a host of new initiatives such as the Learn from Patient Safety Events (LFPSE) service and wider regulatory changes in the 2022 Health and Care Act.

To ensure it’s as relevant and useful as possible to both independent healthcare providers and practitioners, it’s therefore vital that the MPAF also moves with the times.

Since it was published in 2019, IHPN have been working with providers, stakeholders and practitioners to account for the aforementioned changes and look at areas where the framework can be further strengthened to ensure the principles remain in-keeping with current best practice around medical governance in the health system.

We are therefore delighted to launch the “refresh” of the MPAF which takes a new look at the framework. With the support of our External Advisory Group, including CQC, GMC, NHS Resolution, the Department of Health and Social Care and the Patients Association, the MPAF refresh retains the principles-based approach of the framework and continues to emphasize the importance of organisational culture and leadership behaviours in driving clinical governance and the quality of patient care across the independent sector.

Reflecting recent safety and regulatory changes it also strengthens the principles in many areas. This includes giving greater prominence to the importance of patient consent as well as the requirement to have conflict of interest declarations – both key recommendations of the Paterson and Cumberlege inquires.

Likewise, the review of practising privileges section has been updated to better allow for a risk-based approach, directing that a review of practising privileges is undertaken biennially for all medical practitioners and more regularly in circumstances where additional scrutiny is required.

The refresh has more detail on how to raise and respond to concerns, with more links to where organisations can find support. It also now covers the need for independent providers to have structured support for practitioners returning to practice after an investigation and has more detail on best practice for the management of patient complaints. In addition, in the ‘Medical Practitioners Responsibilities’ section, doctors are now asked to seek appropriate help if experiencing pressures that may lead to an impairment of their practice.

IHPN are absolutely committed to supporting our members in the coming months and years to ensure they can successfully embed the MPAF across their organisations. This includes developing a suite of resources – including training events – to ensure providers are in the best possible position to demonstrate their well-led credentials to CQC, and ultimately continue to improve the safety and quality of care they provide to millions of patients every year.

Dawn Hodgkins, Director of Regulation, IHPN