IHPN launch “refresh” of medical governance framework for independent providers

HPN have today launched a “refresh” of its Medical Practitioners Assurance Framework (MPAF), designed to further improve the safety and quality of care independent providers deliver to patients.

Initially launched in October 2019, the MPAF – led by former National NHS Medical Director Sir Bruce Keogh – contains key principles to strengthen and build upon the medical governance systems already in place in the sector and sets out expected practice in a number of key areas.

Care Quality Commission (CQC) now uses the framework’s principles in assessing how well-led an independent service is, with the framework a requirement of the NHS’ 2022/23 Standard Contract which all independent sector providers of NHS-funded care must adhere to.

The MPAF was always designed to be a “live document” and today’s refresh strengthens the framework to ensure it remains in-keeping with current best practice in the health system. This includes taking into account recommendations from the Bishop of Norwich’s inquiry into Ian Paterson, as well as Baroness Cumberlege’s Independent Medicines and Medical Devices Safety Review (IMMDS). Key areas strengthened in the refresh include giving more prominence to expectations around patient consent, and the need to have greater transparency around conflict of interest declarations.

New initiatives such as the Learn from Patient Safety Events (LFPSE) service are also reflected in the refreshed framework, as well as an IHPN Development Plan which sets how the network will support providers to continue to implement the MPAF.

In developing the framework, IHPN was supported by a reference group consisting of representatives from the Department of Heath and Social Care, CQC, the General Medical Council (GMC), NHS Resolution, medical Royal Colleges, Federation of Independent Practitioner Organisations, and the Patients Association.

 David Hare, Chief Executive of the Independent Healthcare Providers Network (IHPN) said:

 “IHPN are delighted to be launching today a new refresh of our Medical Practitioners Assurance Framework (MPAF), reflecting the independent health sector’s commitment to continuously improving the safety and quality of care they deliver to millions of patients every year.

“Since the MPAF was launched in 2019, independent healthcare providers – with the support of CQC and NHS England –  have really embraced the framework, using it to review and update their practices to further raise the bar in medical leadership in the sector.

“With a continued focus amongst the entire healthcare system around improving patient safety and quality, this framework ensures providers adhere to the latest medical governance practices.

“This will not only ensure greater consistency around how clinicians work across the independent sector and NHS, but also give confidence to patients that independent healthcare providers are committed to delivering the safest possible care”.

Dr Sean O’Kelly, CQC’s Chief Inspector of Hospitals, said:

“Robust medical governance is central to patient safety and high quality care. CQC very much welcomes the updates that IHPN has made to strengthen the Medical Practitioners Assurance Framework and we are pleased to have been part of the expert advisory group that helped shape its development.

“Where providers can demonstrate effective implementation of its principles, this is considered as evidence of good governance and informs the judgement we make about how well led services being provided by that organisation are.”

Una Lane, Director of Registration and Revalidation at the General Medical Council, said:

“Since its launch the framework has played an invaluable role helping ensure patients receive safe and good quality care, in both the NHS and the independent sector. This refresh takes account of recent high-profile cases and will strengthen that protection.

“The importance of good local clinical governance cannot be overstated. This updated framework will help medical practitioners, as well as Responsible Officers and designated bodies, to develop and maintain effective local systems, enabling them to provide the best possible care to patients.”

Professor Neil Mortensen, President of the Royal College of Surgeons of England, said:

“The Royal College of Surgeons of England welcomes the updated Medical Practitioners Assurance Framework. There is growing demand for private services, including elective surgery. This makes it all the more urgent to ensure that high standards of care and good governance processes are in place, supporting the specific challenges faced by the sector.

“We have recently published guidance for surgeons working in the independent sector, which aims to provide advice on good practice for individual practitioners. So, we hope this will be used in conjunction with the IHPN framework.

“The framework addresses a number of key areas, including data sharing and whole practice appraisal across the NHS and the independent sector.  Also, quality improvement, and an emphasis on the need for sufficient peer review systems that will reduce the risk of professional isolation and lone practice. We would like to see all independent hospitals, even the small number not in IHPN membership, commit to implementing the framework.”

Rachel Power, Chief Executive of the Patient’s Association, said:

“We expect patients to receive safe and effective care no matter where they are treated. The refresh of the Medical Practitioners Assurance Framework, and the number of providers who have signed up to it, gives patients confidence that the independent sector collects and shares information about the performance of their services, and the practitioners working within them.

“We believe concerns raised by patients or staff offer vital intelligence on how to improve services for patients and can serve as warnings, helping to prevent errors.”

Vicky Voller, Director of Advice and Appeals at NHS Resolution, said:

“NHS Resolution welcome the launch of the refreshed Medical Practitioners Assurance Framework. As a member of IHPN’s reference group, we were able to contribute our expertise in resolving concerns and disputes to the development of the Framework and are confident that it meets current best practice in the health system and, most importantly, provides greater consistency across the NHS and the independent sector, thereby embedding a systems-wide approach to patient safety and quality.”

Rosemary Hittinger, Company Secretary, Federation of Independent Practitioner Organisations (FIPO), said:

“The MPAF refresh demonstrates the sector’s ongoing commitment to rigorous standards and processes of clinical governance.  As we move towards a more integrated system the MPAF will support consultants and providers to enhance and improve patient safety.”

Sally Taber, Director, Independent Sector Complaints Adjudication Service (ISCAS), said:

“ISCAS welcomes the refreshed MPAF, and will ensure that this well respected document is used by ISCAS subscribers as part of their Governance framework. The ISCAS Code has also been updated to include the Complaints Standard Framework (CSF) namely “To include Promoting a just and learning culture, Welcoming complaints in a positive way, Being thorough and fair and Giving fair and accountable responses”, the principles of which are contained within the refreshed MPAF”.