Independent healthcare providers unite to implement new medical governance framework

Independent healthcare providers from across the country have come together to commit to implementing a new medical governance framework that will help ensure all independent sector providers in England are able to further improve the care they are giving to their patients.

The Independent Healthcare Providers Network (IHPN), which represents independent healthcare providers delivering both NHS and privately funded care, asked former national NHS National Medical Director Sir Bruce Keogh to work with the sector to bring together key principles to strengthen and build upon the medical governance systems already in place.

These principles form part of a Medical Practitioners Assurance Framework which will be launched today at IHPN’s annual summit in London, and reinforce expected practice in a number of key areas including:

-Clinical governance structures

-Patient safety, clinical quality and continuous improvement

-Whole practice appraisal of clinicians

-Raising and responding to concerns from staff and patients

A key thread running through the framework is the importance of taking a more “system wide” approach to patient safety, including the effective and timely sharing of information with the NHS about a medical practitioner that could affect the safety or confidence of patients.

In developing the framework, Sir Bruce was supported by an Expert Advisory Group including representatives from the Academy of Medical Royal Colleges, the health regulator the Care Quality Commission (CQC), the General Medical Council (GMC), NHS England & Improvement, the Department of Health and Social Care and the Patients Association.

So far over 29 independent healthcare providers, representing over 200 individual sites, have signed up to implementing the framework, and the CQC has committed to considering the effective and robust implementation of the framework’s principles as evidence of good governance and will inform the judgement they make about how well led a service is. The framework will also be reviewed in late 2020 to ensure the principles remain in-keeping with current best practice around medical governance in the health system.

Sir Bruce Keogh, lead for the Medical Practitioners Assurance Framework, said:

“Independent healthcare providers currently deliver healthcare to millions of people every year, including a significant number of NHS patients. While the vast majority of care in independent providers is of high quality and underpinned by robust safety and medical governance processes, more can and should be done to ensure clinicians and independent providers are working together to perform to the highest possible standards.

“I’ve therefore been delighted to work with healthcare regulators, Medical Royal Colleges and healthcare providers from across the independent sector to develop the Medical Practitioners Assurance Framework which will help foster a more standardised approach to medical governance in the sector and ultimately drive up the quality and safety of care for patients.”

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

“Strong medical governance is the bedrock of safe patient care and I’m therefore delighted that IHPN has had the opportunity to work with Sir Bruce Keogh in developing this framework, which will play a critical role in raising the bar in medical leadership and ensuring greater consistency around how clinicians work across the independent sector and NHS.”

“While the Care Quality Commission made clear in their report on independent acute hospitals last year that the overwhelming majority of care delivered in the sector is either good or outstanding, the sector was quick to act on their call for greater consistency around medical governance. The development of this framework demonstrates this culture of learning and continuous improvement which can be found in the sector and will give confidence to patients that independent healthcare providers are committed to delivering the safest possible care.”

Heidi Smoult, CQC’s Deputy Chief Inspector of Hospitals and lead for independent health said:

“This framework is a welcome development and an important step forward in addressing the need for stronger medical governance across the independent sector. While sign up to the framework is not mandatory or something CQC has the power to enforce, where providers can demonstrate effective and robust implementation of its principles, this will be considered as evidence of good governance and will inform the judgement we make about how well led services being provided by that organisation are.”

Rachel Power, CEO of the Patients Association said:

“We believe any effort to improve patient care must seek to incorporate an understanding of patients’ experiences. It was a privilege to be invited to represent the patient voice during the development of this framework, and we hope that the “patient-friendly” resource that was produced alongside it will help to empower patients to fully engage with their care. We encourage all independent health providers to implement the framework and commit to delivering excellent care to all patients.”

Professor Carrie MacEwen, Chair of the Academy of Medical Royal Colleges said:

“Doctors need to be supported to provide safe, high quality care in all aspects of their professional lives. We therefore welcome this medical governance framework for the independent healthcare sector which does this in a systemic fashion by ensuring that all parties have secure mechanisms to work together to improve patient care in this setting.”

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

“Doctors and senior healthcare leaders play a critical role in ensuring that patients receive high quality care both in the NHS and independent sector. The framework’s guidance on good clinical governance and the use of effective checks and balances in clinical practice are a welcome reaffirmation that we are all guardians of the quality of care which patients receive.

“The independent sector delivers care to both NHS and privately funded patients in the UK. This framework will help bring greater consistency to the development of clinical governance systems and the sharing of information and best practice across organisations and sectors.  This should make a significant contribution to keeping patients safe and delivering high quality care.”

Professor Derek Alderson, President of the Royal College of Surgeons of England, said:

“Every patient has the right to expect safe, high quality care, no matter where they are treated. We can only be confident of this if both the NHS and the independent sector collect and share information about the performance of their services, and the practitioners working within them.

“The Royal College of Surgeons of England is very supportive of Medical Practitioners Assurance Framework. We have been working to improve standards in the independent sector following the tragic Paterson case and we were pleased to be part of the expert advisory group that helped develop this new framework.

“In particular, we hope that, where an individual works in both the NHS and independent sector, the framework will ensure concerns about performance are shared across the sectors, as part of whole practice appraisal, so problems can be responded to quickly. We would like to see all independent hospitals, even the small number not in IHPN membership, commit to implementing the framework.”

BMA private practice committee chair Dr Shree Datta said:

“All doctors must be assured that the system in which they work – whether that is the NHS or independent sector – operates within a clear set of standards, and that clinicians are adequately supported so they can provide high quality care to patients.

“This framework is a helpful stepping stone to improving consistency and boosting confidence in all independent healthcare settings. Indeed, we must work towards a single, unified platform to centralise all information for doctors and patients.”

 Mr Richard Packard, Chairman of Federation of Independent Practitioner Organisations (FIPO), said:

“The Federation of Independent Practitioner Organisations (FIPO) is pleased to have been involved with the production of the MPAF, which will enable a more coordinated approach to improve communication at all levels about a consultant’s practice and should help in the timely identification of any problems to allow early rectification.  The MPAF makes some sensible recommendations relating to the responsibilities of consultants in relation to their practising privileges which FIPO is pleased to support. This is a dynamic document which will evolve over time and should lead to greater assurance for patients.”