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Sir Bruce Keogh to develop framework on the oversight of consultants in independent hospitals

Date of publication: 19th Dec 2018

Categories: Latest news

Former NHS England National Medical Director, Sir Bruce Keogh, is set to lead on the creation of a new framework on how consultants are overseen in independent hospitals, it has been announced today.

While over 60% of independent acute hospitals are rated good or outstanding for safety by the CQC the healthcare regulator has identified some areas where governance systems could be strengthened by some operators, including in the oversight of Consultants. The Independent Healthcare Providers Network have therefore confirmed that Sir Bruce Keogh will lead on the development of a “Consultant Oversight Framework” to ensure that best practice is spread across all independent acute hospitals and that the excellence found by the CQC in many parts of the sector is reflected more broadly.

The framework, which forms part of the sector’s response to the Bishop of Norwich’s inquiry into the issues around the Ian Paterson case, will be developed in close consultation with hospital providers, consultant representatives, regulators, Royal Colleges and the NHS, and will apply to consultants engaged on both practising privileges (PP) and employed arrangements. Key areas to be addressed include:

  • Governance around medical practitioners
  • Information flows about consultants across the healthcare system including between the independent sector and the NHS
  • Practising privileges arrangements
  • Multi-disciplinary team working
  • Monitoring scope of practice
  • Obtaining patient consent

The framework is due to be published in Spring 2019 and will support operators own work in ensuring the highest standards of clinical governance within their organisations.

Sir Bruce Keogh, Consultant Oversight Framework lead said:

“Independent hospitals currently treat over 1.6 million people every year, including a significant number of NHS patients. While the majority of care in independent hospitals is of high quality and underpinned by robust safety and clinical governance processes, more can and should be done to ensure consultants working in all independent hospitals are performing to the highest possible standards. The development of a Consultant Oversight Framework will help foster a more standardised approach to clinical governance in the sector, including better collaboration and information exchange between private and NHS hospitals.”

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

“We are thrilled that Sir Bruce Keogh has agreed to lead the development of a Consultant Oversight Framework for independent hospitals. With over a decade’s experience as the NHS’ national medical director Sir Bruce is the ideal candidate to help improve the consistency of clinical governance processes in independent acute hospitals and to push up standards of care yet further across the sector.

“While the CQC made clear in their report on independent acute hospitals earlier this year that the overwhelming majority of care delivered in the sector is either good or outstanding, inconsistent clinical governance processes were identified as an area of concern. The Consultant Oversight Framework will play a vital role in ensuring that there is greater consistency in the regulation of consultants and that best practice around clinical governance is spread throughout the sector.”


Scope of the framework

The Consultant Oversight Framework will be developed in the context of the English healthcare system only but it will need to be replicable in the devolved nations as well, subject to an effective translation.

The framework will apply to an independent acute hospital context only, rather than to diagnostic and imaging services and other specialist services.

The framework will apply to consultants engaged on a practising privileges (PP) arrangement and employed consultants. Consultants on a PP arrangement may be consultants with a substantive NHS contract or consultants that operate purely privately.

The framework aims to improve consistency in the governance of medical practitioners across the independent healthcare sector by identifying and codifying best practice across a range of areas including:

Governance around medical practitioners
Information flows about consultants across the healthcare system
Whole practice appraisal and revalidation
The role of the Responsible Officer (RO)
The role of the Medical Advisory Committee (MAC) Chair
Role and functioning of MACs.
Practising privileges arrangements
Annual and biennial reviews of practising privileges
Monitoring scope of practice
Reporting and monitoring doctor’s activity levels and performance
Managing concerns about consultants
Obtaining patient consent
Multi-disciplinary Team working

The development of a Consultant Oversight Framework is part of the Independent Healthcare Providers Network’s programme of work to support independent sector operators’ own work in ensuring the highest standards of clinical governance within their organisations.

Other key workstreams include:

Joint best practice workshops including with the CQC on spreading best practice in key areas including safety, leadership, effectiveness, caring and responsiveness.

Work with HQIP (Healthcare Quality Improvement Partnership) to increase sector participation in their National Clinical Audit and Patient Outcomes Programme (NCAPOP).

IHPN are observers of NHS Digital/PHIN’s ADAPt (Acute Data Alignment) Programme which works to integrate data on privately funded healthcare into NHS systems to increase transparency and help drive up standards in both sectors.