We’re part of a whole

What does the Government’s response to the Paterson Inquiry mean for doctors working in independent sector? David Hare reports.

At the end of March, the Government published its long-awaited update on its response to the former Bishop of Norwich’s inquiry into jailed surgeon Ian Paterson. 

The Government’s statement focused on work around five of the inquiry’s recommendations, notably patient information, patient consent, multidisciplinary teams, patient recall and ongoing care. 

Its work on responding to the Paterson Inquiry is still ongoing, and a full response to the Bishop’s report is expected by the end of the year. But what does this interim update mean for independent healthcare providers and those working in the sector?

The Covid-19 pandemic has, of course, dominated the work of the healthcare system in the past year and it was welcome to see the Government acknowledge the ‘critical role that the independent sector has played in supporting the NHS’ over the last year. 

In this light, therefore, it made clear the importance of improving safety and governance across both the NHS and the independent sector and the need for any recommendations to be implemented across the entire healthcare landscape – an important principle we at the Independent Healthcare Providers Network (IHPN) have been advocating for some time. 

A key thread throughout the Rt Revd Graham James’s inquiry was the importance of all healthcare organisations directly providing clear and simple information to patients around all aspects of their care to give them full confidence in the quality of treatment they are receiving.

As part of this, the Government supported the inquiry’s recommendation to have consultants write to patients, rather than GPs, and suggests that guidance published by the Academy of Medical Colleges could be incorporated into the requirements of the NHS Standard Contract. 

As the recommendation specifically states that both consultants in the NHS and independent sector should adopt this practice, the inquiry’s report indicates that there should also be requirements for consultants undertaking non-NHS commissioned work to write directly to patients. 

Period of reflection 

Linked to this, the Government also recommended there should be a short period introduced into the process of patients giving consent for surgical procedures, to allow them time to reflect on their diagnosis and treatment options, with the GMC monitoring this as part of Good Medical Practice.

The Government’s update on the Paterson inquiry also focused on multidisciplinary team (MDT) working and calls for the Care Quality Commission (CQC) to assure itself that all hospital providers are complying effectively with up-to-date national guidance on MDT meetings. 

As part of this, it is suggested that the CQC will work to make questions about MDTs mandatory in its assessments. 

This is an area of treatment planning which IHPN’s Medical Pract­itioners Assurance Framework (MPAF) highlights, making clear that independent providers should formalise arrangements for multidisciplinary team-working, including:

 How relevant clinical data is transferred;

 How the teams are reviewed; 

 Outcomes audited. 

Further recommendations from the Government relate to the work that both University Hospitals Birmingham NHS Trust and Spire Healthcare have done to contact all of Paterson’s patients and review their care, as well as providing support and follow-up care as needed.

Medical device information 

In addition to responding to these five recommendations, the Government also used its statement to highlight three pieces of legislation it is implementing to support patient safety:

  1. Amending the Medicines and Medical Devices Bill to create a power to establish a UK-wide medical device information system;
  2. Establishing a Patient Safety Commissioner for England with responsibility for medicines and medical devices; 
  3. Extending the remit of the Health Service Safety Invest­igation Branch to independent providers. 

Each of the actions specifically mentions and involves the independent sector, reflecting the importance of having a ‘whole- systems’ approach that promotes patient safety across the entire healthcare landscape in the UK, rather than being siloed between the NHS and independent sector.

Core role

So what to make of this update from the Government? 

Of course, there is much progress to be made to ensure the highest possible levels of patient safety in the long term – not least the need to drive forward the data agenda to better capture both consultant scope of practice and clinical outcomes across the health system. 

However, the broad thrust of the Government’s response, that the independent sector plays a core role in healthcare provision and as such a ‘whole systems’ approach to patient safety and clinical governance is needed, is undoubtedly the right one.

We will continue to work with all stakeholders to ensure the full response to the former Bishop’s inquiry supports those working in the independent sector to deliver the safest and highest quality care to patients that they deserve.

David Hare (right) is chief executive of the Independent Healthcare Providers Network