Pushing the private sector’s viewpoint

Key policy and regulatory changes are on their way for independent practitioners in the coming months. Dawn Hodgkins looks at what is on the horizon.

Providers and practitioners across the whole healthcare system are continuing to adapt to living in a world with Covid, in addition to tackling the long-standing quality, safety and workforce challenges facing the health and care services. 

In response to this, the healthcare policy and regulatory landscape is also evolving to meet the needs of the system, with significant implications for those working in the independent healthcare sector. 

Below are just a few of the issues that independent practitioners will need to grapple with in the coming months.    

Mandatory Covid jabs 

While the Covid vaccine rollout has been an undoubted success of 2021, there remains a significant proportion of people who are not exempt yet choose to remain unvaccinated. 

And with pandemic rates remaining high, the Government is proposing to make it a legal requirement for health and care workers to have two doses of a Covid-19 vaccine, unless they have a medical exemption, as a way of keeping staff, patients, and vulnerable groups safe. 

This approach is already in legislation which comes into force on 11 November 2021 for the care home sector. 

From this date, care home managers will be responsible for ensuring that staff deployed to work within the home are either vaccinated or exempt. A consultation published in September aimed at extending this to healthcare providers.

The impact that mandatory vaccination will have on the healthcare sector is not yet clear. However, within NHS services, the number of staff who have had both Covid-19 vaccinations is reported to be around 85-95% in most areas, although this drops to around 75% in others. We anticipate that this picture will be broadly similar in the private healthcare sector.  

The types of workers that the mandatory requirement might apply to could also have a significant impact on both the staff and service delivery. Currently, the proposals just affect front-line clinical staff, but the Government is seeking views on broadening it out to  administrative employees, for example. 

Of course, making Covid vaccination mandatory for the healthcare workforce raises significant and complex employment, legal, ethical and practical questions for all healthcare providers with no easy answers.  

The Independent Healthcare Providers Network (IHPN) is therefore continuing to work with law firm Bevan Brittan to help ensure our members and their workforce fully understand the issues at hand and, critically, that we can learn from the experiences of those working in social care where such legislation is already in place.  

Health watchdog’s evolving assessment approach

Away from Covid-19, the Care Quality Commission (CQC) is continuing to develop its approach to regulation in response to its consultations published in July this year. 

While its five ‘key lines of inquiry’ are expected to stay, it is proposing to develop new I/we ‘quality statements’ to support people using services to understand the assessment framework and to set expectations about what good care looks like from their perspective.  

The CQC plans to be more transparent about the evidence that is used and is proposing to use six evidence categories to determine the key pieces of evidence needed to make a judgement on each quality statement.

These are:

  1. People’s experiences;
  2. What do staff and leaders tell them;
  3. What have they heard from their partners;
  4. What the CQC itself has observed;
  5. What do they know from the organisation’s systems, policies and records;
  6. What can they learn from outcomes and performance data. They plan to allocate a score to each pillar of evidence that will ultimately ‘drive’ the service rating.  

Clearly, there is much work to do to ensure these new changes work for both patients and providers. 

IHPN will therefore be engaging closely with members and the CQC in the coming months. We need to ensure the watchdog has the right data and insight to make accurate assessments of providers, while also ensuring organisations are clear on what they need to do to improve their rating and ultimately the care they deliver for patients. 

GMC review of Good Medical Practice guidance

The CQC is not the only regulator looking to reform the way it works. 

The GMC has also announced that it will be reviewing its core Good Medical Practice guidance, last updated in 2013, which outlines the professional values, knowledge and behaviours expected of doctors working in the UK.  

I am delighted to have been asked to join the GMC’s advisory forum, which will help steer the review and act as a sounding board for key decisions and developments. (See news story on page 9).

It is early days in terms of the review, but a key priority for me in the coming months will be ensuring the revised version is fit for the future and recognises the key role independent providers play in the patient pathway.

I will also want to see that it supports good care and fairness for patients and doctors alike. 

Government response to Paterson inquiry

The end of this year will also see the much-anticipated Government response to the independent inquiry into rogue surgeon Ian Paterson. 

Wide-ranging recommendations include improving communication with patients, strengthening patient consent processes, ensuring effective multidisciplinary team-working is in place, and implementing more comprehensive data collection on consultants working across both the NHS and independent sector.

So there will be much to consider and act upon for all those working in the independent sector. 

IHPN has been playing a key role in the Department of Health’s Programme Board and task and finish groups to help feed into the development of the Government’s response. 

And once published, we will be working closely with members to ensure recommendations are successfully implemented and help the sector deliver the safest possible care for patients. 

These are just a few of the policy and regulatory issues that will be impacting independent healthcare providers and practitioners in the coming months. 

Independent Practitioner Today readers should be reassured that IHPN is fully plugged into all these changes, ensuring that the sector is factored into the new ways of working in the health system and is fully equipped to deliver the best possible care for patients in future.

Dawn Hodgkins (right) is director of regulation at the Independent Healthcare Providers Network (IHPN)