Private sector has a lot to offer trainees

Independent practitioners provide an excellent training ground for NHS junior doctors. David Hare says the aim now is to have more private doctors take part.

Independent providers and practitioners have long played a key role in delivering healthcare to millions of NHS and private patients every year. 

But while the independent sector has played an important role in the education of a wide range of clinical staff, there have been growing calls for the private sector to play a bigger role in the training of the next generation of doctors.

The onset of the coronavirus pandemic, and in particular the national NHS/independent hospital partnership that saw whole NHS teams transferring across to the sector to keep non-Covid services running, gave real impetus to this issue.

And as Independent Practitioner Today readers will know, following detailed conversations between a range of stakeholders, an agreement was reached in September 2020, between the Independent Healthcare Providers Network (IHPN), Health Education England (HEE), NHS England/Improve­ment and the Confederation of Postgraduate Schools of Surgery (CoPSS) to significantly increase NHS junior doctors’ access to training with independent providers delivering care funded by the NHS.

Important contribution

Since then, more than 4,000 NHS doctors in training have accessed training opportunities in the independent sector, with a growing recognition of the role private providers can play in supporting the next generation of medical professionals. 

But what have we learned from this experience to ensure that doctors in training can have the best possible experience working with independent practitioners? IHPN has recently published a report on just this question. 

Firstly, it is important to recognise the important contribution the independent sector can make to medical training. 

In specialising in routine elective procedures such as hip and knee operations and cataract surgery, independent providers offer an ideal training ground for junior doctors to learn from the best independent practitioners in the business, hone their skills and achieve their training targets. 

Practical barriers

And, since 2020, the sector has been vital in ensuring medical training could continue at a time when there was huge upheaval and acute pressures in the NHS. 

However, there remains a number of practical barriers to ensuring the sector can fully support the training of junior doctors.

Through talking to trainees and providers across the system, IHPN has found time and time again that simple administrative issues are often a key barrier in accessing the independent sector and can place a significant burden on both independent practitioners and providers. 

While, of course, the necessary governance processes need to be followed, too often trainees report having to process large volumes of paperwork to be able to enter independent sites, which can delay or prevent access to training opportunities.

Duplicated checks

A significant proportion of the paperwork and checks required are duplications of what has already been done for other training placements, and the process could be considerably streamlined without any consequences for quality and safety. 

We therefore want to see much more co-ordination and information-sharing to enable trainees to move more easily between sites and access training across the entire healthcare system. 

This is a current priority for HEE which is part funding a new Clinical Information Sharing System (CISS) solution, which will offer a ‘single point of truth’ for trainees and allow credentials and other information required for placements to be shared – increasing the mobility of trainees while ensuring governance requirements are adhered to. 

More can also be done to improve planning around trainee placements. Many independent providers report that requests to have trainees were sometimes done at short notice, making it more challenging for practitioners to fit them into existing schedules and ensure employment checks were undertaken.  

Including the independent sector as part of the Doctors in Training rota and implementing more comprehensive, system-wide processes to allow for advanced planning and communication would help with this. 

Such a system-wide approach would also be beneficial with regards to data collection about both the quality and access to training in the independent sector.

Cultural shift

We know independent practitioners provide an excellent training ground for junior doctors and we want to make sure this is captured and recognised by all those in the sector. 

IHPN has therefore begun work with HEE to help consolidate the experiences of trainees in the sector, such as by ensuring questions about accessing training in the independent sector are included in the next National Education and Training Survey (NETS) survey. 

Looking back over the last few years, it is clear there has been a much needed cultural shift on this issue, with a recognition that independent providers and practitioners have a key role to play in the training the next generation of medical professionals. 

While there is still more progress to be made, particularly around taking a more system-wide approach to communication and data-sharing around trainees, IHPN will continue building on this momentum.

And we will ensure independent practitioners have the opportunity to impart their wisdom and can fully contribute to medical training in the long term.

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