Ensuring safety is an ungoing task

David Hare

As we report in our top story this month, doctors in private practice need to be aware of important changes to the Medical Practitioners Assurance Framework. David Hare, chief executive of the Independent Healthcare Providers Network (IHPN), sets the scene.

As Independent Practitioner Today readers may be aware, it is now almost three years since the IHPN, together with former NHS England national medical director Sir Bruce Keogh, launched our Medical Practitioners Assurance Frame­work (MPAF).

While acknowledging the overwhelmingly safe, high-quality care delivered in the independent healthcare sector, this framework of principles – developed with the NHS, regulators and royal colleges – was designed to help foster a more standardised approach to medical governance in the independent sector and drive even further improvements in safety and quality. 

Since its launch in 2019, the framework is now firmly embedded in the patient safety and regulatory landscape. 

The Care Quality Commission uses the framework’s principles in assessing how ‘well-led’ an independent service is and it is now also part of the NHS Standard Contract – requiring all independent-sector providers who deliver NHS-funded care to adhere to it. 

Moreover, the Government’s response to the former Bishop of Norwich’s inquiry into surgeon Ian Paterson noted the ‘significant work’ undertaken by independent providers and individual practitioners to fulfil his recommendations, specifically through the implementation of the MPAF.

Of course, as those working in the sector will know, the world of healthcare does not stand still and the MPAF was always designed to be a ‘live document’. 

Further strengthened

Since it was published, the IHPN has been working with providers, stakeholders and practitioners to look at areas where the framework can be further strengthened to ensure the principles remain in  keeping with current best practice around medical governance in the health system. 

Last month, we were therefore delighted to launch the ‘refresh’ of the MPAF, which takes a renewed look at the framework and takes account of the many changes in the safety and regulatory landscape over the past few years. 

Most notably, this includes:

 The Bishop of Norwich’s independent inquiry report into Ian Paterson;

 Baroness Cumberlege’s Indep­endent Medicines and Medical Devices Safety (IMMDS) Review;

 Their respective Government responses;

 New initiatives such as the Learn from Patient Safety Events service and wider regulatory changes in the 2022 Health and Care Act.

With the support of our External Advisory Group, including the Federation of Independent Pract­itioner Organisations, the MPAF refresh retains the principles-based approach of the framework, but strengthens them in key areas. 

This includes the importance of patient consent and declaring any conflicts of interest – both of which were key themes in both the Paterson and IMMDS reviews. 

Practising privileges

Likewise, the section on reviewing practising privileges has been updated to better allow for a risk-based approach.

It stipulates that a review of practising privileges is undertaken biennially for all medical practitioners and more regularly in the rare circumstances where additional scrutiny or oversight is required. 

And it also highlights the need for independent providers to have arrangements in place to better support practitioners returning to practice after an investigation and has more detail on best practice for the management of patient complaints. 

In addition, in the ‘Medical Practitioners Responsibilities’ section, doctors are now asked to seek appropriate help if they are experiencing pressures that may lead to an impairment of their practice. 

With the health service under scrutiny and many practitioners experiencing system pressures like never before, it is crucial that the MPAF continues to evolve and accurately reflect the latest medical governance practices.

A big thank you!

From everyone at IHPN, we would like to thank all practitioners working in the sector for their engagement with the framework.

We look forward to working with you over the coming years to further embed the MPAF and continually improve the safety and quality of care delivered by independent sector providers to both NHS and private patients.