Practising privileges reviews to be stricter

By Robin Stride

Consultants’ requirements to gain and maintain practising privileges are being standardised in all private hospitals as part of a drive to beef-up patient safety and improve transparency.

The changes are among several in a new version of the four-years-old Medical Practitioners Assur­ance Framework (MPAF) produced by the Independent Healthcare Providers Network (IHPN).

Authors of the 24-page document, designed to enhance the quality of care in the sector, say the content remains consistent with, or has been updated to reflect, relevant new or updated guidance or legislation published since 2019. 

The practising privileges section has been updated to ‘better allow for a risk-based approach, directing that a review of practising privileges is undertaken biennially for all medical practitioners and more regularly in circumstances where additional scrutiny is requires’.

A wide range of medical organisations have reacted positively to the ‘refresh’, including the Feder­ation of Independent Pract­itioner Organisations (FIPO), the Royal College of Surgeons of England, the Independent Sector Com­plaints Adjudication Service and the Patients Association.

Rosemary Hittinger

FIPO company secretary Rose­mary Hittinger said the MPAF refresh demonstrated the sector’s ongoing commitment to rigorous standards and processes of clinical governance. ‘As we move towards a more integrated system, the MPAF will support consultants and providers to enhance and improve patient safety.’

Strengthened areas

Strengthened areas include giving more prominence to expectations around patient consent and the need for greater transparency around conflict of interest declarations. 

New initiatives such as the Learn from Patient Safety Events (LFPSE) service are also reflected, along with the IHPN’s Development Plan which sets out how the network will support providers to continue to implement the MPAF.  

The MPAF is also promoted as a way providers can provide assurance to the Care Quality Com­mission that they are ‘well led’.

Its update takes account of recommendations from the Paterson Inquiry and the Department of Health and Social Care’s response, and the 2020 ‘First do no harm’ report of the Independent Medi­cines and Medical Devices Safety Review. 

Continuously improving

David Hare

IHPN chief executive David Hare said the document reflected the independent health sector’s commitment to continuously improving safety and quality. Providers had used it to review and update their practices to raise the bar and ensure they adhered to the latest medical governance practices.

It would also enable greater consistency in how clinicians worked across the sector and give confidence to patients that independent healthcare providers were committed to delivering the safest possible care. 

The MPAF says although practising privileges policies will vary, sector-wide standardisation of some aspects will provide much needed transparency and set the sector’s expectations of doctors.

It calls for the application for practising privileges to be based on a standard dataset – published as an appendix in the MPAF document – incorporated into all providers’ practising privileges application forms. 

Where doctors are employees, ‘then appropriate recruitment and selection processes, together with policies and procedures for monitoring and managing performance, should reflect the dataset’ .

Reviewed biennially

Practising privileges should be reviewed biennially for all medical practitioners, and more regularly in circumstances where additional scrutiny is required, while practising privilege reviews should be the same across all independent providers. 

The MPAF added: ‘Where the independent provider does not have the required information necessary to make a decision about renewal, practising privileges should be suspended until that information is available. 

‘Collection of whole-practice clinical data, co-operation with the appraisal process and sharing of relevant information should be a requirement for maintaining practising privileges.’ 

Independent providers are told to have robust processes for assessing novel therapies/procedures ‘that protect patients, medical practitioners and the organisation without stifling innovation’.