CMA reins in openness

By Robin Stride

Consultants have welcomed a pledge to limit the amount of information to be made freely available about their private patient outcomes. 

Their response follows a new report from the Private Healthcare Information Network (PHIN) saying that, for specialists, publication into the public domain of measures beyond volume, length of stay, patient feedback and links to registries is not currently recommended. 

PHIN explained that other measures – required by the Competition and Markets Authority’s (CMA’s) private healthcare ‘transparency’ order of 2014 – were ‘not yet appropriate for use as publicly available comparators; for example, because the quality and power of the data limits valid, statistical comparison’.

In a document, supported by the CMA, PHIN said it would continue to keep these issues under review in consultation with stakeholders.

The Federation of Independent Practitioner Organisations (FIPO) said it was pleased the CMA had accepted PHIN’s recommendations to limit the publication of consultant-level metrics until more valid information can be made available. 

It added: ‘FIPO has long argued that outcome metrics derived from hospital episode statistics are not a suitable vehicle to differentiate clinical performance. 

‘Realistically, patient choice of consultant is limited anyway, as it is only self-pay patients who are not constrained when choosing their consultant.’

Civica Medical Billing

Restricted access

In a 42-page assessment of what is needed to complete the CMA’s demands, known as ‘Private Healthcare Order Article 21’, PHIN recommended: ‘Information on all the Article 21 measures on consultant and hospital practice should be published on the restricted-access part of the PHIN website (the portal), so consultants and hospitals can use the information to monitor and improve performance. 

‘Ultimately, this will benefit patients and consumers by improving the availability of data and transparency across the sector. 

‘It will also enable hospitals and consultants to benchmark their performance against their peers – for example, to support their own clinical governance and quality improvement initiatives – and is a necessary step towards any wider publication.’ 

PHIN said publication in the public domain for the hospital-level metrics was essentially complete.

But it needed to look at ways to improve compliance, including data presentation, coverage/participation and data quality. It also aims to adopt some minor, technical enhancements to specific measures. 

It said it should publish nationally aggregated data about procedures, with the ability for this to be broken down to show how outcomes may vary for different patient groups.

Significant milestone 

Jayne Scott

PHIN chairwoman Jayne Scott said the document marked ‘a significant milestone’ in the delivery of the CMA’s Order, as it set out the data that could be ‘meaningfully’ published for each remaining measure.

‘This means publishing data that is understandable by both patients and clinicians so that it can inform patient choice, facilitate shared decision-making or allow statistically valid comparisons between healthcare providers.

‘We remain committed to the principle of publishing data for use by patients but, as set out in detail in this document, this will be contingent on factors such as the quality, and statistical power, of the inbound data.

‘I am grateful to everyone who has been involved in this process which will continue our acceleration of activities and the improvements in patient care that should result.’

PHIN will work with the Patients’ Association and other patient research organisations to help
it present information ‘in ways that are most meaningful and helpful’.

There is a 2026 deadline for publishing the CMA’s demands for information on various performance measures covering surgical procedures carried out in private hospitals. 

PHIN said the report built on its ‘Roadmap and delivery plan 2022-2026 for the Private Healthcare Market Investigation Order 2014’, issued last year, and followed consultation with the private healthcare sector. This included private doctors’ representatives.

See ‘FIPO’s reaction to competition watchdogs easing of rules