Advice to private doctors on cutting costs in complaints probes

Private practice complaints investigators have issued new guidance to help independent providers avoid incurring preventable costs during inquiries.

The Independent Sector Complaints Adjudication Service (ISCAS) has issued an eight-point check-list as part of a position statement for subscribers explaining the criteria on which its adjudicators seek an expert opinion.

This forms part of a position statement on the criteria that independent adjudicators look for before seeking an expert opinion. 

Clinical expert costs are met by the investigated organisation on top of the adjudication, but going down this route can mean a longer inquiry and possibly a delayed conclusion.

ISCAS said: ‘The requirement for a clinical expert is likely to be significantly reduced if good practice is followed at the earlier stages of the complaint process.’

Its good practice pointers say ISCAS adjudicators are unlikely to have the need to instruct an expert where doctor subscribers have:

  1. Informed complainants whether they consider it appropriate to obtain independent advice to be able to respond to the complainant’s concerns.
  2. Explained the degree and nature of the independence of the clinical expert adviser.
  3. Agreed with the complainant the nature, designation and seniority of the person providing independent clinical advice and have informed complainants about any conflict of interest with the treating clinician.
  4. Have agreed with the complainant the heads of complaint upon which independent clinical advice will be sought.
  5. Asked the independent clinical adviser to respond to the relevant heads of complaint rather than providing a general overview.
  6. Agreed with the complainant in advance the questions to be asked of the independent clinical adviser.
  7. Disclosed the independent clinical advice in full to the complainant.
  8. Shared the independent clinical advice with ISCAS adjudicators.