Doctors are under increasing scrutiny when it comes to reporting serious incidents and data-sharing in private practice. Jane Braithwaite presents a timely analysis and gives some useful tips.
A recent BBC Panorama TV documentary entitled ‘How safe is your operation?’ uncovered serious concerns about the sharing of data and incident reporting in the private sector.
With cases such as that of Ian Paterson – the surgeon who wounded patients and carried out unnecessary surgical procedures – making headline news, patients may be rightly concerned that the safety policies and procedures used in private healthcare are not up to scratch.
So, what can private practices do to ensure their services are safe and patient safety is taken seriously, and what tools are available to support doctors in data-sharing?
Why is data important?
First, let’s consider why this information is so important.
As with any industry, analysis of business data will allow companies to see where they are doing well and can help to identify areas that need improvement.
It’s a great way to monitor how the business is running and to pinpoint areas where process changes are required. In healthcare, without recording and analysing clinical data, it is incredibly difficult for organisations to have any kind of handle on trends relating to symptoms, public health, procedure safety… the list goes on.
But why should this be particularly important? The reason is patient safety. Without measuring clinical outcomes, organisations – either in the NHS or the private sector – cannot ensure they are providing the best possible patient care.
Why are the NHS and private sectors different?
According to the Private Healthcare Information Network (PHIN), which was established by the Competition and Markets Authority (CMA) following the 2014 investigation into the private healthcare market, the private healthcare industry has been largely excluded from national healthcare policy for some time.
As a result, the industry is not included in NHS information systems, meaning data is not shared between providers, and treatment information is not reported consistently to national databases.
What data is required?
Datacase singleThe private healthcare information that needs to be shared to supplement the NHS datasets relates to clinical audits, cancer surgery outcomes and figures relating to cosmetic surgery, for example.
Sharing this information will allow for complete oversight of patient outcomes. Policies and strategies in both sectors can then be shaped based on accurate and robust datasets, but basing policies on incomplete data will have a negative impact on patient safety.
It is therefore in the best interests of the NHS, the private sector and, of course, the patients to share this information to increase knowledge and identify any areas that need improvement.
This, of course, means that serious incidents need to be properly documented and reported, as well as information on successful treatments.
However, having a thorough risk assessment policy that includes information on how incidents are reported can only be a good thing for private practices; it will increase patients’ confidence in the fact that, if an incident does occur, it will be dealt with efficiently by the practice.
What can private practices do?
The key issue here is for the different sectors to work together for the good of the patients; data standards need to be brought into alignment. But who is spearheading this and how can private practices get involved?
As mentioned above, PHIN was established in the wake of the CMA’s 2014 investigation and now provides information on private healthcare to the public.
All hospitals providing private treatment are required to publish information on service quality –for example, infection rates, mortality rates and admission figures.
Several NHS trusts have been contacted by the CMA after making insufficient progress in achieving this goal. This is more than a year on from the CMA announcing that private healthcare providers must submit information on their services, allowing patients to have access to information they need to make an information choice about their care.
As well as publishing information on private hospitals, PHIN will also soon be making information available on individual consultants. A recently implemented new online portal allows clinicians to review their performance data ahead of the publishing of the data in 2018.
This gives consultants the chance to review their information to identify any trends or missing data and the portal also features a members’ manual that answers frequently-asked questions and contains more information on the process.
Consultants therefore need to recognise that the landscape in this area is changing and, in future, it appears that data-sharing between the private sector and the NHS will become more regulated.
Practices will need to review their internal policies relating to data – such as data protection, data sharing – and to risk assessment and reporting, and make sure that the relevant stakeholders are involved in their policies.
Moving forward – clarity and consistency
Lawyers and national medical organisations alike are calling for greater consistency here; private hospitals should be subject to the same regulations as the NHS, as so many patients use both services.
A single standard for data procedures and reporting, regardless of how the care is funded, is obviously needed – especially when taking into account the fact that 95% of patients who have planned surgery privately are also NHS patients for other aspects of their healthcare.
There is a clear need to unify standards across sectors. Setting consistent information standards will improve many areas of healthcare, including patient choice, access to information, interoperability between systems, quality of service and integrated care.
There is really no reason to say ‘no’ to joining forces and making patient care the best it can be.