What does the Paterson inquiry mean for independent healthcare?
The Paterson Inquiry report was a damning indictment of the independent healthcare sector in the UK. The inquiry examined a wide range of accountability and responsibility issues following the conviction of rogue surgeon Ian Paterson for 15 years in 2017, later increased to 20 years, by the Court of Appeal. The report found that there were serious failings in the way that independent healthcare providers monitored the actions of consultants, and that there was a lack of accountability for these failings.
One consequence of the terms of reference for the Paterson inquiry was a very public ‘league table’ comparing quality and safety governance in the private health sector with the NHS. The Paterson inquiry compared the independent sector and NHS on areas including information sharing, professional standards, referrals, management of adverse incidents and multi-disciplinary working.
The report made 15 recommendations, including:
- Strengthening the role of patient safety champions. The report found that there was a lack of leadership and advocacy for patient safety in many healthcare organisations. It recommended that every organization should have a patient safety champion who is responsible for raising awareness of patient safety issues and promoting a culture of safety.
- Improving communication between healthcare professionals. The report found that there were many missed opportunities to identify and stop Paterson’s misconduct because of poor communication between healthcare professionals. It recommended that all healthcare organisations should have clear procedures for communicating patient safety concerns, and that these procedures should be regularly reviewed and updated.
- Enhancing the role of independent oversight bodies. The report found that the independent oversight bodies, such as the Care Quality Commission (CQC), were not effective in preventing Paterson’s misconduct. It recommended that the CQC and other independent oversight bodies should be given more powers to investigate and regulate healthcare organisations.
The government has responded to the report by making a number of changes to the regulation of independent healthcare. These changes include:
- Increasing the powers of the Care Quality Commission (CQC)
- Introducing a new code of conduct for independent healthcare providers
- Strengthening the whistleblowing framework for independent healthcare staff
Improving the quality and transparency of independent healthcare in the UK was one of the primary outcomes of the Paterson inquiry report. The report has led to a greater focus on patient safety, and has prompted independent healthcare providers to review their practices.
From our experience in the NHS, we know there are inconsistencies and pockets of poor-practice, and this is the same for the private health sector. Investigating these serious incidents in the NHS must be part of a diligent Safety Governance campaign. Carrying these investigations out in a fair and open manner.
Government response to the Paterson Inquiry
The government has responded to the Paterson Inquiry report, and it has committed to implementing all of the recommendations. However, it is important to note that these recommendations will take time to implement, and it will be some years before it is clear whether they have been successful in improving patient safety.
The Paterson Inquiry report is a wake-up call for the NHS and independent healthcare sector. It shows that there are still significant challenges to be addressed in order to ensure that patients receive safe and high-quality care. The report’s recommendations provide a roadmap for improvement, and it is essential that the government and healthcare organizations work together to implement them effectively.
Spire Healthcare, where Paterson had worked at two of its hospitals, commissioned Verita to review its governance arrangements. The review, published in 2014, found that many of the management and governance arrangements at the two Spire hospitals were weak.
We made 15 recommendations in our final report aimed at strengthening the work of medical advisory committees, the granting and maintenance of practising privileges, the monitoring of consultants’ performance generally, and consultant appraisals. We were also clear that the problems the report identified were common to many independent healthcare providers.
Rightly or wrongly, any quality or safety failings in the independent sector will be viewed more harshly by the media, political and public. Spire has taken the opportunity to act on all 15 of our recommendations across their entire network of 39 hospitals. I would urge other providers to take proactive action now. Independent reviews of current practices to ensure they meet our Paterson inquiry recommendations will help safeguard patients and corporate reputations in future.
As part of our service offering, Verita carry out due diligence on healthcare providers for mergers and acquisitions to review structures and processes to ensure new owners are aware of the strengths and weaknesses of its clinical governance.
We also provide a patient safety incident investigation course to give organisations the information needed to carry out an investigation into a wide range of incidents including safety breaches and professional misconduct.
If you would like to learn more about how the Paterson Inquiry and its consequences for patient safety then please book a free consultation or contact Ed Marsden on 020 7494 5670 or [email protected].
This article was originally published on 17 April 2018 and was updated on 12 July 2023.