Review examining governance arrangements at Spire Healthcare’s hospitals

Review examining governance arrangements at Spire Healthcare’s hospitals

The Client

Spire Healthcare , Healthcare Sector


Governance Issues.

Spire Healthcare commissioned Verita to review the governance arrangements of two of its hospitals after it became known that a consultant breast surgeon had been performing an unregulated procedure and unnecessary operations over many years.

Consultant breast surgeon Ian Paterson had admitting privileges at Spire Parkway Hospital from 1998 and Spire Little Aston Hospital from 1993.


Verita’s review examined governance arrangements at both Spire hospitals from the time of Mr Patterson’s employment until his practising privileges were withdrawn in 2012.


The team, involving partners Derek Mechen and Lesley Sargeant and administrator Scott Robertson, analysed over 5,500 pages of documentation, and conducted 47 interviews, including with patients, senior Spire managers, current and previous Spire CEOs, the Spire Group Medical Director, the Medical Director of the HEFT, fellow consultants of Mr. Paterson, and General Practitioners who had referred patients to Mr. Paterson.

Our report sets out what managers and clinicians at the Spire hospitals knew about his clinical practice, when they knew about it and what action they took in response. Mr Paterson’s patients were also invited to contribute and their views included in the report.


Overall, the review team concluded that many of the management and governance arrangements in place both at the two Spire hospitals and corporately were weak and made 15 recommendations 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. The report makes it clear that while focusing on Spire the matters considered in the report were common to, and of relevance to, many independent healthcare providers.


We made 15 recommendations designed to improve governance, all of which were accepted by Spire. They focused on the work of medical advisory committees, granting and maintaining practising privileges, monitoring consultants’ performance and conducting appraisals.


In March 2014, upon completion of the report, the Spire Healthcare Board published its re-action to the findings (“We welcome the report which makes for difficult reading”) and made the executive summary along with the recommendations available on its website.

In March 2015 the Board further demonstrated their commitment to learning the lessons from the Independent review by publicising their progress in implementing the recommendations – not just at Spire Parkway and Spire Little Aston – but across their entire network of 39 hospitals.