Royal College of Surgeons call for Robust Reporting in the Private Healthcare Sector

10 April 2019.

The Royal College of Surgeons (the “RCS”) has today called for independent healthcare providers to “improve standards in the independent sector and prevent the circumstances that enabled Paterson to continue practising from happening again.”

The position statement, released on 10 April 2019, makes various recommendations for the private sector, including imposing reporting requirements equivalent to those within the NHS; implementing robust practitioner appraisals; and ensuring the sharing of information between the NHS and private sector.

Mr Ian Paterson

For those not familiar with the case that has prompted this call, Mr Ian Paterson is a former breast surgeon who was convicted in 2017 of intentionally wounding patients by carrying out unnecessary operations. He was sentenced to 20 years in prison.

As well as a criminal trial, the case generated large scale civil litigation; over 800 individuals brought claims against the NHS, Mr Paterson and the private hospital where he held practising privileges (for which we acted).

Following Mr Paterson’s conviction, the Government launched an independent inquiry (which is currently ongoing) to "review the circumstances surrounding [his] malpractice that have affected so many patients, as a case study, and consider other past and current practices". The Government's aim is to make recommendations to improve the safety and quality of care provided nationally to all patients, in both the independent sector and the NHS.

RCS Position Paper

The RCS is calling for the "entire healthcare sector" to "do everything it can to prevent someone like Ian Paterson from ever causing harm again”.

The position paper sets out a number of recommendations, including:

  • Equivalent reporting requirements for both the NHS and the private sector (which could be a condition for registration with the CQC);


  • Registration of all new surgical procedures and devices used in either sector, with related data collected in the appropriate national audits, before they are routinely offered to patients;


  • Streamlining robust clinical governance procedures across the independent sector to enable effective monitoring of consultants’ practising privileges, supported by a clearer remit for Medical Advisory Committees;


  • A review of the Appraisal process to encourage sharing of information regarding a Doctor’s performance between the public and private sector;


  • A review of multi-disciplinary team (MDT) working in the independent sector to ensure it includes arrangements for information sharing between the two sectors;


  • A national framework to ensure consistent standards of training. 

The Future

The recommendations are ambitious and potentially onerous, and Government and providers will need to consider each of them in detail to decide whether they can be implemented.  It will then, inevitably, take time for any such overarching recommendations to be implemented.  Whilst this suggests a great deal of uncertainty at the moment for private healthcare providers, one thing is clear: change is afoot. Over the coming months and years, we can expect to see more audits, more regulations and more obligations – all of which will impact on private healthcare providers, as well as their insurers. 

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