Rogue surgeon inquiry to investigate NHS private sector referrals

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Independent inquiry will examine and compare practices of independent and NHS providers
Investigation follows conviction and jailing of rogue surgeon Ian Paterson
Report and recommendations to be published in 2019

The way NHS patients are referred to and from the private sector by individual professionals will be examined by an independent inquiry, the government has announced.

The inquiry, set up to examine the circumstances linked to rogue surgeon Ian Paterson, will also consider how NHS waiting times influence the practice of referring patients to private providers.

Announcing the terms of reference for the inquiry today, health minister Jackie Doyle-Price said it will compare the accountability and responsibility for safety and quality in the NHS and the independent sector, and will examine how information is shared about concerns over performance.

The investigation will be led by Bishop Graham James.

Mr Paterson was a consultant surgeon employed by the Heart of England Foundation Trust who also practised at the private sector Spire Parkway and Spire Little Aston hospitals.

Last year he was convicted of 17 counts of wounding with intent and three counts of unlawful wounding. He was jailed for 15 years.

Issues to be looked at by the inquiry

Comparing the accountability and responsibility for safety and quality of care between independent sector and NHS providers. This will include the appraising, reporting, considering concerns and monitoring of healthcare professionals’ activity, conduct and performance.
How and when information is shared between the NHS, independent sector and others, including concerns raised about performance and patient safety.
How professionals maintain standards and competence.
Comparing multidisciplinary working in the NHS and independent sector.
The role of independent insurers, medical indemnifiers and medical defence organisations, including in the sharing of data.
Medical indemnity cover for professionals in the independent sector.
How patients are referred from the NHS to the independent sector by individual professionals, including the role of NHS waiting times in relation to that practice.
The response to patients following adverse incidents, including clinical recall, in the independent sector and the NHS.

The inquiry will not revisit the evidence of Mr Paterson’s criminal behaviour and conviction but will consider his practise as a “case study” to make wider conclusions.

A full report will be produced in summer 2019 and will include an appendix of patient experiences.

Spire Healthcare initially argued as Mr Paterson was not technically its employee, it was not responsible for his actions. In September, it agreed to settle all claims against it relating to Paterson, paying £27.2m into a £37m fund, with the balance paid by Mr Paterson’s insurers and the Heart of England FT.