A recommendation for there to be a single repository of the whole practice of consultants across England has been accepted by the government, but it has admitted there are many challenges in order to achieve it.
The news came as the government finally published its response to the recommendations made in the Paterson Inquiry in February 2020 surrounding surgeon Ian Paterson - who is currently serving a 20-year jail sentence for 17 counts of wounding with intent. His trial raised serious questions about how surgery in the independent sector is regulated and assured and about the oversight of doctors who work across the NHS and private sector.
One of the recommendations was that 'there should be a single repository of the whole practice of consultants across England'. The recommendation adds: 'This should be accessible and understandable to the public. It should be mandated for use by managers and healthcare professionals in both the NHS and the independent sector.'
The government has said it has accepted the recommendation in principle, adding there are 'many challenges' in moving towards a single repository system.
The inquiry, commissioned by the Government in late 2017 and chaired by Rt Rev Graham James, a former bishop of Norwich, made 17 recommendations, of which the Government has now accepted nine in full, a further 5 in principle and either rejected or is keeping under review the remaining three.
The recommendations largely revolve around hospital-based treatment in both the NHS and the independent sector with the government committing to update on the progress of implementing the recommendations in 12 months' time.
Data on consultant performance in their field was the first recommendation to be accepted. This will have implications for dental consultants as well as their medical colleagues.
Patient communication should be improved by writing to patients setting out their condition and explaining the differences between NHS and private care in hospitals where relevant.
They also recommend that patients have time to consider their diagnosis and options as part of the consent process. This is already a key requirement for all dental registrants as set out in Standards for the Dental Team.
The lack of an independent resolution for complaints in the hospital service was highlighted despite the fact that in primary care the Dental Complaints Service has existed for over 20 years and worked well in resolving the complaints of patients who have received private dental care.
The government has rejected the proposal that when a hospital investigates a healthcare professional's behaviour including the use of HR process, any perceived risk to patient safety should result in the suspension of the healthcare professional. They rejected it on the basis that it would not be fair and proportionate to do so, especially when there are other regulators like the GMC and GDC who can intervene with their own Fitness to Practise procedures.
One particular recommendation asks, as matter of urgency, to reform the current regulation of indemnity products in the light of the serious shortcomings identified by the inquiry. The government's response is pending the 2018 consultation, now four years old on whether to change legislation to ensure that all regulated healthcare professionals in the UK, not covered by state indemnity, should hold regulated insurance rather than discretionary indemnity provided by the mutuals.
Len D'Cruz, head of BDA Indemnity, said: 'The government's response refers to the fact that it has widened its programme of work to inform its ongoing review of the options available for achieving the stated aims and protecting patients. The events and issues surrounding Paterson may have been relatively narrow at first sight, and centred around medical surgical care in NHS and private hospitals, but they have thrown a light on many much wider and often complex issues relating to indemnity and the secure and certain protection of both patients receiving care, and the clinicians who are delivering it.
'The due diligence carried out by the BDA four years ago when investigating the operation of the dental indemnity field in the UK in the wake of concerns voiced by members, led them to reach many of the same conclusions as the government. BDA Indemnity was designed and created in 2019 to address many of the very concerns raised in the Paterson Inquiry, and we look forward to contributing to the promised stakeholder discussions in 2022.'
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BDA reflects on government response to Paterson Inquiry. BDJ In Pract 35, 6 (2022). https://doi.org/10.1038/s41404-022-1019-1