Currently, NHS Digital only collects data from Private Patient Units (based in NHS trusts) or from private hospitals providing NHS commissioned services (such as joint replacements). Historically private healthcare provider data have not been included in many national quality and safety reporting systems. This has meant that care delivered in the private healthcare sector could not be adequately or equally assessed against the same information standards and measurements used in the NHS.
In April 2017 a breast surgeon, Ian Paterson, was convicted of harming his patients. He practiced at the Heart of England Foundation Trust and Spire Healthcare. He was convicted on charges of wounding with intent and unlawful wounding. The issues raised by his unsafe clinical approach to breast cancer surgery highlighted a need for action to be taken to enable visibility of consultants’ performance across both their NHS and private practice. A meeting between the Secretary of State for Health and Social Care and representatives from NHS Digital and the Private Healthcare Information Network (PHIN) subsequently took place on 9 January 2018. The Secretary of State asked NHS Digital to work with PHIN to ensure that private healthcare data could be properly captured and analysed within NHS systems.
The result was the ADAPt programme. The Programme seeks to bring about an alignment in data standards, measurement and reporting systems across NHS and private healthcare in order to enable greater transparency in quality and safety and to support patient choice and opportunities for improving patient care. To begin with this involves piloting data collections of APC activity data from private providers (who have volunteered to take part) during FY2021/22.
The programme was initiated in early 2018 and is jointly led by NHS Digital and PHIN with support from the DHSC, NHS England, CQC and other observer bodies. The piloting was planned to help to inform the future strategic direction of private healthcare information flows.
ADAPt ran a public consultation exercise from 19 February 2020 to 22 May 2020 on the NHS Digital consultation hub, seeking feedback on proposals to change the way in which private healthcare data is collected, processed, reported and disseminated. Participants included providers, clinicians and members of the public.
Thirty responses from across the stakeholder spectrum, including private providers, NHS PPUs, national bodies, professional bodies, consultants and representative organisations were received. The vision for a standardised single source of healthcare information, with common standards across the two sectors was widely endorsed.
An independent inquiry into the issues raised by Paterson was initiated after the inception of the ADAPt programme and its report was published on 4 February 2020. His clinical practice was found to have been “aberrant” and the existing healthcare system “…proved itself dysfunctional at almost every level when it came to keeping patients safe…” (according to the introduction to the report).
Recommendation 1 of the Paterson report is as follows:
We recommend that there should be a single repository of the whole practice of consultants across England, setting out their practising privileges and other critical consultant performance data, for example, how many times a consultant has performed a particular procedure and how recently. 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 independent sector.
The work of the ADAPt programme supports the creation of such a repository, however it should be borne in mind that ADAPt is only concerned with APC data and so does not fully address this recommendation.
The Government published its full response to the Paterson report on 16 December 2021 . It accepted Recommendation One 'in principle' (rather than in full). ADAPt was referenced and the following statement was made:
(The ADAPt) data will be made available for managers and healthcare professionals across the system to support learning and identify outliers. PHIN is already mandated to publish information on consultant practice in the independent sector and will be continuing to roll-out the publication of further metrics in the coming years. Over the next 12 months, we commit to reaching a decision with key stakeholders on what further information should be made publicly available and whether further government action will be needed to achieve this.
This might result in a separate commission from the DHSC to NHS Digital to set up such a repository together with policies and processes around its use.
The ADAPt Programme is working closely with the GIRFT Programme, Cumberlege Programme and NHS England Registries Team to enable Recommendation One in order to identify and deliver attribution for consultant episodes within NHS data in a single data source alongside private activity data.
The Programme is jointly led by PHIN (appointed as the Information Organisation under the 2014 CMA Private Healthcare Market Investigation Order; amended in 2017) and NHS Digital, with support from the DHSC, NHS England, the CQC and other observer bodies.
The ADAPt vision is:
To bring about an alignment in data standards, measurement and reporting systems across NHS and private healthcare in order to enable greater transparency in quality and safety and to support patient choice and opportunities for improving patient care.
PHIN is an independent non-profit organisation that publishes performance data on private consultants and hospitals. PHIN has legal powers to collect and process data (see above). PHIN is funded via a CMA-developed model under which private providers are required to pay it a small fee in respect of every patient treated.
Last edited: 28 November 2022 2:42 pm