The private healthcare sector has been told to up its game on data quality as it is a “long way” off full compliance with the Competition and Markets Authority (CMA) private healthcare market investigation order issued in 2014.
The Private Healthcare Information Network (PHIN) warned there needs to be a “step-change” from the sector in the level of participation and compliance with providing data about clinial performance, outcomes and fees.
The statements came as part of the PHIN roadmap and delivery plan for 2022-2026 as it seeks to push the industry to comply with the CMA order.
The roadmap also reveals private medical insurers have demanded healthcare providers including hospital groups and clinicians speed up compliance with requirements to publish data about patient outcomes and practitioner fees.
It acknowledged that while progress has been made since 2014, the private healthcare sector overall is still a “long way” off full compliance of the CMA order, with a “long-tail” of healthcare providers and consultants who are yet to meet their obligations.
Healthcare providers and consultants are obliged to participate and be compliant with the CMA order and PHIN said it will support the data submission process and make it as easy as it can for consultants to submit fee information.
It added this will be a key dependency on the ability to publish comprehensive information across the sector.
PHIN said that to publish understandable and helpful information for patients, the comprehensiveness and accuracy of the underlying data quality must improve.
It added that “high quality” data was essential to publish case-mix adjusted measures and accurately represent consultants’ practice and this will be something PHIN, private hospital providers and consultants will need to work on over the period of the plan.
Consultants should engage with data
The body told consultants they should engage with the data submitted by private healthcare providers to PHIN and ensure it accurately describes their practice.
Where there are errors in the data, they should report them to the relevant healthcare provider so that corrections can be made.
Consultants who fail to engage must still comply with the CMA order and, therefore, will be included in a ‘presumed publication’ model.
Consultants need to be aware of the limitations in the quality of the data PHIN receives about NHS funded care and the processes for making corrections to it.
They will also need to provide fee information, including self-pay consultation and procedure fees and insured patient fee arrangements.
Under the plan, PHIN will give medical secretaries and administrators access to its portal to ease administrative demands on busy consultants.
PHIN said it will only publish performance measures at consultant level where it is aligned with its publication principles, for example, where it is statistically possible and where the information is meaningful for patients.
The plan also states consultants will receive the help and support they need from PHIN to achieve compliance with the CMA’s order.
For more on the plan: CMA increases oversight and criticises private healthcare providers for delays to publishing fee and outcome data – Health & Protection (healthcareandprotection.com), PHIN introducing PMI-based approach to publishing consultant fees – Health & Protection (healthcareandprotection.com).