Two private hospitals have been publically warned about not providing data on performance and patient outcomes and threatened with regulatory enforcement if they fail to meet a six month deadline to do so.
The Competition and Markets Authority (CMA) rebuked the Ulster Independent Clinic and Fortius Clinic after they failed to comply with The Private Healthcare Market Investigation Order by not providing data to help prospective patients compare healthcare providers and consultants.
The regulator warned the pair of private hospitals they must provide information for publication about the quality of their private healthcare services.
The CMA noted both hospitals had now produced a plan to achieve compliance within six months and if this is not fulfilled, the regulator can take further enforcement action. This could include issuing legally binding directions or beginning court action.
Previous warnings issued
Under the CMA’s Private Healthcare Market Investigation Order 2014 (PHO), a private hospital must supply the Private Healthcare Information Network (PHIN) with information about the treatment it has carried out for its private patients so it can be published for patients and healthcare professionals to see.
However, concerns have been rising about hospitals, clinics and practitioners not meeting the requirements and last year, both PHIN and the CMA warned the private healthcare sector to up its game on data compliance.
In August PHIN called for a “step-change” from the sector in the level of participation and compliance with providing data about clinical performance, outcomes and fees to deliver the remaining requirements of the PHO.
Alongside PHIN’s delivery plan, the CMA rebuked the private healthcare sector for its slow compliance with requirements to publish transparency data about fees and outcomes.
And in October, the CMA upped its language threatening to take enforcement action on private hospitals and doctors not supplying data about the quality of care they are providing.
The warning was issued alongside an open letter to the private healthcare industry highlighting there were still some consultants and hospitals who had made little or no effort to comply with the legally-binding obligations.
Failed to provide data and resolve issues
In its latest action, the CMA found that Fortius Clinic in London and Ulster Independent Clinic in Belfast failed to provide the data specified in the order, which means PHIN cannot process and publish a range of information related to patient care and outcomes.
They were also found to have failed to adequately resolve data issues that would support information on consultants at the clinics to be published.
This breach of the PHO means private patients are unable to make accurate comparisons when choosing a provider through important markers such as patient feedback and patient outcomes. These failures are detailed in the CMA letters written to the hospitals.
David Stewart, executive director, markets and mergers at the CMA, said: “Choosing private healthcare is an important and, at times, difficult choice.
“So, it is vital that private hospitals empower customers, through PHIN, with the information to help them understand and select the best care for them and their families. Some hospitals are not doing this.
“Consultants must also provide their consultation and treatment fees for publication, and three-quarters have already done so.
“So, we are now ramping up enforcement action to ensure that the remaining hospitals and consultants that are breaking the rules will face the consequences, so patients don’t lose out.”
‘Significant’ data compatibility issues
The Ulster Independent Clinic issued a statement saying it has been registered with PHIN and provided admitted patient care data information and annual settlement of fees since 2016.
It added it was committed to ensuring full compliance with the PHO and said despite “significant” compatibility challenges presented by different data systems between regions of the UK, it had already taken significant steps in this regard.
Most recently it provided an action plan to the CMA outlining how it proposes to achieve full compliance with the order by 30 September 2023.
“Through our ongoing engagement with the CMA we have emphasised that the digital health care platform in Northern Ireland is not the same as that in England on which the data capture for PHIN has largely been based,” the clinic continued.
“As a small, independent and charitable hospital based in Northern Ireland (NI) we currently have no centralised province-wide digital data capture of patient information and are required to adhere to NI specific regional legislative and regulatory requirements.
“This therefore has necessitated significant additional work and resources from hospitals in Northern Ireland to provide the information in the required format for the PHIN system.
“For example, we already publicly share patient feedback on our website, but this needs to be reconfigured to meet PHIN specific data requirements.
“This challenge has been recognised by both Regulation and Quality Improvement Authority (RQIA) and PHIN and there are ongoing communications to enable compliance for all private healthcare providers in Northern Ireland,” it added.
Health & Protection has also contacted Fortius Clinic for comment. According to the CMA’s letter, Fortius Clinic has provided a plan to comply with the requirements by next month.
Fortius told Health & Protection it takes the CMA’s decision to publish some matters of non-compliance very seriously, adding it has engaged in a positive fashion with PHIN throughout this process in order to become compliant with the Order by sharing with them an action plan which confirms how it will achieve full compliance by the end of May.
Fortius also said it that it believes the areas highlighted by the CMA represent a “minor” breach of the Order.
The group also pointed out that the cohort of patients on which it reports to PHIN are exclusively those who have had a surgical procedure and represents only 5% of total patient visits.
It further confirmed its requirement to provide NHS numbers for private patients will be submitted to PHIN, where available but added it does not believe that the absence of an NHS number adversely impacts PHIN’s ability to inform patients of the Fortius Clinic’s performance.
According to the clinic, the Patient Reported Outcome Measures (PROMS) data relates to fewer than 100 patients, less than one-tenth of one per cent of total patient visits.
The clinic also revealed that it routinely collects anonymised data on patient feedback, adding to date PHIN have been unable to accept anonymised data, preventing the clinic from reporting its high feedback scores. As PHIN have since changed this requirement, Fortius is now able to submit anonymised data.
It added while there were 18 historic data issues related to the provision of information from some consultants and a failure to pick up the notice that was given, these have been swiftly resolved.
“Fortius is very proud of the care and experience given to its many thousands of patients,” Fortius continued. “We will continue to work with PHIN in improving the quality and diversity of information it provides and will remain vigilant in its full compliance with the CMA Order.”