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Colleges express concern about outsourcing patient care to private hospitals

By Mindo - 09th Sep 2020

Close up of woman doctor hands using digital tablet at clinic. Closeup of female doctor in labcoat and stethoscope holding digital tablet, reading patient report. Hands holding medical report, copy space.

The Presidents of RCSI, RCPI and the College of Anaesthesiologists of Ireland have raised concern that the planned outsourcing of patient care to private hospitals could negatively impact on continuity of care and training opportunities for NCHDs.

In a recent letter addressed to colleagues, signed by the Presidents of all three Colleges, concern was expressed that “outsourcing through the current NTPF [National Treatment Purchase Fund] model will impact on continuity of patient care and NCHD training, especially in craft specialties”.

The letter has caused consternation among some full-time private practice consultants, with one such consultant telling the Medical Independent (MI) the Colleges were concerned about protecting the private practice of public hospital consultants.

In the letter, dated 31 August, the Presidents noted that “there is now an enormous backlog of scheduled care and it is probable that a high proportion of scheduled care will be outsourced to the independent sector”.

“We will be writing to the senior leadership of the HSE, Hospital Groups and the Department of Health to ask that the traditional outsourcing model employed by the NTPF should be modified so as to preserve training, maintain good clinical governance and continuity of care for patients.

“We feel that local Hospital Group advocacy for this position would also be helpful. We believe that a model of outsourcing, which allows the consultant trainer and trainees follow their patient to the independent sector will not only facilitate the training for trainees but will also promote proper patient continuity and good clinical governance.

“Selection of procedures to be part of an outsourcing model should be in accordance with a framework where the complex surgeries remain within teaching hospitals but that more routine, day case type work could be carried out in an independent hospital facility.

“This would allow access to the operative training experience but not impact on the need for the requirement for our hospitals to have on-call emergency rotas in the private sector.”

The Colleges planned to write to the State Claims Agency to ensure “that all CIS [clinical indemnity scheme] cover will extend to outsourced procedures carried out by the public hospital team on behalf of the HSE”.

The letter concluded by asking members to recommend this view to clinical directors and hospital managers.

As reported by MI last month, the HSE has issued a tender seeking access to private healthcare services for ongoing care needs, due to a lack of capacity in the public system arising from Covid-19.

Meanwhile, talks are continuing between health officials and private hospitals on arrangements in the event of a surge of Covid-19 cases.
Last month the Private Hospitals Association (PHA) informed the HSE that a proposed agreement did not address the serious concerns of private consultants.

In a letter to Mr Liam Woods, HSE National Director of Acute Operations, on 21 August, the PHA referred to the hostility that arose from the previous agreement.

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