31 October 2019

Independent healthcare providers from across the country have committed to implementing a new Medical Practitioners Assurance Framework. Following a summer of consultation, the new framework was launched on 23 October 2019 with the intention of strengthening clinical governance in the independent sector to ensure that independent healthcare providers are able to further increase the quality of patient care that they provide.

The Independent Healthcare Providers Network (IHPN), which represents independent healthcare providers, collaborated with former national NHS National Medical Director Sir Bruce Keogh to develop some key principles to strengthen and build upon the medical governance systems already in place in the sector.

These principles form part of the Medical Practitioners Assurance Framework and reinforce expected practice in a number of key areas including:

  • Clinical governance structures
  • Patient safety, clinical quality and continuous improvement
  • Whole practice appraisal of clinicians
  • Raising and responding to concerns from staff and patients

In developing the framework, Sir Bruce was supported by an Expert Advisory Group including representatives from the Academy of Medical Royal Colleges, the Care Quality Commission (CQC), General Medical Council (GMC), NHS England & Improvement, the Department of Health and Social Care and the Patients Association.

This new framework is highly relevant for independent healthcare providers and it sets out the expected level of practice to be attained. The framework itself is not legally binding, but it does set out the expected level of practice which is intended to align with the legal requirements.

A key thread running through the framework is the importance of taking a more “system wide” approach to patient safety, including the effective and timely sharing of information with the NHS about a medical practitioner that could affect the safety or confidence of patients.

So far, over 29 independent providers representing over 200 individual sites have signed up to implementing the framework, and the CQC has committed to considering the effective and robust implementation of the framework’s principles as evidence of good governance. The framework will be reviewed in late 2020 to ensure that the principles remain in line with current best practice around medical governance in the health system.


The publication of the framework has been positively received by the independent sector. There has been a renewed effort to improve clinical governance and self-reporting in the independent sector. Last year’s CQC report on acute independent hospitals described the overwhelming majority of care delivered in the sector as either good or outstanding, but it did also call for greater consistency around medical governance in the sector. This new framework is evidence of the sector’s ongoing push for improved medical governance and safer patient care as a result.

If you have any questions in relation to this article, please contact Patrick Parkin or your usual Burges Salmon contact.

This article was written with the support of Tom Needham, trainee solicitor.

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Patrick Parkin

Patrick Parkin Partner

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