By Charlotte Bark, Vice President of Healthcare at Lockton
It’s no secret amongst health professionals that Brits are increasingly turning to private healthcare as they face long waits for treatment. And it’s not just patients that are suffering from the strain, with consultants also acutely feeling the impact. With health worker strikes already dominating headlines in the first few months of the year and amid growing pressure on the NHS, consultants are understandably looking elsewhere for improved pay and working conditions.
The proof is in the numbers, with a British Medical Association survey in December finding that four in ten junior doctors said they plan to leave the NHS as soon as they can find another job – with pay being the key driver. And many of those prospective leavers are thinking about working abroad, or even setting up their own private practice.
But entering private practice is not without risk. Despite the attraction of the private sector and all that it can offer, there are several considerations consultants must take into account as they look to open and operate their own practice.
Discretionary versus contractual indemnity cover
It’s important for anyone wishing to work in private practice to be aware of the possibility of suffering a medical negligence claim, as they lose the protection the NHS’s indemnity cover provides.
It is essential that consultants take out adequate and appropriate cover to avoid leaving themselves exposed should a claim be made against them. Addressing this at the point of entry into the private sector is vital to prevent significant financial setbacks further down the line.
Discretionary indemnity cover, although a popular choice across the private sector, does not provide cover for all eventualities. As its name suggests, such cover is discretionary, meaning there is no guarantee it will be paid out. Not only that, but the medical defence organisations (MDOs) which provide such cover don’t have to provide any comprehensive rationale behind their decision, casting a shadow of uncertainty over any privately practising consultant.
By contrast, contractual cover is available through a select few specialist insurers, providing guaranteed cover within the terms of the policy. Unlike MDOs, contractual indemnity insurers are also regulated, meaning that consultants can pursue any coverage disputes via a free and easy legal ombudsman service.
Conduct financial and legal checks in good time
Setting up a private practice carries a number of administrative, financial and legal implications for consultants.
In such a situation, it is best practice to seek specialist advice to ensure one is being compliant with the relevant regulation – including that regarding taxation and data protection. Consultants must also put in place the necessary protocols and systems to handle any claims of malpractice that may come up.
Other considerations at this point include completion of the relevant Disclosure and Barring Service (DBS) check applications, as well as registration with the Care Quality Commission (CQC), unless you are exempt.
Location, location, location
Where to practice is a key question any consultant must consider.
Some may prefer to practice from home or from a dedicated consulting room, whereas others may opt to do so from either a private or NHS hospital. If practicing in a private hospital, consultants must be aware of the likely increased costs doing so involves – including fees from the use of ancillary staff or equipment.
Private consultants practicing in an NHS hospital, meanwhile, must ensure they have approval from the relevant hospital authorities. They must make sure that all work is completed outside of their NHS working houses and avoid using ancillary NHS staff to perform private work.
Regardless of setting, though, it goes without saying that all consultants must uphold rigorous standards of health and safety for both their staff and patients. Failure to do so, such as through the use of inadequate equipment, may leave doctors liable for any injuries sustained.
Telehealth and remote consultation
A consequence of the Covid-19 pandemic, a growing number of consultants are opting for telemedicine and other virtual platforms to reach and engage with patients.
Such virtual platforms are on the rise and are proving popular with many patients due to the ease of access, speed and versatility they bring, particularly when compared to the traditional, in-person meetings many of us were accustomed to prior to the pandemic.
However, these too come with their own risks. Technical faults, loss of information and difficulties communicating when not face-to-face can also pose challenges for consultants seeking to practice on a remote or virtual basis. All healthcare providers must therefore ensure they follow telemedicine best practice, including verifying third-party technology suppliers, encrypting sensitive data, using secure logins and ensuring staff are adequately trained to carry out the above tasks.
As more move to more digital ways of working, cyber insurance can also be a useful tool for consultants wanting to protect themselves from the possibility of a cyber-attack or the loss of confidential patient and third party provider data. Cyber hackers know that we’re moving to an increasingly digital world, and are using this as an opportunity to go after more and bigger targets, meaning many more are opting to insure themselves against this ever-growing risk.
It’s clear the face of healthcare in the UK is rapidly changing. With many professionals making the switch from the public to private sector, there are a host of key issues consultants must take into consideration when setting up and during operation of their private practice. Getting on the front foot will not only protect you from any risks, but also allow your new business to thrive in a difficult marketplace.
