While most independent acute hospitals provide good quality care, inspections by the Care Quality Commission (CQC) raised concerns over the safety and leadership of some services.
The regulator also said “a lack of effective oversight” of consultants with practising privileges was a “major concern”.
The issue had been “brought into sharp focus” by the case of the rogue breast surgeon Ian Paterson, who carried out unnecessary operations in NHS and private hospitals, it added.
The Royal College of Surgeons (RCS) said the report “exposes the poorer practices of some independent providers and underlines the need for a renewed focus on improving patient safety”.
Of the 206 independent acute hospitals inspected, 62% were given a “good” rating overall and 8% were described as “outstanding”. However, 30% of private hospitals were deemed to need improvement.
The Care Quality Commission said it was particularly concerned about safety, with 41% of private hospitals rated as requiring improvement in this area and 1% as inadequate. Almost a third were rated as requiring improvement and 3% as inadequate in terms of how well they were led.
In his foreword, Professor Ted Baker, chief inspector of hospitals at the CQC, wrote: “Our inspections also identified concerns around the safety and leadership of some services, often as a result of a lack of safety checks and poor monitoring of risks. Too often, safety was viewed as the responsibility of individual clinicians, rather than a corporate responsibility supported by formal governance processes.
“In particular, we found that monitoring of medical governance such as scope of practice of individual consultants was not consistently robust. Such a failure of effective governance was brought into sharp focus with the recent case of the surgeon Ian Paterson.”
Consultants operating under practising privileges are not employees of a hospital but regulation sets out that they should be considered in the same way as other staff. In some cases the CQC found a “lack of robust and effective oversight of practising privileges”, with many consultants treated “as ‘customers’ bringing business to the hospital” meaning providers “could be reluctant to challenge them”.
