The CQC announces new information sharing agreements with prominent health insurers

As a group, insurers constitute the main funders of private healthcare. They therefore necessarily hold a large amount of information concerning both the experience of patients and the quality of care dispensed by providers in the private sector.

Recognising this, the CQC has entered into collaborative information sharing arrangements, Memoranda of Understanding (MoU), with four of the largest health insurers in the market: AXA, Aviva, BUPA and Vitality.

What information will be shared?

In addition to data regarding identifiable areas of concern and mechanisms of improving care, the MoUs will also enable insurers to share the following categories of information:

  • Claimant’s feedback of their experiences of care, including complaints
  • Patient safety risks
  • Evidence of emerging themes which may be indicative of a wider safety issue across a hospital or provider group
  • Outcomes of insurer visits to services that identify safety issues
  • Poor clinical treatment or poor clinical outcomes for patients

The CQC anticipates that it will able to utilise the data shared under the MoUs to:

‘improve how it monitors quality and safety in these services, as part of maintaining an effective regulatory system, to ensure people are provided with safe, effective, compassionate, high-quality care.’

Cooperation between insurance providers and the CQC

The approach pursued by the introduction of MoUs appears to be a fundamentally positive one that should facilitate cooperation between insurance providers and the CQC.

The announcement comes shortly after the CQC published a report entitled ‘The state of care in acute hospitals’ in which it found that 41% of independent hospitals inspected ‘required improvement’ in respect of safety.

Improving the safety and quality of care

The establishment of MoU agreements also comes at a time when the independent inquiry into the serial malpractice of the breast surgeon Ian Paterson is well underway. Paterson was convicted of 17 counts of wounding with intent in 2017.

That inquiry has been set up with the dual aims of highlighting issues raised by the Paterson case and making ‘recommendations to improve the safety and quality of care provided nationally to all patients, in the independent sector and in the NHS.’

It will be interesting to see whether the MoUs achieve their objective of helping to identify shortcomings in practice more quickly and to bring about improvements to the overall care provided to patients. In principle, it should contribute to those ends.

For more guidance or information, please contact:

Stewart Duffy
Partner
T. 
020 7227 7418
E. 
stewart.duffy@rlb-law.com

William Bainbridge
Trainee Solicitor
T.
 020 7227 7435
E.
 william.bainbridge@rlb-law.com


Disclaimer

This briefing is for guidance purposes only. RadcliffesLeBrasseur accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.

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