How we work with doctors

THE CMA Order

In October 2014, the Competition and Markets Authority ("CMA") published the Private Healthcare Market Investigation Order 2014 (the "CMA Order"). The CMA Order requires private hospital operators (such as HCA UK) to disclose on their websites certain information relating to the way the private hospitals interact with referring clinicians; that is a clinician that has practising privileges and/or has the ability to refer patients for treatment or tests at a private hospital.

Full details about the investigation and the Order can be found on the CMA web page here.

Useful outcome statistics for all private healthcare operators can be found on the Private Healthcare Information Network website here.

Caring for our patients is HCA’s first priority. We are proud that leading doctors choose to run their private practice from an HCA UK hospital or specialist treatment centre. HCA believes that our patients and prospective patients should be able to find out about and to understand how we work with your doctor.

HCA does not typically employ the doctors who see patients at our hospitals and facilities. Most doctors are therefore self-employed practitioners who treat patients under the terms of a contract between us, which we call a Professional Service Agreement. We support our doctors so that they can focus exclusively on patient care without the burden of managing a practice. We charge them fairly for the service we provide.

A number of doctors provide us with clinical guidance on how to how to deliver the best possible care to patients and run our hospitals safely and efficiently. We pay those doctors for this service at Fair Market Value (FMV) and we use an independent company to provide assurance around our FMV calculations.

This information disclosed on this page is supplied in accordance with the Private Healthcare Market Investigation Order 2014; and is true and accurate to the best of HCA’s knowledge and belief.

The following low-value services are provided free-of-charge to referring clinicians with practising privileges at HCA facilities:

- General services to ensure appropriate clinical care (such as in-house training, chaperones)

- Workplace amenities (free/subsidised tea and coffee including for patients, on-site meals, stationery, and car parking spaces which are allocated on a first-come, first-served basis)

- General marketing (such as general promotional events, consultant directories and internet profiles)

Secretarial and administrative services

HCA sometimes employs medical secretaries to liaise with patients, deal with correspondence, make appointments and handle patients’ enquiries on doctors’ behalf. Sometimes, medical secretaries work for more than one doctor. They help to manage complex processes such as payroll, making administration efficient both for doctors and – most importantly – our patients. Medical secretarial services are made available on a non-discriminatory basis and on equivalent terms in accordance with the CMA Order. We charge doctors for using this service at Fair Market Value (FMV).

More details are provided at each hospital’s How We Work With Doctors webpage.

Consulting rooms

HCA UK considers that doctors must be able to see our patients without delay, and in close proximity to our diagnostic and treatment facilities. In order to achieve this, we licence our consulting rooms to doctors at Fair Market Value on an hourly or sessional basis at market rates, which we determine by calculating the rent we pay to landlords plus overheads (including rates, services charges, utilities). Consulting rooms are made available on a non-discriminatory basis and on equivalent terms in accordance with the Order.

More details are provided at each hospital’s How We Work With Doctors webpage.

Training

Where appropriate, we contribute to the cost of training and professional development of doctors via external training and attendance at medical conferences.

Car parking spaces

In addition to the above, some of our facilities have car parking spaces available, which are allocated on a first-come, first-served basis.

"Putting patients first" was the founding philosophy of the doctors who established HCA in 1968. Since then, we have worked closely with medical professionals to put the health and wellbeing of all patients at the centre of what we do. Working closely with doctors is integral to our delivery of excellent patient care across all our hospital facilities.

HCA’s medical advice and clinical quality processes:

HCA offers wide-ranging care to patients, as well as the delivery of complex specialisms, including but not limited to: complex cancer services; cardiac surgery; neurosurgery; organ transplantation; and, complex paediatric care. We provide the highest level of intensive care (level 3) in each of our hospital facilities to support that complexity of care. We also have a team of preeminent consultant doctors who work with us to advise us on clinical quality.

Our clinical quality processes are designed to ensure that we are able to manage complex services and facilitate the best possible care for patients. As in the NHS, senior doctors spend a proportion of their time: overseeing audits and clinical governance procedures; reading and disseminating management guidelines and policies; serving on specialty advisory committees and Departmental Management Teams; carrying out hospital subcommittee duties; taking on Lead Clinician roles; updating unit documentation; dealing with complaints, clinical incident investigations and critical incident reviews; and, participating in local clinical governance committees and local and national guideline groups.

Our advisers are among the most respected and eminent consultants in the UK, and our patients benefit from the high-level clinical advice of doctors who are leaders in their fields.

HCA’s clinical advisers:

HCA works closely with a number of esteemed medical advisors. Amongst HCA’s advisers are Professors in the following specialties: breast surgery, cancer care, cardiology, cardiothoracic surgery, dermatology, gastroenterology, general medicine, haematology, hepato-pancreatic-biliary, intensive care, interventional radiology, orthopaedics, obstetrics, respiratory medicine, rheumatology and urology.  

HCA‘s medical advisers have collectively authored over 5,000 papers in a range of publications such as the Lancet, the British Medical Journal, the New England Journal of Medicine, as well as numerous leading specialty-specific publications.

Our advisers are founders, presidents, chairmen and representatives of dozens of national and international specialty bodies. Many are active in the Royal College of Surgeons and other Royal Colleges, in addition to which a number are active tutors, examiners, trustees and council members.

As senior clinicians, our advisers are often sought to consult on health issues for governmental and intergovernmental organisations including the UK Trade and Investment department (UKTI), the Department of Health, the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO). 

We are extremely proud that these consultant doctors choose to work with HCA.

Fees charged by clinical advisers:

HCA is charged an hourly rate by consultant doctors in return for their expertise and advice on how to operate excellent hospital facilities. These hourly rates are calculated on the amount that those consultants earn in the independent sector for their clinical work.

The vast majority of doctors who provide advice to HCA also have practicing privileges to treat patients in our facilities, but are under absolutely no obligation to do so. They are free to treat  patients at any other private facility as opposed to HCA’s in compliance with the Bribery Act, GMC guidance and the Private Healthcare Market Investigation Order 2014.

Advisers’ NHS commitments:

Whilst c. 10% of the doctors who advise HCA have retired from the NHS after an average of 30-35 years practice, 90% still practice in the NHS. 

HCA is passionate about ensuring that the advice we receive from consultants should in no way compromise their NHS commitments. According to a 2013 National Audit Office report, 97% of consultants have an NHS Work Plan that outlines their commitments to the NHS and the time they can give to independent sector work.  In that report, most trusts stated that consultants, on completing their “programmed activities”, work an additional programmed activity at standard rates for the NHS, where required, before undertaking private practice work.

HCA requires the doctors that provide us with medical advice to attest that they are not compromising their NHS commitments to do so.

Dr Maurice Slevin

Professor Paul Ellis