Code of Conduct for Private Practice by DOCUMENT VERSION CONTROL

Transcription

1 LINCOLNSHIRE PARTNERSHIP NHS FOUNDATION TRUST (LPFT) Code of Conduct for Private Practice by Medical Staff Document Type and Title: Authorised Document Folder: DOCUMENT VERSION CONTROL Code of Conduct for Private Practice by Medical Staff Policy Human Resources New or Replacing: Document Reference: Replacing 3b Version No: 2 Date Policy First Written: January 2008 Date Policy First Implemented: January 2008 Date Policy Last Reviewed and Updated: February 2015 Implementation Date: January 2008 Author: Approving Body: Associate Director of HR and Leadership Quality Committee Approval Date: September 2015 Ratifying Body: Local Negotiating Committee (LNC) Ratified Date: March 2015 Committee, Group or Individual Monitoring LNC the Document: Review Date: March 2018 LPFT / HR3b - July

2 Contents 1. Introduction 2. Purpose 3. Duties 4. Definitions 5. Development of Policies and Procedures (including Equality and Impact Assessment) 5.1 Introduction and General Principles 5.2 Disclosure of Information about Private Practice 5.3 Scheduling of Work and Job Planning 5.4 Scheduling Private Commitments Whilst on Call 5.5 Provision of Private Services Alongside NHS Duties 5.6 Patient Enquiries about Private Treatment 5.7 Promotion of Private Services by Consultant 5.8 Promoting Improved Patient Access to NHS Care 5.9 Increasing the NHS Capacity 5.10 Managing Private Patients in Trust Facilities 5.11 Use of Trust Staff 5.12 Identification of Private Patients 5.13 Use of LPFT Data for Private Work 6. Consultation, Approval and Ratification Process 7. Review and Revision Arrangements including Version Control 8. Dissemination and Implementation of a Policy 9. Policy Control including Archiving Arrangements 10. Monitoring Compliance with and Effectiveness of Policies and Procedures 11. References 12. Associated Documentation LPFT / HR3b - July

3 1. Introduction 1.1 It is an established principle that NHS bodies must be impartial and honest in the conduct of their business and, in order to ensure that strict ethical standards are maintained it is essential that conflict does not arise between the private interests of staff and their NHS duties. 1.2 There are three crucial public service values that must underpin the work of the health service: Accountability everything done by those who work in the NHS must be able to stand the test of parliamentary scrutiny, public judgements on propriety and professional codes of conduct. Probity there should be an absolute standard of honesty in dealing with the assets of the NHS: integrity should be the hallmark of all personal conduct in decisions affecting patients, staff and suppliers, and in the use of information acquired in the course of NHS duties. Openness there should be sufficient transparency about NHS activities to promote confidence between the NHS body and its staff, patients and the public. 2. Purpose 2.1 This policy is intended to make clear the Trust s requirements on the part of staff in achieving this aim. 2.2 NHS staff are expected to: Ensure that the interests of patients remain paramount at all times Be impartial and honest in the conduct of their official business Use the public funds entrusted to them to the best advantage of the service always ensuring value for money It is also the responsibility of staff to ensure that they do not: Abuse their official position for personal gain or to benefit their family or friends Seed to advantage or further private business or other interests, in the course of their official duties 3. Duties 3.1 The Board of Directors is accountable for: Commitment through endorsement of this policy LPFT / HR3b - July

4 3.2 The Chief Executive is accountable for: Ensuring the proper application of this policy through the appropriate management arrangements 3.3 Line Managers are responsible for: Ensuring that the guidelines/procedures laid down within this policy are stringently adhered to Ensuring that staff are conversant with Policy 3.4 Staff are responsible for: Ensuring they understand policy Ensuring they adhere to guidelines/procedures laid down within this policy. 4. Definitions None 5. Development of Policies and Procedures 5.1 Introduction and General Principles The following set of key principles underpins the relationship between the Trust s Medical Practitioners, the Trust and private practice: The provision of service for private patients should not prejudice the interest of Trust or disrupt Trust services. There should be no real or perceived conflict of interest between private work and Trust work. With the exception of the need to provide emergency care, Trust commitments should take precedence over private work where there is a conflict, or potential conflict, of interests. Except in emergencies, medical practitioners should not provide private patient services that will involve the use of Trust staff or facilities, unless an undertaking and authority to pay for those facilities has been obtained from (or on behalf of) the patient These standards apply to medical practitioners who are Trust employees and who undertake private practice: In Trust facilities Privately or In independent facilities LPFT / HR3b - July

5 5.2 Disclosure of Information about Private Practice Medical practitioners will declare in writing any business, professional interest, or other non Trust work, which may directly or indirectly give rise to or may reasonably be perceived to give rise to any conflict of interest, or which is otherwise relevant to the medical practitioner s proper performance of their contractual duties. This information will include details of private practice commitments, including timing. Location and broad type activity, to facilitate effective planning of Trust work and out of hours cover. (Reference paragraph 3.4 Guidance on Standards of Business Conduct for Staff). Relevant business or professional interests will be disclosed at least annually as part of the Job Plan Review; information will be provided in advance about any significant changes to this information. In line with the requirements of revalidation a medical practitioner will submit evidence of private practice to an appraiser. It should be noted that for private practice, the appraiser may be different from the Trust appraiser. 5.3 Scheduling of Work and Job Planning Where there would otherwise be a conflict or potential conflict of interests, Trust commitments must take precedence over private work, subject to paragraph the medical practitioner is responsible for ensuring that private commitments do not conflict with Trust activities scheduled as part of the Trust s job plan Regular private commitments must be noted in the Job Plan Medical practitioners engaging in private practice are expected to provide emergency treatment for their Trust patients, should the need arise. Circumstances may also arise in which medical practitioners need to provide emergency treatment for private patients during time when they are scheduled to be working for the Trust. Medical practitioners will make alternative arrangements to provide cover if emergency work of this kind regularly impacts on the delivery of Trust commitments Medical practitioners should ensure that they have arrangements in place; such that there can be no significant risk of private commitments disrupting Trust commitments Where there is a proposed change to the scheduling of Trust work, the Trust will allow a reasonable period for medical practitioners to rearrange any private sessions, taking into account any binding commitments that the practitioner may have entered into (e.g. leases). Where a medical practitioner wishes to reschedule private commitments to a time that would conflict with scheduled Trust work, they should raise the matter with the Trust at the earliest opportunity. LPFT / HR3b - July

6 5.4 Scheduling Private Commitments Whilst on Call Medical practitioners should never schedule private commitments that would prevent them from being able to attend a Trust emergency whilst they are on call for the Trust Where a medical practitioner is asked to provide emergency cover for a colleague at short notice and the medical practitioner has previously arranged private commitments, the medical practitioner should only agree to do so if these commitments would not prevent them from returning at short notice to attend to an emergency. If the medical practitioner is unable to provide cover at short notice it will be the Trust s responsibility to make alternative arrangements Medical practitioners may exceptionally be required to provide emergency care for private patients whilst they are on call for the Trust; where medical practitioners find that this is a regular occurrence, they should reschedule their private commitments to reduce such occurrences. 5.5 Provision of Private Services Alongside NHS Duties The Trust will not authorize any medical practitioners to undertake private practice during the course of their NHS scheduled time or working week Where a patient pays privately for a procedure that takes place at a Trust facility, it should take place at a time that does not impact on normal services for Trust patients. Such procedures should only occur when the patient has given an undertaking to pay any relevant charges to the Trust. 5.6 Patient Enquiries about Private Treatment Where in the course of their duties a medical practitioner is approached by a patient and asked about the provision of private services, the practitioner may provide only such standard advice as has been agreed by the Trust for such circumstances During the course of their Trust duties and responsibilities the medical practitioner will not make arrangements to provide private services, or ask any other member of staff to make such arrangements on their behalf, unless the patient is been treated as a private patient by the Trust. 5.7 Promotion of Private Services by Consultants In the course of their Trust duties and responsibilities medical practitioners will not initiate discussion about providing private services, or ask any other Trust staff to initiate such discussions on their behalf. LPFT / HR3b - July

7 5.7.3 Where a Trust patient seeks information about the availability or waiting time for Trust and/or private services, practitioners should ensure that any information provided by them, or provided by other Trust staff on their behalf, is accurate and up to date Medical Practitioners should no use letterheads or business cards employing the Trust addresses, telephone, fax number or addresses or advertise their services using these. (Reference paragraph 3.4 Policy on Standards of Business Conduct for Staff). 5.8 Promoting Improved Patient Access to NHS Care Subject to clinical considerations, medical practitioners will be expected to contribute as fully as possible to reducing waiting times and improving access and choice for Trust patients. This should include ensuring that patients are given the opportunity to be treated by other Trust colleagues or by other providers where this will reduce their waiting times and facilitating the transfer of such patients. 5.9 Increasing the NHS Capacity Medical practitioners will make all reasonable efforts to support initiatives to increase Trust capacity, including appointment of additional medical practitioners Managing Private Patients in Trust Facilities Medical practitioners may only see patients privately within Trust facilities with the explicit agreement of the Trust Medical practitioners who practice privately within Trust facilities must comply with the Trust s policies and procedures for private practice. The Trust will consult with such Medical practitioners when adopting or reviewing such policies Where it has been agreed that the medical practitioner may use the Trust s facilities for the provision of private services: The Trust will determine and make such charges for the use of its services, accommodation or facilities as it considers reasonable. Any charge will be collected by the Trust, either from the patient or a relevant third party. A charge will take full account of any diagnostic procedures used, the cost of any laboratory staff that have been involved and the cost of any Trust equipment that might have been used Private Patients in NHS Facilities Except in emergencies, medical practitioners will not initiate private patient services, which involve the use of Trust staff or facilities unless an undertaking to pay for those facilities has been obtained from (or on behalf of) the patient, in accordance with the Trust s procedures. LPFT / HR3b - July

8 Private patients will normally be seen separately from scheduled Trust patients. Under no circumstances will a practitioner cancel a Trust s patient s appointment to make way for a private patient Use of Trust Staff If Trust staff are asked to assist a medical practitioner in providing private services, or to provide private services on behalf of a medical practitioner, it is the medical practitioner s responsibility to ensure that other staff are aware that the patient or service user, on whose behalf the service is being provided, has private status Trust staff that are asked and agree to undertake private work for a medical practitioner must not do so in their NHS work time or use any NHS equipment or facilities without prior agreement from the Trust. (Reference paragraph 3.4 on Standards of Business Conduct for Staff) Identification of Private Patients Medical practitioners practicing privately within Trust s facilities must comply with the Trust s policies and procedures for private practice. This includes a personal obligation by any medical practitioner responsible for admitting a private patient to Trust facilities to ensure, in accordance with local procedures, that they identify that patient as private and that the responsible manager is aware of that patient s status Use of LPFT Data for Private Work Medical practitioners must not access LPFT data relating to private or potential private patients without gaining authorization through the current IG/access to medical information procedures. If in any doubt, medical practitioners should raise the matter and request access via their senior manager or clinical director. Non-approved access to patient information for private work purposes will be seen as a matter for disciplinary action. 6. Consultation, Approval and Ratification Process Consultation feedback will be maintained as per COR11 and appropriate amendments made to policy before approval. 7. Review and Revision Arrangements including Version Control Corporate and Legal Services will maintain a version control sheet, as per COR Dissemination and Implementation of a Policy This policy will be disseminated as per COR Policy Control including Archiving Arrangements LPFT / HR3b - July

9 Corporate and Legal Services will retain a copy of each policy for a minimum of 10 years in line with the recommendations contained within Records Management NHS Code of Practice (2006) LPFT / HR3b - July

10 10. Monitoring Compliance with and Effectiveness of Policies and Procedures Systems Monitoring and/or Audit Criteria Measurables Lead Officer Frequency Reporting to Action Plan/Monitoring Systems in Confirmation Associate Annually LNC Associate place to of private Director of Director of HR ensure that Medical staff adhere to code of conduct practice via annual Job plan review and reaffirm policy HR Standards/Key Performance Indicators TARGET/STANDARDS All managers/medical guidelines within this Policy KEY PERFORMANCE INDICATOR staff follow Where deficiencies are identified an action plan will be drawn up to address same 11. References The Department of Health s A Code of Conduct for Private Practice Guidance for NHS Medical Staff Medical Staffs Terms and Conditions of Service Trust s Guidance on Standards of Business Conduct for Staff 12. Associated Documentation None LPFT / HR3b - July

11 STAGE 1 - Screening to establish if the proposed function has any relevance to any equality issue and/or minority group Directorate: Function to be Assessed: Existing or New Function: Assessment Date: Human Resources Reformatting Code of Conduct for Existing 9 February 2009 Private Practice By Medical Staff 1. Briefly describe the aims, objectives and purpose of the function: To format an existing policy into new Trust format 2. Who is intended to benefit from this All staff function, and in what way? 3. What outcomes are wanted from this An up to date policy that is relevant function? 4. What factors/forces could/ contribute/ National directives and or changes in legislation detract from these outcomes? 5. Who are the main stakeholders in Medical Staff, Managers, relation to the function? 6. Who implements the function, and who is responsible? Managers, Medical Staff, Human Resources 7. Are there concerns that the function has a differential impact on the following groups and what existing evidence (either presumed or otherwise) do you have for this? Race N This function will be consistently applied to all staff Disability Age Gender Religion or Belief N This function will be consistently applied to all staff N This function will be consistently applied to all staff N This function will be consistently applied to all staff N This function will be consistently applied to all staff LPFT / HR3b - July

12 Sexuality N This function will be consistently applied to all staff If the answer to question 7 is YES, a partial EIA must be completed. Should the function proceed to a partial impact assessment? N If no, please state date of next review: December 2009 Date on which partial impact assessment to be completed by: N/A I understand the Impact assessment of this function is a statutory obligation and that, as owners of this function, we take responsibility for the completion and quality of this process. Signed (Assessor) Ann Waring Date 9 February 2009 Print Name Ann Waring Signed (Section Head)... Date... Print Name... LPFT / HR3b - July