The Medical Advisory Committees in independent hospitals have had increasing responsibilities as anticipated below in 2012. MACs should review all clinical governance issues, Key Performance Indicators (KPIs), all deaths and adverse events. Consultants awarded practising privileges should be reviewed carefully by the MAC in terms of scope of practice. The future roles and responsibilities of MACs will no doubt feature strongly in the Public Inquiry in to the Private Sector to be chaired by the Bishop of Norwich.
Background to Medical Advisory Committee (MAC) responsibilities and functions in the Independent Sector – June 2012
Medical Advisory Committees (MACs) in all UK independent hospitals are seeing their roles increase. The original Care Standards Act imposed statutory responsibilities on the MAC Chairman and the whole committee. Revalidation will mean an increased workload and the advent of Responsible Officers and enhanced appraisal is currently being implemented. This will add another layer of governance with considerable resource implications as consultants, whether fully independent or the much larger group who have a NHS contract, will be asking for their private hospital performance data for appraisal purposes. In addition there will be a need for internal appraisal for private hospital employed staff which will have to be arranged by the Responsible Officer.
The MAC will be required to impose stricter rules on consultants over issues such as audit, note keeping and clinical practice. Complaints, clinical incidents and the involvement of the GMC are likely to increase. MACs in larger hospitals will need to oversee subgroups of consultants responsible for governance and quality issues and some hospitals are appointing Medical Directors to assist in a supervisory role.
The recent OFT report has emphasised the need for a cost/quality assessment and whilst this is now going to be part of the Competition Commission Market Study there is a greater emphasis on outcome measures by the regulators and the insurers. In addition, the changes being introduced by some insurers and regulators involve a growing intrusion in to consultant performance and scope of practice. For these reasons the “advisory” role of the MAC Chairman and Committee will be enhanced.
FIPO MAC Guidelines
At several previous FIPO Nat-MAC meetings the MAC Chairmen requested some more formal, professionally structured Guidelines to assist them in their role. FIPO produced these Guidelines with input from the GMC, the MDU, the MPS, various hospital providers and the Healthcare Commission. These may have to be revised in 2010 when new regulations concerning Responsible Officers and Revalidation come in to force.