At PHIN, our role involves publishing information to increase transparency in the private healthcare market, so that ‘Everyone can make confident choices about their healthcare to get the best outcomes'.

That may sound like a fairly straightforward task, but in a complex industry with multiple partners and stakeholders it has proved to be a significant challenge. However, we’re making excellent progress, and recently delivered stage 1 (bronze) of the Private Healthcare Market Investigation Order.

One example of the complexities we face is the getting the correct balance between transparency for patients and respecting the privacy of the consultants providing healthcare services.

Greater transparency is about improving patient safety as well as choice. While many patients assume that safety is a given, some who have had traumatic experiences campaign for much greater transparency of consultant outcomes. Private medical insurers and other organisations similarly want assurances about the safety and quality of the consultants to whom they send their patients.

It’s a bit of a chicken and egg situation. On the one hand there is a legal requirement for data to be submitted and published, with benefits for competition and safety, but on the other hand, things are often more nuanced and inappropriate use of data can lead to loss of income, reputational damage and challenges to mental health and wellbeing for consultants.

It’s an issue we’ve dealt with to some extent before when developing our Evidence-based Assessment. For that we agreed to publish some of the data required by the Order ‘behind closed doors’ on our portal rather than on the patient-facing website. This is because the quality and power of the data limits valid, statistical comparison.

That data includes measures such as consultant mortality rates for which straightforward numbers do not tell the whole story. For example, one consultant may be taking on more complex cases than another.

Publication on the portal allows hospitals and consultants to look at the data and make appropriate changes without putting consultants at risk. We believe this still leads to a better outcome for patients, even though patients don’t have direct access to the data themselves.

Transparency and privacy are not issues for PHIN alone, and we recently brought together representatives from all the major private medical insurers and the required balance was one of the topics we discussed.

It was pointed out that most consultants want to do their best for patients and therefore welcome data that shows what they do, and don’t do, well along with the ability to benchmark against their peers. They just want data to be shared responsibly and accurately. This is something we always take very seriously at PHIN, recognising our responsibilities when dealing with healthcare data.

It was also suggested that we need to get better at using the data that is published, as data is rarely, if ever, the starting point when something has gone wrong. Rather than outliers being identified and pre-emptive action taken, it is often down to a patient or group of patients to make their concerns known before any action is taken. This is further complicated by patients often being reluctant to criticise their consultant as medical professionals are often put on a pedestal.

Therefore, as a sector, including regulators, hospitals, consultants, insurers and PHIN, we need to continue to get better at delivering high quality data appropriately and taking action – including raising concerns with the relevant party(ies) – to maintain patient safety. We’ve seen an increasing success of this with the Responsible Officer Network (including NHS as well as independent sector representatives) in the past few years, but it is everyone’s responsibility, even if it’s not their legal duty, to report issues appropriately, for example to a regulator.

If this is done responsibly, using data does not need to be at the expense of consultant privacy, nor would it contravene UK GDPR rules if it is a ‘legitimate interest’ issue.

There is probably no black and white answer to how far we should go with transparency to be fair to patients and consultants, but we have a duty of care to both and it’s certainly an issue to keep at the front on mind. I’d welcome your thoughts and insights on the topic.