Intended for healthcare professionals


Guidance needed for consultants working for private providers, says BMA

BMJ 2016; 353 doi: (Published 21 June 2016) Cite this as: BMJ 2016;353:i3481
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

Doctors have called on the BMA to create guidance for consultants who work for private companies but treat NHS patients.

Delegates at the BMA Annual Representatives’ Meeting in Belfast on Tuesday 21 June passed a motion which called for guidance for consultants “who treat NHS patients but are no longer employed by NHS trusts.”

Gordon Mathews, ‎a consultant orthopaedic surgeon, said that a “significant volume” of NHS elective surgery was now done in private hospitals. “You may not like that but it’s going to continue for some time,” he said.

Matthews said that some of this work was carried out by NHS consultants but some was done by consultants who did not have an NHS consultant contract. “These consultants may have retired from the NHS or they may have always worked independently,” he said.

He said that in this situation a number of issues might arise—such as whether the consultants who were looking after NHS patients were covered by crown indemnity. “That situation is a little vague and varies from contract to contract,” he said.

Matthews said that there could also be issues if a patient who was being treated in a private hospital required an extended stay and input from doctors from other specialties. “Who has responsibility for arranging this and for reimbursement for the staff involved?” he asked.

“At the present time, precise responsibility for much of this clinical activity is not clearly defined or understood, and in the interest of patients and the consultants themselves guidance is needed in regards to best practice,” he added.

Eleanor Dreager, a genitourinary medicine consultant, said, “There are already consultant jobs being advertised under private providers to provide NHS care for NHS patients and we do need some guidance on how to act in those situations.”

She added, “We need to be protected in looking after our NHS patients even if we are being employed by private companies.”

Keith Brent, chair of the BMA consultants committee, said, “This is about supporting our members to do the right thing for their patients.”

He added, “Off the top of my head I know there are considerable numbers of psychiatric patients whose inpatient beds are in non-NHS trusts and most hospices are not under the NHS banner but they have consultants in palliative care.

“So I think it would be useful for us to produce guidance on it.”