Technology and the Keogh Report - High Quality Care

How can iConsultAesthetic support the recommendations for providing High Quality Care?

Recommendation 1 

The Royal College of Surgeons (RCS) should establish a Cosmetic Surgery Interspecialty Committee. This should consist of representatives from all the relevant specialty associations and professional associations and societies, including plastic surgery, ENT surgery, maxillofacial surgery, ophthalmology, breast surgery and gynaecology. Its task should be to: 

Set standards for the training and practice of cosmetic surgery. 
Make arrangements for the formal certification of all surgeons regarded as competent to undertake cosmetic procedures, taking account of training and experience. 

Establish and oversee a clinical audit database for cosmetic surgery, working with the Healthcare Quality Improvement Partnership (HQIP). 

Work with the Parliamentary and Health Service Ombudsman (PHSO) on dispute resolution (see recommendations regarding accessible resolution and redress). 

Meet the General Medical Council (GMC), Care Quality Commission (CQC), and the Medicines and Healthcare products Regulatory Agency (MHRA) regularly and, when appropriate, with provider representatives, to discuss current issues and share information and intelligence on the quality of care being provided. 

Develop a specific code of ethical practice for cosmetic surgery, in collaboration with the GMC, to include guidance on advertising, insurance requirements and the psychological assessment for patients.

Recommendation 2 

The RCS Interspecialty Committee should work with the CQC and the new Chief Inspector of Hospitals to ensure that providers follow the standards developed. In the meantime, the Review Committee recommend that only doctors on a GMC Specialist Register should perform cosmetic surgery, and that those doctors should work within the scope of their Specialty specific training. 

Recommendation 3 

The RCS Interspecialty Committee should be responsible for developing clear, credible outcome measures for cosmetic surgery that are published at individual surgeon and provider level on the NHS Choices website. 

iConsultAesthetic records patient notes and outcomes at the moment of treatment, it could easily incorporate the RCS outcome measures which could then be shared with the NHS Choices website.

Recommendation 4 

All non-surgical procedures must be performed under the responsibility of a clinical professional who has gained the accredited qualification to prescribe, administer and supervise aesthetic procedures. 

iConsultAesthetic requires professional body and the registration number of the Prescribing Healthcare Professional, who would have also performed the physical examination. This information is then recorded on the patient documentation and clearly identifies to the patient the accrediting body and qualification.

Recommendation 5 

Non-healthcare practitioners who have achieved the required accredited qualification may perform these procedures under the supervision of an appropriate qualified clinical professional. 

iConsultAesthetic requires professional body and the registration number of the Healthcare Professional. This information is then recorded on the patient documentation and clearly identifies to the patient the accrediting body and qualification. 

Recommendation 6 

The Government’s mandate for Health Education England (HEE) should include the development of appropriate accredited qualifications for providers of non-surgical interventions and it should determine accreditation requirements for the various professional groups. This work should be completed in 2013. 

iConsultAesthetic requires professional body and the registration number of the Healthcare Professional. This information is then recorded on the patient documentation and clearly identifies to the patient the accrediting body and qualification. The system could also reference a database of accredited HCP’s. 

Recommendation 7 

All practitioners must be registered centrally. The register should be independent of particular professional groups or commercial bodies, and should be funded through registration fees. 

Recommendation 8 

Entry to the register should be subject to: achievement of accredited qualification premises meeting certain requirements adherence to a code of practice that covers handling complaints and redress, insurance requirements, responsible advertising practice and consent practices continued demonstration of competence through an annual appraisal.

iConsultAesthetic requires professional body and the registration number of the Healthcare Professional. This information could reference the central register preventing individuals not registered from performing consultations using the system. iConsultAesthetic could also capture the qualification, approved premises, date of last appraisal, and record these on the patient documentation. 

Recommendation 9 

The CQC should recruit inspectors with appropriate expertise and experience in this sector.

Recommendation 10

The CQC should work with professional organisations to produce inspection guidelines for cosmetic surgery providers. 

Recommendation 11 

Risk-based and unannounced CQC inspections should be performed. 

Recommendation 12 

The CQC should use this data and clinical audit findings to analyse outcomes and assess risk, and this data should be used to guide inspection teams. 

Recommendation 13 

Full participation in all clinical audit and data collection programmes that have been recommended by the RCS Interspecialty Committee should be part of CQC registration requirements. 

This information could be made available to patients on the iConsultAesthetic System, and any changes to the CQC status could be sent to patients registered with that clinic through “Push Notifications” 

Recommendation 14 

Data on performance should be made publicly available at surgeon and provider level. 

This information could be made available to patients on the iConsultAesthetic System, and any changes to the Performance Data could be sent to patients registered with that clinic through “Push Notifications” 

Recommendation 15 

Providers should be required to notify the public on their websites of any CQC inspection concerns or notices. 

This information could be made available to patients on the iConsultAesthetic System, and any changes to the CQC status could be sent to patients registered with that clinic through “Push Notifications” 

Recommendation 16 

All providers must keep full patient records, including clear operative records and precise details of any implant or device used. Providers should also be able to access data of implant cohorts readily and this should be available to regulatory authorities. Details of the surgery and implant used must be sent to the patient and to the patient’s GP. 

iConsultAesthetic keeps detailed pre and post treatment notes, along with before and after images, batch numbers of product and expiry dates. This information is added to the patient record and made available to both the patient and the patients GP. 

Furthermore, the Review Committee accepts the recommendation made by the NCEPOD in its report On the face of it9, that: 

Recommendation 17 

‘Independent healthcare providers should only allow practising privileges to those cosmetic surgeons who can demonstrate that they have achieved and are able to maintain competence in the procedures which they offer’.