4.3.2 Private practice

Surgeons working in the private sector, including independent sector treatment centres (ISTCs), must ensure transparency in their dealings with patients in respect of costs for services and any actual or potential limitations of clinical care. You should:

• Make arrangements for the continuity of care of inpatients.
• Maintain the standard of record keeping as indicated in section 1.3 and audit all surgical activity as indicated in section 2.1.
• Ensure that patients are made aware of the fees of your services and the full cost of their treatment before seeking their consent to treatment. This should include fees relating to follow up treatment and potential complications where further treatment or revision is required.
• Inform patients if any part of the fee goes to any other healthcare professional.
• Make clear to patients the limits of the care available in any independent hospital used, such as the level of critical care provision and the qualification of the resident medical cover.

• If working solely in private practice, organise and participate in annual appraisal and maintain a portfolio of evidence of your professional activities. You should enable peer review of your surgical activities and participate in audit and continuing professional development.

• Ensure that you are a member of a medical defense organisation or that you have other appropriate indemnity and insurance cover for your practice.

• If you work both in the NHS and the private sector, you should:
  • Undertake similar types of procedures in both settings.
  • Not allow your private commitments to interfere with the fulfillment of your NHS contracted duties.
  • Not use NHS staff or resources to aid your private practice unless specific arrangements have been agreed in advance. Time spent in private practice and away from your NHS duties should be clearly identified in your job plan.
  • When seeing a patient as part of your NHS practice, not mention or recommend your private practice unless the patient raises this with you first.