Practising Privileges Agreement
Purpose:
To ensure that all healthcare professionals granted Practising Privileges within Freshfaced's
services are subject to appropriate checks and monitoring to safeguard those using the services.
Summary
1.1. This document provides details of the criteria and conditions under which licensed registered medical, dental and nurse practitioners (referred to below as Medical Practitioner(s)) may be granted authorisation by the Practice Manager to undertake the care and treatment of patients in a Freshfaced Clinic (each referred to below as a/the Clinic).
1.2. These criteria and conditions are referred to as Practising Privileges or PPs. PPs are a discretionary personal licence to undertake consultations, diagnosis, treatment and surgery in accordance with relevant legislation, regulation, and Freshfaced policies and procedures and any terms laid down from time to time by the Clinic.
1.3 At the Clinic, the Practice Owner and Practice Manager bear operational and regulatory responsibility for all activities within the Clinic. The Clinic is registered for this purpose with Healthcare Improvement Scotland.
1.4. Save where an express written contract of direct employment is entered into with Freshfaced, all Practitioners granted PPs with respect to the Clinic are independent self-employed contractors.
Scope/Roles & Responsibilities
2.1. Medical Practitioner
The Medical Practitioner must:
· be of good character, including not being convicted in the UK of any offence or convicted elsewhere of any offence which, if committed in the UK, would constitute an offence, if the offence relates to the conduct required in carrying on a regulated activity. This requirement includes not having been erased, removed or struck-off a register of professionals maintained by a regulator of health care in the UK or elsewhere.
· have the qualifications, competence, skills and experience which are necessary for the work to be performed by them, and be capable by reason of their health, after reasonable adjustments are made, of properly performing the professional duties for which they are engaged through the grant of PPs.
· act in accordance with the terms and conditions contained within Freshfaced's Practising Privileges Policy and the Appendices to it (noting that those terms and conditions may be amended from time to time at Freshfaced’s discretion)
2.2. Practice Manager (PM)
The Practice Manager has a responsibility to ensure that there are robust systems and processes within the organisation for:
· undertaking appropriate employment checks for medical appointments (this includes the granting of PPs) obtaining appropriate references and resolving any issues that may arise recording the results of the checking process evidencing that all clinicians working within the organisation are fit to practise.
3. Policy Statements
3.1. Eligibility for Practising Privileges
3.1.1. All Medical Practitioners must hold a GMC, GDC or NMC licence to practise to be eligible to apply for PPs at Freshfaced, pursuant to the Regulations. The title Practising Privileges denotes that Medical Practitioners are “practising” and therefore require a licence.
3.1.2. Medical Practitioners will usually hold a substantive post in the NHS, however this is not always required and applications may also be accepted from clinicians who have a Designated Body other than the NHS.
4. Applications for practising Privileges
4.1. A Medical Practitioner meeting the criteria may apply by phone, e-mail or in writing to the Practice Manager to request an application pack for PPs. If granted, the subsequent authorisation is on the basis of a licence to practise in the relevant Clinic.
4.2. Those granted PPs are independent self-employed contractors and are not employees, agents or sub-contractors of the Clinic. As such, they are responsible for their own tax, national insurance, pension and indemnity arrangements. Freshfaced will accept no vicarious liability for the acts, omissions or defaults of Medical Practitioners granted PPs, or for those whose actions they have formally accepted accountability for.
4.3. Medical Practitioners must fully complete an application form which is available from the PM.
4.4. Medical Practitioners will need to provide evidence of infectious disease immunisation status, details of hepatitis B vaccination and evidence of hepatitis B status. Hepatitis B surface antibody levels above 100 miu/ml is considered a satisfactory response to vaccination.
4.5. Medical Practitioners will need to provide evidence of adequate insurance or indemnity cover for the provision of services with any details of restriction of cover. They must also provide information on previous/pending claims. It is the Medical Practitioner’s responsibility to ensure that they have adequate medical malpractice indemnity or insurance arrangements in place. In accepting a Medical Practitioner’s indemnity arrangements Freshfaced gives no representation or warranty that the levels of cover are adequate for the Medical Practitioner’s own circumstances.
4.6. Applicants will need to provide evidence of appropriate GMC, GDC or NMC registration and licence to practise.
4.7. Applicants will need to provide evidence of data controller registration or exemption.
4.8. Applicants will need to disclose:
· any investigations, suspension, dismissal or informal but enforced leave of absence in the NHS
· any investigation, restriction, suspension or withdrawal of practising privileges granted by another private clinic
· any investigation, restrictions or suspensions undertaken or endorsed by a regulatory authority
4.11. Medical Practitioners will need to apply for a Protection of Vulnerable Groups (PVG) check at enhanced level, countersigned by a representative of Freshfaced. PVG checks are required to be updated according to risk / change of circumstances, and in line with, Disclosure Scotland and HIS guidance and Freshfaced’s own requirements. All Medical Practitioners will have to apply to the PVG for a new disclosure certificate at enhanced level every three years and as a pre-condition for retaining PPs.
5. Scope of Practice
5.1. If granted , PPs will be defined by the Practice Owner/Practice Manager according to one (or if applicable more than one) of the following categories:
a) Provision of general dentistry
b) Provision of non-surgical cosmetic treatments (Botulinum toxin, dermal fillers and PDO threads)
c) Provision of orthodontics
d) Provision of dental implants
5.2. PPs will only apply to those procedures or techniques that are part of the Medical Practitioner’s normal practice or where the Medical Practitioner can provide evidence of adequate training, competency and experience. Scope of practice and the procedures the Medical Practitioner will undertake will be defined at application for PPs. Any change will need to be supported by evidence of training, competency and experience and to be agreed with the Practice Owner/Practice Manager. Practice scope will be revisited as part of regular reviews of PPs.
5.3. No Medical Practitioner may admit patients to, or treat patients in, the Freshfaced Clinic or any connected site(s) other than in accordance with their specified PPs, nor may they practise outside the scope of agreed procedures or clinical activities without the explicit consent of the Practice Owner.
6. Maintenance of Practising Privileges
6.1. PPs will be formally reviewed every two years. This will take the form of a meeting with the Practice Owner.
6.2. Every year Medical Practitioners must provide the Practice Manager with:
· satisfactory evidence of adequate insurance or indemnity cover for the provision of services
· evidence of GMC, GDC or NMC registration and current licence to practise
· evidence of hepatitis B and C immune status and HIV status, in those undertaking exposure prone procedures
· evidence of data controller registration or exemption
· confirmation of participation in relevant mandatory training:
o Basic Life Support (including Paediatric BLS where appropriate)
o Fire Safety
o Health & Safety
o Infection Prevention
o Information Governance
o Manual Handling
o Protection of Vulnerable Adults
o Safeguarding Children
6.3. Medical Practitioners must maintain full registration with the GMC, GDC or NMC and must inform the Practice Owner immediately of any change in their registration or notification of any complaint to their professional body. This includes (but is not limited to) conditional registration, suspension at any time or investigation pending or in process, even if in a foreign country.
6.5. Medical Practitioners must at all times act in accordance with the Professional Duty of Candour and must be open and honest with patients when something goes wrong with their treatment or care which causes, or has the potential to cause, harm or distress. This means that Medical Practitioners must tell the patient when something goes wrong, apologise to the patient, offer (in conjunction with the Practice Manager) an appropriate remedy or support to put matters right and explain fully to the patient the short and long term effects of what has happened. All communications in relation to Freshfaced patients must be agreed in advance with the Practice Manager or the clinicians professional indemnity/insurance.
6.6. Medical Practitioners must inform the Practice Owner as soon as they are aware of any on-going legal action for alleged medical negligence, any previous litigation or threatened litigation in connection with their professional performance (whether at Freshfaced or elsewhere), or any criminal convictions.
6.7. Medical Practitioners are expected to meet the Continuing Education requirements of their relevant Professional Body and participate with any requirements relating to whole practice appraisal and auditing.
6.8. Medical Practitioners must immediately notify the Practice Owner of any change in their circumstances which may have a bearing on the quality of their patient care or the safety of their patients. In particular, in the event of infection with hepatitis B or C or HIV, this must be notified as soon as practicable and the Medical Practitioner must not undertake exposure prone procedures until advised otherwise by an occupational health physician and agreed by the Practice Owner.
6.9. All Medical Practitioners must fully participate in the clinics audit and cleanliness requirements. These include (but are not limited to) Patient Reported Outcomes Measurement (Feedback Survey), Infection Control audit, Cleanliness audit and Medicines audit.
6.10. Medical Practitioners are required to participate fully in Freshfaced’s complaints procedure, and, specifically, respond in a timely manner to requests for statements and responses to complaints from patients to enable resolution within published timescales.
7. Restriction, Suspension or Withdrawal of PPs
7.1. PPs may be restricted, suspended or withdrawn by the Practice Owner at any time (including prior to commencing an investigation when concerns have been raised about a Medical Practitioner’s conduct or performance). In circumstances which the Practice Owner considers warrant it, such as where there may be a threat to patient safety, the Practice Owner will restrict or suspend PPs immediately.
7.2. Freshfaced cannot guarantee to provide the level of facilities at all times to meet the individual requirements of every Medical Practitioner. The Practice Owner therefore reserves the right to refuse to grant or withdraw PPs or to withdraw permission to use facilities on commercial grounds, which may affect an individual’s ability to practise. If this should occur, wherever possible reasonable notice would be given to the Medical Practitioner(s) concerned.
7.3. Examples of situations that might give rise to the restriction, suspension or withdrawal of PPs include, but are not limited to:
· failure to comply with Freshfaced policies (including the terms of this Practising Privileges Policy). Freshfaced policies are developed at a local level in order to minimise risk, primarily to patients, but also to Freshfaced as a whole. They are developed in both contexts after consultation and careful consideration of statutory and regulatory issues, together with good practice guidance issued by various sources. Any Medical Practitioner in breach of any such policy is therefore presenting unacceptable risk to patients and the clinic's business and such activity will comprise grounds for withdrawal of PPs. It is the Medical Practitioner’s responsibility to familiarise themselves with all relevant policies and maintain their level of knowledge
· health issues, including where a Medical Practitioner contracts a disease or infection which renders them a danger to the safety of patients, colleagues or staff because of the risk of transmission or where a Medical Practitioner contracts a disease or infection, the effects of which reduce or impair their ability to carry out their clinical duties safely and effectively or otherwise reduce their clinical effectiveness
· fitness to practise issues where professional misconduct on the part of the Medical Practitioner has occurred, not necessarily within Freshfaced, or where an allegation of such conduct has been made and is being actively investigated
· where misconduct of either a clinical or non-clinical nature has occurred which, in the judgement of the clinic, or Freshfaced itself, might bring the clinkc or Freshfaced into disrepute or cause commercial harm, or where harm to patients has resulted
· abusive behaviour towards staff or colleagues
7.4. For the avoidance of doubt the above is not an exhaustive list of the situations which might give rise to the restriction, suspension or withdrawal of PPs, in relation to which Freshfaced retains full discretion.
8. Confidentiality & Other Policies
8.1. As described above, all Medical Practitioners with PPs must comply with all of Freshfaced’s policies and procedures as published and amended at any time by Freshfaced. In respect of confidentiality, this will include keeping confidential and not disclosing to any third parties any information relating to the business or financial affairs of the Clinic, or matters and information in relation to clinical governance data, unless required to do so by law, regulation or by prevailing medical ethics.
9. Record Keeping
9.1. Clear contemporaneous medical records are critical to effective communication and to enable safe patient care. The Medical Practitioner is responsible for providing relevant medical information for the completion of the patient record. This must be updated at every visit and dated, timed and signed (automatically with software of excellence). Records should be:
· keep clear, accurate and legible records, reporting the relevant clinical findings, the decisions made, the information given to patients, and any drugs prescribed or other investigation or treatment
· make records at the same time as the events you are recording or as soon as possible afterwards
10. Remuneration
10.1. Remuneration will be agreed and confirmed in writing separately, prior to issuing and acceptance of a PP.