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One is good, Two is better

Representatives of the UK-based Trent Accreditation Scheme (TAS) attended the second International Medical Travel Conference, hoping to gain more exposure for their services. At present, Hong Kong is TAS’ sole international outpost. (Cebu Doctors’ University Hospital in the Philippines is reportedly applying for the programme, IMTJ learned at press time.)

TAS surveyors Professor Steven Green, an infectious disease specialist and Dr Tim O’Carroll, an anaesthesiologist, participated as well as presented papers on the value

of accreditation. Professor Green remarked: “It was our first outing (to a medical travel conference) and we were heartened by the response.”

TAS was set up in the UK in 1993, originally as a result of concerns about the quality of care in isolated hospitals, of which there were a number in the Trent Region, one of the largest NHS (National Health Service) regions with a population of 4.5 million and staff of 85,000. These regions no longer exist following several NHS reorganisations. The name “Trent” also comes from a river, which runs through the Northeast Midlands of England.

Liz Brownhill, Trent scheme manager, told IMTJ in a separate interview that the organisation was approached by the Hong Kong Private Hospitals in 1999 and but refrained from taking the initiative overseas as, at the time, the NHS was undergoing upheaval and staff were busy with these issues and maintaining their workload. The partnership eventually went ahead, resulting in 12 facilities passing Trent qualifications. “We realised the scheme had worked well and is robust in Hong Kong, and that it could be adapted to other overseas situations.” Trent-accredited hospitals in the Special Administrative Region include Canossa Hospital, Hong Kong Adventist Hospital (below), Matilda International and St Paul’s Hospital among others.

What is Trent’s unique selling proposition? Brownhill explained: “We are the only whole hospital accreditation scheme based with the UK NHS and all our surveyors work within the NHS and/or private hospitals, plus we have a very few recently retired people. Our surveyors are mainly clinical staff with a few managers. Hence, we have access to all the up-to-date good practices. We have links with all professions colleges such as medical Royal Colleges and also universities. Our standards are revised as practice changes and as guidelines are issued as staff are the ones who know most about these.

“In our overseas work, we involve local people in setting the local standards so that the standards reflect local practice and culture, and we train local clinical and other staff to be surveyors. The whole ethos of the scheme is one of development – we do not inspect. We have discussions about practice, we watch what is happening during surveys and we maintain contact with hospitals between surveys to enable them to develop both the staff and the organisation.”

All Trent surveyors like Professor Green and Dr O’Carroll are volunteers, who continue working in their clinical roles, meaning it is a real peer review scheme where surveyors can talk on an equal basis with staff in hospitals and understand fully the situation. No surveyors are paid for surveying and there are no full-time surveyors.

Brownhill added: “Our administration is very small as most work is again undertaken by staff doing other NHS work. Surveyors find that being a surveyor is excellent for their personal development and many have found that the skills they have gained through surveying have helped them gain promotion. Professor Green agreed, saying: “We, surveyors, are not shareholders in Trent, nor do we live off a salary because we don’t receive any. Our motives are different.

“We feel we have a part to play in medical tourism because we are keen to see that the British people who go overseas are dealt with safely.”

Trent accreditation fees, Brownhill emphasised, are reasonable, “as we do not have a large administration nor paid surveyors”. An annual fee for belonging to the scheme covers cost for surveys such as travelling expenses, training of surveyors, any presentations prior to surveys, special training events which are run every year such as Good Practice Days when people present what has been identified as good practice during survey, and a newsletter. Once an annual fee is agreed, there is no additional charge.

And what does it hurt to add another feather to one’s cap? Said Professor Green: “You might already be JCI-accredited, but getting another one might put you ahead of the pack.”

At press time, there were an estimated 40 Trent-accredited hospitals.