Patient Safety Spotlight interview with Ian Gargan, Chief Executive of the Private Healthcare Information Network (PHIN)

Summary

This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Ian talks to us about rebuilding patient trust in the healthcare system, how the Private Healthcare Information Network (PHIN) is helping to improve decision making for patients in the private sector, and why recognising the link between physical and mental health is vital to patient safety.

About the Author

Dr Ian Gargan has extensive experience as a medical doctor and qualified psychologist. He has worked in the public and private healthcare sectors leading organisations driven by data to improve patient outcomes.

Questions & Answers

Hi Ian, please can you tell us who you are and what you do?

My name is Ian Gargan, I’m Chief Executive of the Private Healthcare Information Network (PHIN). I have been in healthcare for over 25 years; I started my career as a forensic psychologist and later retrained as an orthopaedic surgeon. I have always had a very keen interest in the links between mental and physical health—I’m still registered in both specialties and am very proud of that practice. I have always been conscious of patients’ needs and attuned to what the healthcare industry is doing to serve patients.

I started working at PHIN in September and was really excited to take on the role. I have had a number of other roles, as a Chief Medical Officer, working with the Department of Work and Pensions and for businesses in England and Ireland, which have all been focused on seeing paradigm shifts in the system that improve care for patients. I believe PHIN can help achieve shifts in patient outcomes—we want to ensure people’s health is optimised by the choices patients make in the private health sector.

Tell me a bit about PHIN—what is it and what does it do?

PHIN is a non-commercial, Government-mandated not-for-profit that collects data from over 150 providers at 450 sites in the UK. That data describes the consultants, hospitals and insurance opportunities a patient can have when they are going to choose their healthcare in the private sector. Patients can go to the PHIN website and look at which hospitals provide the treatment they require, who the doctors are, what the potential length of stay might be and what the outcomes could be. It takes some of the stress away from the patient in helping them decide where they are going to go and who is best suited to treat them. I think of patients as customers who should demand brilliant customer service.

It’s important to make clear that PHIN is not a regulator; we’re there to serve patients and improve care, not regulate it. While we can inform patients, individuals still have to use that information at their own discretion.

How did you first become interested in patient safety?

I became interested in patient safety on the first day I walked into university to study psychology. It is an absolutely implicit requirement for any healthcare professional who wants to take care of patients. I was always conscious that the learning I received was going to inform the mental and physical health of patients and took it for granted that safety was synonymous with that treatment—it’s not an add-on, it’s an absolute must. 

I became even more acutely aware of patient safety during my surgical training when I was a senior house officer (SHO) and started to be autonomous for decisions on the hospital floor. I was responsible for taking patient histories and preparing patients for surgery; it made me consider whether every single decision I was making was safe for the patient, and whether it would make them feel more vulnerable.

Which part of your role do you find the most fulfilling?

There are two aspects of my job that I find very fulfilling. One is the intellectual challenge. It’s important for me to be intellectually stimulated—I love reading data, making sense of it, and looking at how we are going to contextualise that data to make it useful for the patient. It’s very complicated and we haven’t figured it all out yet, but that’s what we’re working on!

Secondly, serving patients and improving their health is close to my heart, and I feel that PHIN does that. I work with a group of very clever people who all have a shared focus on optimising patient health, so that the outcomes from an intervention are the best they can be. I know that the PHIN team really believes in the patient being the top priority, and that’s very fulfilling. The north star for me in any job that I’m doing is, “Am I helping a patient, serving a patient or doing anything with the patient community that will optimise their health?”

What patient safety challenges do you see at the moment?

I could talk for a long time about the challenges for patients in the healthcare system at the moment, but one of the main challenges is that patients are nervous. Society is under a great deal of stress at the moment, having come out of the pandemic to a world in turmoil. This has contributed to people being fearful about making healthcare choices, so we need to build trust in the healthcare sector with individual patients. 

People are lacking confidence in systems generally today, so where people’s physical and mental health is concerned, it’s really important that we remove any sense of crisis from the healthcare decisions they make. One of PHIN’s major ambitions is to build that trust with patients and make sure they feel that whatever is going on in the world, it won’t affect their care.

What do you think the next few years hold for patient safety?

In the 25 years I’ve been in healthcare, I’ve seen massive innovation on a year-to-year basis. One of the things that excites me so much about medicine is the fact that there is always innovation and learning. 

Data and technology will play a massive role in patient health in the next few years. Patients demand certain insights and knowledge now; they require data and want to know where they are going to get the best service. In 2033, I think patients will have far more knowledge about their health and who is going to provide them with the best care, and at what price. One of the main reasons I was so interested in leading PHIN is that this data and technology is going to be a game changer over the next few years. We want to be first in line to inform that innovation.

If you could change one thing in the healthcare system right now, what would it be?

If I had a magic wand, I’d deal with waiting lists! I’d make sure people weren’t waiting for essential care, and at a minimum I would give patients more insight into where they are in the queue for treatment.

From the day I started working in medicine, there has always been a duress; we’ve always been trying to get on top of the workload. It’s a hard place to work with that kind of pressure, and it’s a terrible thing for a patient to be lying there wondering how long they are going to be waiting there for a bed. As a healthcare professional, it just feels so bad to not be able to change the situation for waiting patients.

Are there things that you do outside of your work that make you think differently about patient safety?

I’m a massive sports and fitness fan and am very proactive in my fitness, for example, I enjoy taking part in triathlons. I think that focus has been facilitated by my job as I don’t want to get sick! 

An article in Neuroscience and Biobehavioral Reviews says that 20 minutes of exercise a day when your heart rate increases by 20 minutes a day is as effective as taking an antidepressant.[1] Anything that builds up my mental health, wellbeing and resilience makes me more productive at work, better for the people I work with and helps prevent me needing healthcare interventions. 

Tell us one thing about yourself that might surprise us?

I’ve spent a lot of time in prison! When I was a forensic psychologist I spent time training in Australia, Ireland and the UK and had to write assessment reports for people being sentenced or going to trial. I would go into prisons all the time to hear defendants’ stories and act as an expert witness.

References

1 Kandola A, Ashdown-Franks G, Hendrikse J et al.  Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019 Dec;107:525-539