Control clinical risk across fragmented care networks
Before it becomes claims exposure
Private healthcare doesn't fail because of poor care. It fails because responsibility fractures across networks.
Insurers commission care they don't deliver. Providers deliver care they don't fully document. Patients move between digital services, private providers, and the NHS. Claims arrive later — detached from intent, context, or accountability.
Every handover creates liability risk unless it is governed. Inference Clinical exists to make those handovers explicit, traceable, and defensible — before harm, dispute, or write-off occurs.
Why private healthcare carries more hidden risk
Private healthcare involves constant movement: insurer to provider, digital consultation to physical appointment, private care to NHS follow-up, device alert to clinical decision.
Each transition transfers clinical responsibility. But the infrastructure to make that transfer explicit, auditable, and defensible often does not exist.
This is not a clinical failure. It is an infrastructure failure.
The Seven Flows provide the governance infrastructure that allows private healthcare to scale without multiplying liability.
What insurers actually gain: visibility into what happens after authorisation, clinical intent tracking (not just outcomes), separation of patient risk from delivery risk, claims defence with evidence (not reconstruction), and identification of high-risk pathways before losses materialise.
Governance stops being retrospective. Risk becomes observable.
Moments where governance gaps become visible
These failures rarely appear as incidents. They surface later as claims disputes, write-offs, regulatory questions, or reputational damage.
A member sees a GP through a digital provider. The consultation note exists in one system. The consultant they see next week uses another. Context arrives late, incomplete, or not at all.
A patient transitions from private consultant to NHS follow-up. The NHS clinician inherits responsibility without the history. The private imaging exists but is not visible in the NHS record.
Remote monitoring generates an alert. It reaches a queue. No one owns the escalation. By the time it surfaces, the window for early intervention has closed.
An insurer authorises treatment. The referral enters the provider's system. Whether the patient was actually seen, and what happened, remains invisible until a claim arrives.
These failures are not caused by negligence. They are caused by infrastructure that was never designed to govern handovers across organisational boundaries.
The Seven Flows exist to close these gaps.
Private healthcare is scaling. The infrastructure has not kept pace.
The forces reshaping private healthcare (digital access, remote monitoring, network models, consumer expectations) are all multiplying handovers. Each handover introduces risk unless it is explicitly governed.
Fragmented patient journeys
Members see GPs digitally, consultants privately, have procedures at NHS hospitals, recover at home with remote monitoring. Every transition is a gap where context gets lost.
Governance that cannot scale
The Care Quality Commission expects the same standards whether you see 100 patients or 100,000. Manual clinical governance does not scale. Retrofitting compliance after growth is expensive and fragile.
Data without provenance
Remote monitoring devices generate millions of data points. Which are clinically meaningful? Which are artefacts? Without validation at source, clinical decisions rest on noise.
For insurers, these gaps do not appear as governance issues. They appear as loss ratio pressure, broker escalation, and disputed responsibility — long after the opportunity for early intervention has passed.
Same invariants. Private healthcare context.
The governance gaps in private healthcare are not different from the NHS. They are the same invariants playing out across different organisational boundaries. Identity still needs verification. Consent still needs to travel with data. Responsibility still needs explicit transfer.
What changes is the operating model: commercial timelines, network complexity, and the need to demonstrate value to payers.
The Seven Flows are necessary conditions for safe handover. They do not replace clinical judgement or contractual arrangements. They make responsibility observable, attributable, and defensible across commercial networks.
Identity
In private healthcare: Member matching across provider networks. The same patient may appear with different identifiers in insurer, digital provider, consultant, and NHS systems.
What this flow stabilises
Trusted identification of patients, practitioners, and organisations, maintained across every handover, regardless of which system is involved.
The guarantee
Every clinical action is attributable to a verified patient, a verified practitioner, and a verified organisation, even when the patient moves across network boundaries.
Explore all Seven Flows in detail →Built for how you work
Reduce claims risk across fragmented provider networks
See what happens after authorisation. Defend decisions with evidence. Intervene before losses materialise.
- Visibility into what happens after authorisation
- Evidence-backed underwriting and claims decisions
- Earlier intervention through connected pathways
- Reduced disputes and write-offs
- Member experience that survives scrutiny
Govern outcomes and manage risk at scale
Turn governance from overhead into operational advantage. Continuous clinical safety, real-time risk visibility, evidence that satisfies CQC.
- Continuous clinical safety at scale
- Real-time risk visibility across network
- CQC-ready evidence by design
- Outcome measurement that drives improvement
Multi-site coordination with consistent governance
Operational efficiency without compromising safety. Integration with consultants who work across NHS and private settings.
- Multi-site governance consistency
- Consultant integration across settings
- Patient experience that differentiates
- Audit-ready compliance evidence
NHS standards. Commercial agility.
We built to NHS interoperability and safety standards from day one. Your private patients often become NHS patients, and vice versa. That investment means you get governance that regulators recognise, without the integration headaches.
UK Core FHIR R4
Native NHS interoperability for seamless data exchange across private and public settings.
DCB 0129 / 0160
Clinical safety methodology built in, not bolted on. Hazard logs and safety cases by design.
DTAC-ready
Digital Technology Assessment Criteria alignment for NHS procurement pathways.
CQC-aligned
Regulatory governance framework that generates evidence automatically.
UK GDPR
Data protection compliance with explicit consent management and audit trails.
ISO 27001 ready
Information security management framework for enterprise deployments.
Glossary
- Clinical Governance
- The framework through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care.
- Care Quality Commission (CQC)
- The independent regulator of health and adult social care in England. CQC monitors, inspects, and regulates services to ensure they meet fundamental standards of quality and safety.
- DCB 0129 / DCB 0160
- NHS Digital clinical safety standards. DCB 0129 applies to manufacturers of health IT systems. DCB 0160 applies to health and care organisations deploying those systems.
- FHIR (Fast Healthcare Interoperability Resources)
- An international standard for exchanging healthcare information electronically. UK Core FHIR R4 is the NHS-specific implementation.
- DTAC (Digital Technology Assessment Criteria)
- A baseline set of criteria that digital health technologies must meet to be considered for NHS procurement, covering clinical safety, data protection, technical security, and usability.
- Handover
- Any point where clinical responsibility, patient information, or care activity transfers between teams, organisations, or systems. Each handover creates risk unless explicitly governed.
Start with a Governance Audit
Map liability, responsibility, and risk across your network. Bounded. Non-disruptive. No commitment required.
Start with a Governance Audit