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Tibacare

Clinical Network Standards

Professional expertise should travel with professional responsibility.

Legal and claim review in progress

This page describes the standards and ways of working Tibacare intends to apply. Its substantive wording remains under accountable review, and it does not mean that the services, partnerships or arrangements it mentions are already in operation.

Tibacare connects clinicians and healthcare organisations across professional, organisational, and geographical boundaries.

Participation carries responsibilities to patients, professional colleagues, local healthcare teams, and the integrity of clinical decision-making.

A patient's location or relative lack of access should never be treated as a reason to lower professional standards.

Same responsibility across borders

Distance should change access, not professional standards.

Relevant expertise may be geographically distant from the patient. That distance does not reduce the professional responsibilities around clinical judgement, confidentiality, dignity, or collaboration.

Participation in Tibacare does not reduce the responsibilities already applying to a clinician or healthcare organisation.

Global access should extend expertise—not dilute responsibility.

  1. 01

    Applicable law & regulation

    Participants remain responsible for the legal and regulatory requirements applying to the service, clinician, patient, and organisations involved.

  2. 02

    Professional obligations

    Clinicians remain subject to the standards and responsibilities associated with their professional registration and practice.

  3. 03

    Patient & service location

    Remote or cross-border work can create additional requirements connected with the patient's location and where the service is received.

  4. 04

    Tibacare network standard

    Tibacare may set additional participation expectations. A higher patient-protection standard is expected where applying it does not conflict with applicable law.

Distance is not a reason for weaker

  • Professional behaviour
  • Clinical judgement
  • Confidentiality
  • Dignity and fairness
  • Appropriate documentation
  • Responsible remote care
  • Respectful collaboration

The public network principles

Six standards shape participation.

These principles are the public shorthand for the professional culture of the network. They apply to clinicians, participating organisations, and Tibacare's role in enabling access.

  1. Patient interests first

    Clinical need, patient safety, dignity, fairness, and appropriate care come before commercial or organisational interests.

  2. Expertise within its limits

    Clinicians are expected to work within their competence, appropriate scope, and the limitations of the service being provided.

  3. Independent professional judgement

    Clinical opinions remain the independent professional judgement of the clinician providing them.

  4. Responsible collaboration

    External expertise should work alongside patients, local clinicians, and healthcare organisations rather than unnecessarily displacing local care.

  5. Confidential & accountable practice

    Clinical information, professional records, and digital systems should be used only for appropriate authorised purposes.

  6. Speak up, learn & remain accountable

    Patient-safety concerns should be raised appropriately, and participants should cooperate with legitimate governance and review processes.

Access to expertise can be purchased. A preferred clinical conclusion cannot.

Clinical practice

Responsible expertise includes knowing its limits.

Not every clinical question can or should be resolved remotely. A responsible contribution may identify uncertainty, request more context, or conclude that local assessment is needed.

Sometimes the appropriate professional conclusion is that more information or physical care is required.

Scope & competence

Expertise has boundaries.

Clinicians should recognise when a question falls outside their expertise, when another specialty is more appropriate, or when more information, examination, investigation, or multidisciplinary input is needed.

A clinician should never feel required to provide an answer simply because a case has been allocated to them.

Remote care

Remote access is not appropriate for every situation.

Where remote care is insufficient, clinicians should be able to recommend local assessment, physical examination, investigations, imaging, emergency assessment, hospital care, or another suitable pathway.

Tibacare is not an emergency medical service.

Communication & participation

Clinical expertise should be understandable.

Communication should be clear, respectful, honest, and proportionate, including appropriate acknowledgement of uncertainty and material limitations. Patients should understand the nature and purpose of the clinical interaction.

Consent and patient participation should be meaningful and appropriate to the clinical activity.

Clinical documentation

Professional advice should leave an appropriate record.

Relevant professional work should be clear, attributable, accurate, timely, appropriately detailed, and useful for continuity where required.

Tibacare may provide workflow tools; the clinician remains responsible for the clinical record they create or approve.

Safety & safeguarding

Safety concerns should be acted on.

Participants should remain alert to urgent clinical risk and appropriate safeguarding concerns, recognise service limitations, communicate the need for local action, and use relevant escalation pathways.

Patient-safety concerns should not be ignored because care is remote.

Professional culture

Digital care remains professional care.

The same expectations of dignity, fairness, appropriate boundaries, and respectful conduct apply across video, audio, messaging, case collaboration, and other approved digital workflows.

Expertise comes first, but respect runs in every direction.

Our operating principle

Global expertise + local care

External expertise should strengthen local healthcare, not attempt to replace it.

Across the network

Global expertise contributes specialist depth

  • Specialist knowledge
  • Another professional perspective
  • Sub-specialist expertise
  • Second opinions and complex-case input
  • Multidisciplinary collaboration

Close to the patient

Local care contributes context and continuity

  • Knowledge of the patient and local context
  • Physical examination and investigations
  • Treatment, procedures, and emergency care
  • Available services and practical constraints
  • Continuity with the wider healthcare team

Professional culture

Expertise without hierarchy.

Specialist knowledge should complement rather than diminish the role of clinicians already caring for the patient. A specialist may contribute depth in a particular condition while a local clinician understands the patient, available care, family circumstances, and continuity.

Professional collaboration should recognise both specialist depth and local clinical knowledge.

Professional independence

Clinical judgement belongs with clinicians.

Tibacare can provide infrastructure, coordinate access, organise workflows, and connect organisations with expertise. It does not determine a diagnosis, treatment recommendation, second-opinion conclusion, or whether further assessment is needed.

Likewise, an organisation purchasing access or capacity should not require, suppress, alter, or misrepresent a clinician's professional conclusion.

  1. Organisation

    May purchase access or reserve capacity

    Infrastructure, coordination, workflows, and clinical capacity can be arranged around a defined service.

  2. Clinician

    Retains independent professional judgement

    The clinician remains free to agree, disagree, express uncertainty, request information, recommend escalation, or decline work outside their competence.

  3. Patient & clinical need

    Remain central to the professional conclusion

    Diagnosis, recommendations, and clinical opinions should arise from the available information, relevant expertise, and responsible judgement.

Capacity can be contracted. Clinical conclusions cannot.

Conflicts of interest

Relevant financial, referral, ownership, personal, commercial, or payer interests should be identified and appropriately managed. A material conflict may make participation in a decision inappropriate.

Professional disagreement

Reasonable clinicians may reach different conclusions. Disagreement should be handled through evidence, explanation, professional reasoning, and respect—not hierarchy or commercial pressure.

Honest professional representation

Titles, specialty, qualifications, experience, registration, services, and professional opinions should be represented accurately without inappropriate guarantees.

Different professional conclusions do not automatically mean one participant has behaved improperly.

Shared responsibility

Organisations participating in the network also have standards to uphold.

Hospitals, insurers, employers, NGOs, governments, and other participating organisations shape the information, conditions, and continuity around a clinical collaboration. Responsible access therefore depends on more than clinician behaviour alone.

  1. 01

    Respect clinical independence

    Do not pressure clinicians towards predetermined findings or recommendations.

  2. 02

    Provide appropriate information

    Support collaboration with relevant, accurate, and sufficiently current clinical context.

  3. 03

    Protect patient information

    Use clinical information only through appropriate authorised processes.

  4. 04

    Maintain local responsibility

    External input does not remove responsibility for local assessment, treatment, emergency action, or continuing care.

  5. 05

    Support continuity

    Help clinically relevant outputs reach those appropriately responsible for ongoing care.

  6. 06

    Respond to safety concerns

    Act appropriately when serious clinical or safeguarding concerns are raised.

  7. 07

    Cooperate & represent accurately

    Engage with legitimate governance and do not misrepresent Tibacare, clinicians, opinions, relationships, or availability.

Case information integrity

Good specialist input depends on good clinical context.

Organisations and referring professionals should make reasonable efforts to provide a clear clinical question and relevant, accurate information. Important context should not be knowingly omitted, altered, or presented misleadingly to obtain a preferred opinion.

Accurate representation

Relationships and opinions should be described honestly.

Participating organisations should not misrepresent Tibacare, clinician employment or partnership status, service availability, professional credentials, or the meaning of a clinician's signed opinion.

Trust & accountability

Access follows responsibility.

Confidentiality, appropriate information sharing, responsible technology, and professional accountability remain connected. Participation in a network does not create unrestricted access or remove individual responsibility.

Confidentiality & sharing

Access follows responsibility.

Participation does not provide general access to patient information. Information should be accessed for an authorised purpose, where relevant to the person's role, and shared through appropriate pathways only as reasonably required for the clinical purpose.

Being part of the network is not permission to access every record in the network.

Technology & workflow

Technology supports professional work.

Digital or automated tools do not replace professional responsibility. Healthcare professionals remain responsible for outputs they adopt or approve and should not place patient information in unauthorised external tools.

Using the Clinical Workspace does not create a right to access information unrelated to an authorised role.

Speaking up & review

Concerns should be capable of being raised.

Good-faith concerns about patient safety, professional conduct, safeguarding, information access, conflicts, pressure, or misuse should be raised through the appropriate available route without commercial pressure to remain silent.

Participation includes professional cooperation with legitimate governance activity.

Ongoing status

Verification is not the end of accountability.

Clinicians should keep relevant professional information current and notify Tibacare about material restrictions, suspension, scope, eligibility, or indemnity changes where required.

Professional participation can be reassessed when relevant circumstances change.

Standards apply to Tibacare too

The platform operating the network is also accountable.

  • Preserve professional independence
  • Operate responsible access and governance processes
  • Protect information through controls appropriate to the service
  • Provide suitable clinical workflow infrastructure
  • Respond appropriately to serious concerns
  • Avoid commercial pressure on professional conclusions
  • Represent clinicians, relationships, and services accurately

Governance

Standards have to mean something.

Concerns about participation may be reviewed through Tibacare's applicable governance processes. A review does not assume fault; it asks participants to engage professionally with legitimate scrutiny.

  • Review participation or access
  • Apply additional requirements where appropriate
  • Restrict or suspend participation
  • End participation where circumstances warrant it
  • Follow another applicable professional, legal, or regulatory process where required

Tibacare's governance processes do not replace the authority of applicable professional regulators or public authorities.

Our commitment

Access should widen. Standards should not fall.

Tibacare operates across healthcare systems with different laws, resources, professional structures, and levels of specialist access. Those differences should be understood and respected.

Participants remain responsible for the laws and professional requirements applying to their work. Where Tibacare's network standard sets a higher patient-protection or professional expectation, and applying it does not conflict with applicable law, that higher standard is expected.

A patient's location or relative lack of access should never be treated as a reason to lower professional standards.

The purpose of cross-border access is to extend expertise—not create a lower tier of professional care.

Related trust routes

Public standards sit alongside more specific guidance.

Verification establishes the professional basis for participation. Clinical Network Standards govern expectations while participating. More detailed privacy, security, safeguarding, complaint, and governance procedures remain in the guidance or operational policies appropriate to each service.