Treating private patients in the NHS poses risks to care of NHS patients and use of NHS funds

Income from private patients in the NHS is predicted to grow by 6%/year to 2020, but this may pose risks to the use of NHS funds and the care of NHS patients.

In response to a Freedom of Information request, Leeds Teaching Hospitals and eight other trusts reported making a loss on the treatment of private patients in some or all of the years from 2010/11-2015/16.

Already the Department of Health principles that “provision of services for private patients should not prejudice the interests of NHS patients or disrupt NHS services” and “NHS commitments should take precedence over private work” are being compromised.

This is the conclusion of a Centre for Health and the Public Interest report on NHS treatment of private patients: the impact on NHS finances and NHS patient care.

There are three main ways in which the Department of Health’s principles are being compromised:

  • the loss of capacity for treating NHS patients
  • taking notes on private patients admitted without adequate notes reduces clinicians’ time away for caring for NHS patients; and queue jumping by private patients makes NHS patients wait longer for planned operations
  • the lack of clarity about whether the 6% growth in income from private patients would represent a net financial gain to the NHS

The Centre for Health and the Public Interest report calls for measures to be put in place so that the Department of Health’s Code of Practice for Private Patients is adhered to.

Please write to your MP and your Hospital Trust Board, supporting this call.

You can email your MP here  and find your Hospital Trust Board’s contact details here.

Loss of capacity for treating NHS patients

In 2016, about 1% of NHS hospital beds in England were set aside or used for private patients at any one time. This is a small but significant percentage, at a time when hospital bed numbers have fallen considerably over the last 30 years, with more hospital bed cuts in the pipeline as a result of Sustainability and Transformation Plans/Accountable Care Systems.

The Centre for Health and the Public Interest report notes (p 8):

“With overnight bed occupancy rates peaking at 95% (or even more) during the winter months, the loss of capacity for treating NHS patients is potentially a significant issue.”

Lack of clarity about whether income from private patients is greater than the costs of treating them

At a time when NHS hospitals are massively underfunded and under pressure to make risky economies, significant NHS resources are devoted to treating private patients, without any clarity that the NHS benefits from allocating resources to the treatment of private patients.

The Centre for Health and the Public Interest report notes (p 14):

“[T]his is an issue that needs urgent clarification. When NHS income from private patients is predicted to grow by 6%/year to 2020 it is important to determine whether this would represent a net financial gain.”

The lack of clarity about the costs of treating private patients in the NHS was shown by responses to a Freedom of Information request to 117 NHS hospitals to provide income and expenditure relating to the annual number of finished consultant episodes.

73 NHS hospitals were unable to report their expenditure, mostly due to not measuring or reporting it. 9 trusts – including Leeds Teaching Hospitals and Wrightington, Wigan and Leigg – reported making a loss on the treatment of private patients in some or all of the years from 2010/11-2015/16.

There is no standard price-setting approach to treating private patients across he NHS. Some prices may be set low, and even below cost, in order to compete in the local private healthcare market or to attract or retain consultants.

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