Effects on NHS Patients

There are indications that some trusts are giving preference to private patients to the detriment of NHS patients. For example, the Royal Marsden says in the section of its Forward Plan [1] outlining how the trust informed governors:

Governors agreed to the development and implementation of a strategy for an increase in private activity. This is expected to achieve a business of £100m (50 – 60%) increase as soon as realistically possible.

In 2011/12 private patient income was £51m so “a business of £100m” is a significant increase in the number of private patients. However, the trust also says in its Forward Plan:

Without new investment in hospital capacity any further increase in private capacity is likely to require a reduction in NHS capacity.

This indicates that the trust will treat fewer NHS patients. The trust says that it will increase the numbers of private patients and it will need to decrease the numbers of NHS patients. If private patient income is to benefit NHS patients then an increase in the number of private patients should lead to an increase in NHS patients.

The University Hospital Southampton NHS Foundation Trust has problems achieving the 18 week target for cancer patients and the May 2012 board papers [2] says that the trust agreed with commissioners to move 250 patients from the trust’s waiting list to private providers.

However an RTT recovery plan has been signed off with commissioners which will see commissioners supporting the movement of up to 250 patients directly from the UHS backlog to private sector providers. This provides a level of mitigation for the by specialty performance to be delivered in full by the end of Q2.

Meanwhile, the same board papers [3] says that a priority area for the trust’s sustainability is:

Diversification of Income. Training and increase volumes of private patients.

These two statements say that the trust has problems providing its core purpose, which is to provide services for NHS patients, yet it plans to increase the number of private patients it treats. This raises the question of why the trust is keen to distract itself with private patients when it has problems treating NHS patients, so much that it has to transfer those patients to private providers?

The Dudley Group’s CarePlus private unit delivers dermatological services of a low clinical value that NHS commissioners no longer fund. However, the trust’s Annual Report [4] says that the trust has problems delivering capacity for maternity:

To continue providing safe, effective care for women and their babies accepted for delivery at Russells Hall Hospital, we have reluctantly taken the decision to temporarily limit future bookings to the maternity unit for a period of 12 months from April 2012 while we look into the feasibility of increasing capacity to meet demand.

This indicates that the trust is turning away mothers-to-be because of capacity issues, but they still have the capacity to provide private patients with treatments that have low clinical value.

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[1] www.monitor-nhsft.gov.uk/sites/all/modules/fckeditor/plugins/ktbrowser/_openTKFile.php?id=10781
[2] Key Performance Indicators, p74 www.uhs.nhs.uk/Media/TBFiles/TBfiles2012/PapersTrustBoard29thMay2012.pdf
[3] Ibid, 5 Year CIP Update, p105
[4] www.monitor-nhsft.gov.uk/sites/all/modules/fckeditor/plugins/ktbrowser/_openTKFile.php?id=12991