South London and Maudsley NHS Foundation Trust
The Forward Plan  gives as a risk the number of NHS patients having to be put into private sector beds.
Acute and forensic overspill into private sector beds if activity cannot be managed within SLaM’s own bed capacity. New risk share arrangements are in place with local PCTs for 2012/13 and the Trust is progressing plans to open new triage beds to help mitigate any potential impact.
For example, the May 2012 Board papers  say
Overall 22 beds had been used outside the Trust in March, the highest number all year and at levels not seen in the Trust since 2009. Croydon was the main area of pressure which had 24 acute overspill placements in the private sector on 12/4/2012. Discussions have taken place with the PCT to agree the 2012/13 contract and in particular the agreement to risk sharing on this issue. These had reached successful conclusion.
In the Forward Plan the trust identifies as a risk the greater tendency of commissioners to tender services:
Increase in tendering may result in contracts being awarded to a broader range of providers, which will have a negative impact on the Trust’s income.
The Forward Plan says that the trust is expecting to expand its private patients business:
To continue to be a market leader SLaM will be looking to broaden it’s [sic] market base with a growing national (NHS and self-funding) and international income base to offset reductions in income from local commissioners.
As a key milestone in 2011/12 to maintain financial sustainability, the trust says:
Identification of new business opportunities and markets including the Trust’s private patient income stream
The Forward Plan gives some details about its plan to increase private patients, giving the following timetable:
2011/12 Pilot selected private patient services. 2011/12 Expand the private patient services offered and income generated. Perform regular reporting & review based on cap limit. 2012/13 Create formalised relationships and service level agreements [SLAs] with the independent sector [such as Private Medical Insurers]. 2013/14 Review and refresh private patients strategy
The trust also says that it will:
As part of the SLaM strategy the Trust is looking to develop business outside of its existing operating areas.