Britain’s National Health Service is outsourcing an increasing number of eye and hip operations in order to cope with the growing demand for surgeries.
The National Joint Registry reports that the NHS has performed more routine surgeries in its hospitals until 2014. However, the increase in the last decade is barely noticeable as the private sector plays a larger role.
The numbers indicate that the NHS is increasingly relying on private providers to cover the costs of medical treatments. This poses a risk to the long-term financial stability of the NHS.
Michelle Tempest is a partner with healthcare consultancy Candesic. She said that the NHS needed to use private sector services more for scheduled, non-emergency surgeries, including a variety of surgical and medical procedures. She added that the trend “is likely to spread to other operations”.
Using outsourcing can help speed up treatment and decrease waiting lists in certain situations. However, most operations are actually done by NHS staff in their free time in private hospitals. This might limit the staff’s availability for state services. Medical experts also warn that fragmented and lack of expertise in handling post-operative complications can harm patients’ health.
Both the Conservative Party and the Labour Party have agreed to increase the involvement of the private sector in the NHS. Outsourcing is expected to continue as the national policy.
Wes Streeting, shadow health secretary, said: “Nobody should wait in pain as hospital beds that are available lie empty”. Labour will utilize the extra capacity of the private sector to expedite patient care.
More than a third (35%) of hip and knee surgeries funded by the NHS in England, Wales, and Northern Ireland are done at private hospitals like CircleHealth Group or Spire Healthcare, according to the National Joint Registry.
More than half of hip and knee replacements are done by private healthcare providers because many patients have insurance or pay for the procedures themselves. According to Timothy Wilton, the medical director of NJR, the increase in patients choosing to pay for private healthcare shows that the system is broken. Waiting lists have significantly increased as a result.
Although hip and knee replacements are considered planned procedures, they still have a significant impact on people’s quality of life.
According to the latest NHS statistics, waiting times for routine hospital treatments in England reached record levels in September. Patients waited for nearly 7.8mn appointments.
The NHS charges less than independent hospitals for a simple hip replacement. The price charged by independent hospitals to private patients is between £12,000.00 and £15,000.00. Private hospitals, especially in wealthy London, prefer to accept insured or self-paying clients.
NHS England pays private and state hospitals the same fee for each operation, but the tariffs may not accurately reflect the complexity of the operation.Wilton said that most private hospitals did not have intensive care or multidisciplinary medical support, so they took the easy cases and left the more expensive, difficult, and difficult patients to the NHS.
The patient can also be sent back to NHS if the operation is not successful. NHS hospitals are still facing financial challenges due to dealing with complex cases that require multiple clinical experts and long hospital stays.”The full cost of the care never gets met,” said Tempest from Candesic.
NHS England agreed that it is right to use all the available resources, including the independent sector, to decrease waiting times and provide the best possible care for patients.
These problems are exacerbated by the rapid decline in NHS hospital beds across England. According to the Kings Fund, the number of beds has decreased by more than half in the last 30 years, to only 141,000, despite a rapid increase in patient numbers.
The number of beds in the wards has been reduced because it was thought that many operations could be done as day cases. This has caused problems for the urgent patients and the hip and knee surgeons who now struggle to find beds. Surgeons sometimes couldn’t perform their work despite being paid due to long waiting times.
The government stated that it was “on track to create an extra 5,000 permanent hospital beds staffed this winter.”
There has been a sharper increase in the outsourcing of ophthalmology to private operators, such as Spamedica Newmedica Optegra and large private hospitals.
According to Jordan Marshall, policy director at the Royal College of Ophthalmologists, there has been a significant increase in the outsourcing of cataract surgeries in the past five years.
60% of cataract procedures funded by NHS in England are done by private sector, which is a 30% increase before pandemic. NHS England reimburses a total of around PS841 for a straightforward cataract surgery procedure.
Marshall said that private healthcare is necessary to decrease waiting lists for cataract surgeries, but there are concerns about the NHS aftercare. More complex surgeries for high-risk patients, such as those with glaucoma or age-related macular degeneration, may also be delayed, Marshall cautioned.
The majority of treatment is provided by NHS staff in their spare time in private clinics and hospitals. According to Tim Gardner from the Health Foundation, the NHS pays a price because of the time spent by staff on this.
Gardner mentioned that although the private sector can assist the NHS in handling the backlog of elective care, it cannot be a substitute for addressing the major problems in the health system.