matt james: choice and independent hospitals
TRANSCRIPT
Private Healthcare Information Network Understanding competition and choice in the NHS
Prepared by Matt James, Chief Executive
for Nuffield Trust/ IFS
20 May 2013
What is PHIN?
A new not-for-profit organization
which collects data
from independent hospitals
to publish comparative information,
helping patients, policyholders and GPs
to make better-informed choices
and hence to raise standards.
• Established 2012, launched April 2013
• Not-for-profit, funded by subscriptions
King Edward VII's Hospital Sister Agnes
Our website launched on 30 April, and will feel familiar to anybody who has used Choices
• Search by: Location, Procedure & Age
• Information returned
– Contacts
– Regulated categories of activity
– Volume of activity
– Length of stay
PHIN’s remit is independent hospitals, covering both NHS-funded and privately-funded care
NHS Funding
NHS Provision
“The NHS”
NHS Funding
Independent Provision
“The Independent Sector”
NHS “patient choice” at ISTCs
and private hospitals
Private Funding
NHS Provision
“NHS Private Patient Units”
Private Funding
Independent Provision
“Private Hospitals”
NB: draft data
Around 1 million patients were admitted into independent hospitals in 2012
• PHIN’s data for 2012:
– Privately funded: c650,000
– NHS-funded: c350,000
• 183 hospitals included at present
• Website covers independent providers only at this point
• Could provide information by practice/ CCG if requested
NB: draft data
Three main points of response to IFS Report
1. High growth cannot continue
2. Quality matters at least as much as volume
3. Hips an Knees are a key focus, but not representative
– Independent providers conduct:
• c19% of Primary Hip and Knee replacements, but
• c5% of all elective procedures
Get it while it’s hot: growth of independent NHS elective care will slow dramatically
• ISTCs -
– No more being built
– All are at or near capacity
• Choice in private hospitals
– c157 available hospitals
– Only c16 remain eligible
– Marginal capacity remains
• Purpose-built hospitals
– Investment now too risky
0
200
400
600
800
1000
1200
NHS Purchased independent-provided acute care (£m)
Other
G-Sup
Diagnostic
ISTCs
Local & Choice
Source: Laing & Buisson Private Acute Medical Care UK Market Report 2012
Quality in the independent sector holds up well
Independent Hospitals Specialist Orthopaedic Hospitals NHS Hospitals
Source: Hospital Episode Statistics (HES) / PROMs, The NHS Information Centre for health and social care.
Incr
eas
ing
He
alth
Gai
n
Hip replacement – PROMS health gain
14
15
16
17
18
19
20
21
22
23
24
GR
EA
T W
ES
TE
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HO
SP
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…
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AN
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ITY
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Ad
jus
ted
Oxfo
rd H
ip S
co
re H
ealt
h G
ain
* Hospitals treating at least 50 patients during the selected period
Primary hip replacement: Top 50 hospitals* ranked by mean adjusted Oxford Hip Health Gain Score
(NHS funded care, Apr '11–Mar '12)
• Independent healthcare is much broader than hospitals (and the NHS is broader still)
– Mental health
– Primary care and Out of Hours
– Prison health
– Home healthcare
– Nursing homes
– etc
It is important to remember that hospitals are just one part of the picture
NHS Partners Network membership shows the breadth of services offered