matt james: choice and independent hospitals

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Private Healthcare Information Network Understanding competition and choice in the NHS Prepared by Matt James, Chief Executive for Nuffield Trust/ IFS 20 May 2013

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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

Initial information is modest, but much more will be added over coming months

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.

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Hip replacement – PROMS health gain

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* 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