Matt James: Choice and independent hospitals

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Matt James: Choice and independent hospitals

  1. 1. Private Healthcare Information NetworkUnderstanding competition and choice in the NHSPrepared by Matt James, Chief Executivefor Nuffield Trust/ IFS20 May 2013
  2. 2. What is PHIN?A new not-for-profit organizationwhich collects datafrom independent hospitalsto publish comparative information,helping patients, policyholders and GPsto make better-informed choicesand hence to raise standards.• Established 2012, launched April 2013• Not-for-profit, funded by subscriptionsKing EdwardVIIs HospitalSister Agnes
  3. 3. Our website launched on 30 April, and will feelfamiliar to anybody who has used Choices• Search by: Location, Procedure & Age• Information returned– Contacts– Regulated categories of activity– Volume of activity– Length of stay
  4. 4. Initial information is modest, but much more will beadded over coming months
  5. 5. PHIN’s remit is independent hospitals, covering bothNHS-funded and privately-funded careNHS FundingNHS Provision“The NHS”NHS FundingIndependent Provision“The Independent Sector”NHS “patient choice” at ISTCsand private hospitalsPrivate FundingNHS Provision“NHS Private Patient Units”Private FundingIndependent Provision“Private Hospitals”NB: draft data
  6. 6. Around 1 million patients were admitted intoindependent hospitals in 2012• PHIN’s data for 2012:– Privately funded: c650,000– NHS-funded: c350,000• 183 hospitals included atpresent• Website covers independentproviders only at this point• Could provide information bypractice/ CCG if requestedNB: draft data
  7. 7. Three main points of response to IFS Report1. High growth cannot continue2. Quality matters at least as much as volume3. 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
  8. 8. Get it while it’s hot: growth of independent NHS electivecare 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 risky020040060080010001200NHS Purchased independent-provided acute care (£m)OtherG-SupDiagnosticISTCsLocal & ChoiceSource: Laing & Buisson Private Acute Medical Care UK Market Report 2012
  9. 9.  
  10. 10. Quality in the independent sector holds up wellIndependent Hospitals Specialist Orthopaedic Hospitals NHS HospitalsSource: Hospital Episode Statistics (HES) / PROMs, The NHS Information Centre for health and social care.IncreasingHealthGain Hip replacement – PROMS health gain1415161718192021222324GREATWESTERNHOSPITALS…NORFOLKANDNORWICH…UNIVERSITYHOSPITALSOF…THEROYAL…SPIREHULLANDEASTRIDING…THEHORDERCENTRE-ST…EMERSONSGREENNHS…SPIRENORWICHHOSPITALCOUNTESSOFCHESTER…WORCESTERSHIREACUTE…MIDCHESHIREHOSPITALS…IMPERIALCOLLEGE…CALDERDALEAND…SPIREPORTSMOUTHHOSPITALDUCHYHOSPITALHAMPSHIREHOSPITALSNHS…BMI-THEALEXANDRA…SPIRELIVERPOOLHOSPITALBMI-BATHCLINICAIREDALENHSFOUNDATION…SPIRECHESHIREHOSPITALYEOVILDISTRICTHOSPITAL…BMI-GORINGHALLHOSPITALABBEYGISBURNEPARK…PORTSMOUTHHOSPITALS…MIDESSEXHOSPITAL…PENINSULANHSTREATMENT…NORTHUMBRIAHEALTHCARE…ROYALSURREYCOUNTY…CAMBRIDGEUNIVERSITY…SHEPTONMALLETNHS…SURREYANDSUSSEX…CLAREMONTHOSPITALCHELSEAANDWESTMINSTER…BARLBOROUGHNHS…NUFFIELDHEALTH,DERBY…TRAFFORDHEALTHCARENHS…EASTCHESHIRENHSTRUSTBMI-THESANDRINGHAM…BMI-THEDROITWICHSPA…SPIREMURRAYFIELDHOSPITALSPIRELEEDSHOSPITALROYALDEVONANDEXETER…SPRINGFIELDHOSPITALIPSWICHHOSPITALNHSTRUSTSPIREWASHINGTONHOSPITALNUFFIELDHEALTH,NORTH…BMI-THORNBURYHOSPITALMOUNTSTUARTHOSPITALDORSETCOUNTYHOSPITAL…AdjustedOxfordHipScoreHealthGain* Hospitals treating at least 50 patients during the selected periodPrimary hip replacement:Top 50 hospitals* ranked by mean adjusted Oxford Hip Health Gain Score(NHS funded care, Apr 11–Mar 12)
  11. 11. • Independent healthcare is much broader than hospitals (and theNHS is broader still)– Mental health– Primary care and Out of Hours– Prison health– Home healthcare– Nursing homes– etcIt is important to remember that hospitals are just onepart of the picture
  12. 12. NHS Partners Network membership shows thebreadth of services offered

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