In this week's Daily Mail (I don't confess to be an avid reader....), the Health Editor publishes the results of an "investigation" which highlights how NHS trusts are encouraging NHS patients needing cataract surgery to opt for private treatment within the NHS trust.
The Daily Mail submitted Freedom of Information requests to 150 NHS trusts and from the 91 responses concluded that " more than half of NHS hospitals now allow patients to pay for treatment themselves." and that "Some actively encourage them to jump the NHS queue or bypass the strict eligibility criteria by paying themselves, known as ‘self-funding’."
They also reported that:
- University Hospital Southampton, patients are offered a ‘cataract choice service’ where they pay £1,400 per eye.
- Leeds Teaching Hospitals is charging £3,450 per eye.
- The Royal Free in London charges £2,750 per eye.
For comparison, the Private Healthcare UK Self Pay Market Study 2016 reports the lowest price for cataract surgery in the UK at £1,850 (Chelmsford Private Day Surgery Hospital), the median price point at £2,310 and the highest at £3,400 (London Vision Clinic).
53 of the responding Trusts said that a total of 697 patients had opted for self funding in the past year. It is estimated that around 320,000 cataract operations are undertaken in the NHS each year, so we are probably talking about less than 1% of patients opting for the paid for NHS option.
The NHS establishes thresholds for cataract surgery. It is believed that some Trusts are now tightening up on their approach to reduce the pressure on waiting lists; offering the option of self funded treatment within the NHS is of course one solution.
In May 2016, ophthalmology Referral to Treatment Waiting Times in England looked like this:
- 370,235 patients were waiting to start treatment.
- 92% of patients were waiting less than 17 weeks.
And during May:
- 41,271 patients started admitted treatment.
- And half of these patients started treatment within 12 weeks.
If the NHS PPU's were to adopt a more aggressive role in targeting waiting list patients, could they help to reduce the growing pressure on NHS funded services. And what would be the political impact ?
The growing role of the NHS PPU
The role of the NHS PPU in healthcare provision in the UK has always been a confused one, and a political hot potato.
Laing & Buisson estimate that in 2014, £476 million of private patient revenue was generated within NHS private patient facilities. In London, those PPUs within the teaching hospitals deliver significant revenues for their NHS trusts, with a high proportion from international patients. Private patient income at Moorfields Eye Hospital in London and though its operation in Dubai rose from £16.1m in 2010‑11 to £23.0m in 2015/16 and made a made a net contribution to the trust of £4.3 million.
The lifting of the "private patient income cap" has meant that more NHS trusts are looking for opportunities to grow their income through the delivery of private treatment. Can they achieve this in the current political environment? And more importantly, can they compete effectively with their rivals in the commercial sector?