Greater use of private hospitals will have ‘limited impact’ on NHS backlog

Despite being championed by ministers and the Labour Party, private hospitals can only play a limited role in bringing down waiting times, a new study concludes.

The Government’s Elective Recovery Taskforce, which reports soon, has been tasked by ministers with ‘turbo charging’ efforts to cut waiting times by making more use of independent sector providers (ISPs), while Labour’s Shadow Secretary of State, Wes Streeting, called for ISPs to be used to cut the backlog of treatment.

The report from the Health Foundation concludes that greater use of the independent sector, while having an important role to play, will only have a limited impact on the NHS backlog and is no substitute for addressing wider issues such as staff shortages, social care and underfunding.

Previous analysis by the Health Foundation found that the share of NHS-funded operations carried out by ISPs increased every year from the early 2000s - when it became a key plank of the Blair government’s drive to reduce NHS waiting times - to 2020/21, when the pandemic struck.

With more than 7.2 million people currently waiting for hospital treatment, the new analysis looks in detail at the use of independent sector providers (ISPs) in the delivery of NHS-funded ophthalmic (treatment for eye disorders) and orthopaedic care (hip, knee and hand procedures), two areas where the independent sector’s share of care has grown most. The new report finds: 

• Overall, the number of NHS-funded treatments has only just recovered to pre-pandemic levels. The share of this activity delivered by ISPs stands at 8.7%, an increase from 7.7% pre-pandemic.
• The independent sector has rapidly increased the number of inpatient ophthalmic care procedures it carries out for the NHS, with 4 in 10 (38.6%) procedures conducted by independent sector providers (ISPs) in February 2022 – up from around 2 in 10 (23.3%) pre-pandemic.
• Much of this growth is for cataract procedures, which are relatively simple and can easily be scaled up. This rapid scaling is not happening for most ophthalmic procedures apart from cataracts, or for orthopaedic care.
• ISPs delivered nearly a third (31.2%) of NHS-funded inpatient orthopaedic care in February 2022, up from more than a quarter (26.8%) pre pandemic, a much smaller increase.
• The study also raised important questions about inequalities in access to independent sector delivered NHS care. In ophthalmology, the analysis found that post-pandemic, overall treatment volumes in the most deprived areas were still 1% lower than before the pandemic, while in the richest areas they were 5% higher. This is largely driven by faster growth in areas where ISPs are more likely to be located.
• The study also found that, in both specialities, white patients are consistently more likely to receive NHS-funded care delivered by the independent sector than patients from other ethnic groups.

While greater use of the independent sector is a key policy for elective recovery, the public is divided on its use. Recent polling by Ipsos for the Health Foundation found that 39% of people support the NHS paying for more patients to be treated in private hospitals, with 34% opposed and 24% say they neither support nor oppose.

Charles Tallack, Director of Data Analytics at the Health Foundation, said:

‘Patients are facing unacceptable waits, and the NHS has a huge challenge to increase activity to the levels needed to bring down waiting lists. Our study shows that, while it has an important role to play, the independent sector is not a panacea for bringing down waiting lists, despite it being at the heart of the elective recovery plan.

‘To truly increase activity and bring down waiting lists, the government must address the major problems facing the NHS – from the lack of an adequate workforce plan to historic under-investment, as well as pressures in social care.’

Media contact

Creina Lilburne
creina.lilburne@health.org.uk
020 7664 4647