Private hospitals overtake NHS for hip and knee replacements

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Private hospitals offer more hip and knee replacements than the NHS for the first time since the procedures were widely introduced in the 1960s and 1970s.

While the NHS remains focused on Covid-19, independent hospital chains, including Circle Health Group, Nuffield Health, HCA Healthcare and Spire Healthcare, have doubled the number of private patients, according to an analysis of official figures from the consulting firm in Candesic healthcare for the Financial Times. .

Although the total number of hip and knee surgeries remains lower than in 2019, research found that 56% of the total surgeries performed in the first eight months of this year were performed in private hospitals, against 40% during the same period. two years ago.

Michelle Tempest, analyst at Candesic, said it was a “turning point” that showed more people “are choosing to go private.” “There is a change happening and we are seeing the consumerization of health care; people are starting to shop and some are choosing to go private as the waiting lists keep growing. “

Hip and knee surgeries have traditionally been the ‘bread and butter’ of private hospitals, with outsourced NHS work being an important part of their business model. But the number of NHS patients treated at their facilities has dropped significantly, from 27% of the total volume in 2019 to 18% in 2021.

The shift from NHS work to privately paying patients comes despite long waiting lists for treatment and a deal last year when the government paid all of the operating, interest, rental and staff costs of the hospitals in exchange for their help during the public emergency. The government still has not disclosed the cost.

David Rowland, director of the independent think tank Center for Health and the Public Interest, said the private hospital sector could not provide this level of activity without the use of thousands of NHS consultants working in their spare time.

“It must be difficult for the 5.3 million people on NHS waiting lists to know that NHS employees are choosing to spend their time treating paying patients rather than helping clear the backlog of the NHS, ”he said.

Although most private operations are still paid for through insurance plans, the biggest growth has been patients paying an upfront fee for their operation, especially in areas where NHS hospitals have been slow to re-establish elective surgeries. The price for a hip or knee replacement surgery varies between £ 8,000 and £ 15,000 depending on the provider and location.

Private hospital operators prefer self-paid patients because the margins are higher than for outsourced NHS work. “Everyone in the industry is having an exceptional year for self-pay,” said a private hospital operator. “All of the private hospitals are pretty full and are looking at how they can increase productivity, for example by opening weekend evenings. If you run a private hospital for the sake of profitability, you want self-pay as much as possible.

Circle Health Group, which merged with BMI to become Britain’s largest private hospital operator, said it was using MRI scanners on the backs of trucks in hospital parking lots to deal with the increase in Requirement. It is also expanding two of its hospitals with factory-built modular theaters this fall as part of a £ 100million investment program.

Spire, the only listed private hospital company in the UK with 40 hospitals across the country, has already reported an 81% increase in self-pay revenue in the second quarter of 2021 compared to the second quarter of 2019.

Growth of the private sector may be hampered by a shortage of operating room capacity, as well as staff, most of whom work for the NHS. However, two of the largest hospital chains in the United States – the Mayo Clinic and the Cleveland Clinic – are planning to expand in the UK, with Cleveland planning to hire its own doctors breaking the model used by the rest of the hospital industry. private. .

Research shows NHS hospitals have restarted elective surgeries such as hips and knees at very different rates, with some areas like South West London performing only 10% of the operations they performed before the crisis .

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