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NHS outsourcing to the independent sector: politicians vs the public

Words by:
Account Director
January 14, 2022
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It’s no secret that the NHS is dealing with a serious challenge, both in the short term due to Covid-19 hospitalisations, and over the medium term as it deals with a growing care backlog. Throughout the pandemic, the NHS has made use of private hospitals, ranging from the bulk buying of independent hospital capacity in early 2020, to a more tailored “on call” approach since 2021, often referred to as “surge capacity” by Health Secretary Sajid Javid.

Now a new deal with the independent sector has been struck, triggered in part by extremely high staff absences in the NHS, combined with a growing number of non-Covid patients now seeking treatment. The three-month agreement will see independent healthcare organisations put staff and facilities put on standby to support the NHS should Covid-19 lead to unsustainable levels of hospitalisations or staff absences. The deal will only be triggered if Covid patients in a particular area prevent the NHS from providing urgent care – not an unrealistic scenario given that multiple Trusts have received help from Army medics in recent days.

Unlike previous arrangements, the new deal will allow NHS Trusts to send a wider range of patients to the independent sector for treatment including those requiring some forms of cancer surgery and other care not normally delivered under existing arrangements. This reflects the growing number of non-Covid patients now seeking treatment, after largely avoiding doing so during the first and second Covid waves. Balancing the needs of Covid and non-Covid patients will be a key challenge for the NHS over the rest of the winter period, further stretching capacity and staffing.

The current pressure on the NHS has also shifted the political perception of the independent sector’s involvement. Labour has signalled a move to a more pragmatic position in recent weeks, with Shadow Health Secretary Wes Streeting MP stating that Labour supported the use of the independent sector to clear the significant care backlog of 13 million cases (and rising). This change of position means that the government and the largest opposition party now clearly support the use, albeit limited, of the private sector in the NHS. Given the scale of the challenges faced by the NHS, additional longer-term arrangements are likely to be made at a local and national level and the signs are that the use of private provision will form part of this.

While politicians may see a clear need for outsourcing to the independent sector to help ease the burden on the NHS, the public isn’t yet so sure. Polling conducted in December 2021 by WA’s in-house Research and Insights team has shown that the public are considerably more sceptical of the commissioning of the independent sector by the NHS than politicians.

While a significant minority (37%) of people think the NHS should commission the independent healthcare sector to help eliminate the care backlog, many remain unconvinced by its use. Further doubts exist over the profit that these companies should be able to make on NHS contracts. 45% of respondents stated that private healthcare providers should not profit from such contracts, with only 12% believing independent sector providers should be allowed to make uncapped profits on NHS contracts. While public perceptions of the independent sector making large profits from NHS contracts differ from the reality – agreements have broadly been to provide services at cost so far – they will nonetheless be a key stakeholder over the medium term as independent sector involvement in the NHS continues.

The NHS will need additional independent sector to enable it to make headway with the care backlog over the longer term, making long-term working arrangements between NHS Trusts and private hospitals extremely likely. While the independent sector will have the backing of Parliament, maintaining public consent for its work may require careful management.

If you would like to discuss the results of WA’s Research and Insights polling in more detail, please get in touch.

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