Private sector’s future

By Robin Stride

2018-2028 for webMassive change is on the way for independent practitioners across all areas of their work – but those who are serious about private practice can still expect to prosper.

That is a central message from ‘leading lights’ in the sector who we asked to mark Independent Practitioner Today’s 10th anniversary issue by predicting the landscape for our readers in a decade’s time.

Ten key areas to watch are:

1. Consultants

Insurers will cease to register consultants as individuals and will deal with properly established and regulated groups, according to a leading observer.

Accountant Ray Stanbridge said those who do not want to join groups will work through locum agencies or become employed by hospitals.
Positive and consistent clinical outcomes will be reflected by additional pay and those ‘not up to standard’ can expect a fee cut.

Independent Doctors Feder­ation chief executive Sue Smith agreed more would be employed directly by hospitals, but she warned doctors to beware of swapping one set of bureaucratic shackles for another.

Commentators predict Harley Street will be challenged by less expensive more local locations while some consultants could work more internationally.

Rosemary Hittinger, associate adviser to the Federation of Independent Practitioner Organ­is­ations, said: ‘The future will belong to practitioners who establish understandable and relevant measures, such as long-term sepsis rates or cancer survival rates, that prove the value they provide for their patients.’

2. Patients

Phone/text accessibility will be normal and patients will demand more information about alternatives and a more candid assessment of results.

Outcome measures, performance statistics and customer service are forecast to be increasingly greater determinants of where a patient will go than just a ‘name’. But the personal touch will remain the ‘holy grail’ with many patients, particularly for GPs.

3. Quality

Doctors will have to provide more comparable data about previous outcomes and so must do more auditing of results.

A vibrant practice will increasingly rely on showcasing quality through evidence. Patients are expected to make more informed choices about providers, using new website data.

4. Indemnity/insurance

Doctors in higher-risk areas of medicine will find it harder to get cover and some self-employed specialties will find it impossible.

New models offering doctor-specific indemnity cover could help, but a continued shift is predicted away from defence bodies to insurance companies.

5. Self-pay

Competitive pricing will be needed as self-pay increases. But doctors will need to be on the ball to ensure billing and collection procedures work.

Private GP Dr Alix Daniel said: ‘The patient of 2028 will be a self-payer or have an insurance better tailored for modern care. There will be more self-referred patients and the idea of GP referral may have vanished by then.’

6. Hospitals and clinics

In 2028, there will be fewer beds and overnight stays. All hospitals will be embracing day-case treatment referrals.

New hospitals and clinic groups will emerge where people live and some existing ones will face huge pressure or be out of business.

More doctors will commit to contracts with shares in the organisation to try and control the care they deliver, while more online clinics will provide slicker ways to provide care.

7. Technology

Doctors will have more time to care for patients, thanks to revolutionary developments, while practice/patient communication will be more streamlined and totally secure.

Online booking will be normal, there will be integration between hospital systems and practice management systems, everything will be viewable on a hand-held device and there will be robotic assistants.

Paper invoicing will be old hat, while a central online directory will hold all practitioners’ essential information in one place.

8. Private medical insurers

Groups are predicted to flourish as insurers look to this model of care. The lone practitioner will be an anachronism.

A continued push is expected to try and limit payments to private practitioners and more insurers are expected to come under bigger company umbrellas and take on their payment structures.

James Sherwood, Bupa UK director of health and benefits management, said: ‘Crucially, I expect insurers and hospital providers will seek to redesign processes and systems around the customer, enabling a simpler and enhanced experience when accessing and claiming for care.’

9. NHS

The NHS will offer more of its non-core business to the private sector. 2-5% of all NHS trust’s activity and income will be from insured and self-payers.

10. Regulation

More interventionist control from regulators like the GMC, Care Quality Commission and the Competition and Markets Auth­ority appears inevitable, according to commentators.

It is predicted accountability will continue to have additional benchmarks set by regulators that can determine a practice’s success reputation and viability.