Private practice lift off!

On 25 August,2020 | In News

It’s all change again for private practice access. The chairman of the Federation of Independent Practitioner Organisations (FIPO), Mr Richard Packard, reveals the plan

Mr Richard Packard

Since the beginning of the Coronavirus crisis, the hospital providers in the independent sector have had a role in providing extra capacity for NHS patients to allow the NHS hospitals to cope with a surge in Covid-19 patients. 

This was, of course, with almost total cessation of private treatment. There was always going to be a phased withdrawal from this extreme position – and the latest changes have now been revealed.

In phase two of the NHSE contract with the independent sector, weekday hours from 9-5 belonged to the NHS. Time outside this was for use for private treatment. 

The onus on using the weekday capacity was very much with NHS trust managers. This was not satisfactory as a way to restart private practice. 

But FIPO understands from recent conversations with the Independent Healthcare Providers Network (IHPN) that this has now fundamentally changed.

In London, almost all private providers will be removed from an NHS contract with effect from 7 September. This will apply to a few other centres outside London also. This will mean there will be a return to pre-Covid arrangements.

Cutting waiting lists

For the rest, as reported in the press, the Government has earmarked up to £10bn to reduce the NHS waiting lists, which have been vastly inflated as a result of the cessation of routine elective surgery during the pandemic. 

This money will be paid to private providers for clinical services under a new procurement framework that the NHS intends to put in place essentially to supersede the current contractual arrangement. 

The Prior Information Notice (PIN) for this framework was published on 17 August: https://ted.europa.eu/udl?uri=TED:NOTICE:386840-2020:TEXT:EN:HTML&src=0

Here is a brief description from the tender document.

‘This PIN provides early notification of the intention to launch a Procurement in September to establish a Framework Agreement of service providers able to support the reduction of waiting lists forecast to increase as a result of Covid-19 interrupting and reducing available NHS capacity.

The services in scope are: 

  1. NHS inpatient and outpatient services – including full supporting pathology and imaging services – and urgent elective care and cancer treatment to service users in line with nationally set criteria; 
  2. NHS inpatient non-elective care – either direct admission or transfer from an NHS organisation. The framework agreement may be accessed by all clinical commissioning groups and NHS trusts and foundation trusts across England.’

Bids invited

This procurement framework is just like any other public sector procurement in that it invites bids from relevant providers on a commercial basis. There is no scope for an industry-wide approach here and it will be up to individual operators if and how they choose to respond.

Tender bids will need to be received by 27 August and the contracts awarded by the end of November. The contracts will be expected to run for two years in the first instance with an option to extend for a further two years. 

The major difference with previous arrangements is that the independent sector providers now decide whether they want to be involved in providing these services for the NHS, not the other way around. 

Of course, as in the past, some hospital groups will want to continue to do NHS work as the majority of their throughput. Others may feel that private practice will bounce back, probably assisted by a surge in self-pay patients who choose not to wait for the NHS.

In the meantime, until the new procurement arrangements are finalised, the IHPN has renegotiated the current NHS contract so that private hospitals will be free to utilise the following from 7 September:

 London – 100% of their capacity for private patients;

 South East – 30-40% of their capacity for private patients;

 Remainder of England – a minimum of 25% of normal working hours capacity for private patients with immediate effect;

 Scotland looks like it will follow London in allowing private hospitals to return towards pre-Covid arrangements;

 Northern Ireland has already allowed private hospitals to return to pre-Covid arrangements;

 Wales is likely to allow 25% of core hours for private patients.