Private sector ‘should take the lead in cancer’

By Robin Stride

A private hospital group boss has urged the independent healthcare sector to seize the opportunity to be at the forefront of cancer care.

He argued that the private acute sector could be leading the way in innovative and world-class cancer care.

John Reay, president and chief executive of HCA Healthcare UK, challenged providers at Laing-Buisson’s Private Acute Healthcare Conference to ‘shape’ healthcare delivery not just follow it.

They should think outside the traditional parameters of the elective private provider model, he said.

For his hospital group, this had meant investing in a system that enabled it to overcome small single-site challenges and achieve the strong governance, innovation and patient-centred care that clients expected.

Mr Reay said: ‘At HCA UK, we have run a series of surveys about what our patients most seek in their cancer treatment. It is interesting to discover that, in Britain at least, being treated at known hospitals is “desirable”, but not top of the patients’ list.

‘The key requirement is being treated in a governed and managed system, accompanied in their journey and knowing that the best and latest treatments are available to them.’

Accompanying the patient

He explained that, at HCA hospitals, a clinical nurse specialist accompanies the patient and helps explain their treatment – from supporting their understanding to communicating with doctors, arranging tests and helping schedule appointments.

Medical boards are run for each tumour type across its hospital network, chaired by senior consultants. They oversee best practice, innovation and ensure multidisciplinary teams (MDTs) are reviewed for every patient.

MDTs needed a lot of support, he said, ensuring each meeting had at least two of each specialty to guarantee balanced judgement. 

This was easy at site level for common cancers, but for rarer varieties use was made of the group’s network to run a cross-site MDT drawing from 366 cancer specialists.

 

A key concern for patients was safety. But Mr Reay said the private sector was slowly busting the myth that it could deal with hips or hernias but not cancer.

Surgical on-call rotas

Part of that safety was having surgical on-call rotas ready to cover an emergency post-op. Voluntary rotas provided no guarantees, as surgeons had NHS on- call commitments and could not be always on call.

‘Again, using our network of hospitals, HCA UK delivers back-up from paid surgical rotas. The cost of these rotas can be carried by our collective group.’

He told the conference consultants were reassured by the presence of a high level of ST5, ST6 trainees and resident doctors. 

HCA had 120 critical care beds to guarantee intensive care, if needed, and a 24-hour ambulance service available to move patients when requested.

‘Since 2018, out of over 105,000 inpatient admissions, only 34 or 0.14% have required a transfer out. Conversely, in the past 18 months we have transferred in 461 patients from the NHS.’

Mr Reay said increasingly good Care Quality Commission results were being awarded across the whole private acute care industry and the sector should ensure the message about its quality and safety was much stronger. 

National registries

Independent providers should embrace opportunities to submit data to national registries and where they could not, to push to be part of them.

‘The divergence that exists between how the NHS and independent sector providers record activity is making it difficult for patients to compare the care being provided. We want to make it easier for patients to make that comparison. 

‘We have been lobbying to be able to do more on this and we hope that upcoming changes to the Health and Social Care Act reflect this.’

The hospital chief urged the sector to support the work of the Private Healthcare Information Network (PHIN). 

‘Transparency can provide irrefutable evidence of quality care. And transparent outcomes drive improvement. We have introduced patient-recorded outcome measures in multiple specialties, going above and beyond the standard PHIN requirements.’

He said by creating a network of over 800 beds, ‘approximately the size of a large teaching hospital’, HCA UK had provided the infrastructure that enable the type of care that a single-site operation of 50-200 beds would find prohibitive.

The model worked particularly well across London, but the group could also apply elements of this to its location in Manchester and, coming in January 2024, in Birmingham.

• See ‘Surrey’s new cancer hub’