Merits of private work in NHS units
There are some big advantages for consultants in doing their private practice in NHS private patient units (PPUs). Andrew Robertson shows why.
When I managed my first private surgical hospital some 25 years ago, a patient, funded by the NHS, arrived for his elective surgery and immediately ordered a bottle of champagne, thinking it would be on the house.
I mention this by way of an example as to what people thought when ‘going private’ – the smart environment, one’s own room with en suite bathroom, a fine selection of food and drink.
Speed of access to treatment and one’s own consultant were also considerations. But quality of treatment, safety and outcomes were not necessarily at the forefront of a patient’s mind.
Thankfully, this has changed over the years with patients far more focused on the quality of their care and the performance of both surgeon and hospital.
Environment and experience do, of course, matter – we all enjoy a little luxury – but they are not the most important elements of restoration to good health.
The range and complexity of treatments offered in any hospital will depend upon its facilities, equipment and resources, particularly the training and expertise of its staff.
Safety net
NHS hospitals in general have large departments focused on specific specialties, with those departments having specialist staff including consultants, nurses, radiographers and therapists.
In addition, there is always a range of medical and clinical staff on-site as well as on-call. They will have intensive care units that support the more complex surgery and provide a safety net to any adverse events.
Although some will say that all those staff and facilities are there for NHS patients, all patients, whether on a public or private pathway, are trust patients and will of course be cared for, irrespective of this, should the need arise.
Limited facilities
Many private hospitals, particularly the smaller ones, have more limited facilities and staffing structures and therefore have a limit on what treatments they can offer. That does not mean to say that the care is substandard; far from it
Many will concentrate on more routine, elective surgery with only those with higher dependency or intensive care units able to offer more complex surgery.
Consultants who choose to develop their private practices in any hospital should think about whether that hospital will support and even enhance their reputation.
They will want their patients to be grateful that their consultant chose to take them to that hospital because they had an excellent outcome and felt safe and well looked after. The overall experience is very important, but the outcome the highest priority.
Mix of facilities
There is a real mix of facilities offered by trusts specifically for private patients. These range from dedicated private patient wards, theatres and consulting rooms comparable to any smart private hospital, to the use of side rooms and little differentiation between NHS and private pathways.
For the less complex surgery where risk is much lower, perhaps the quality of facilities may be more important to some, but the more complex the surgery the importance surely diminishes.
While I would argue that it is worth trusts investing in private patient facilities, even those that are still considering it have much to offer consultants that complement the quality of care for their private patients.
Key factors include convenience and familiarity. If the trust enables the development of private practices, then why waste time travelling elsewhere when it’s on your doorstep and one can see inpatients more easily?
Familiarity a bonus
Familiarity of the environment and facilities is an advantage, as well as with the staff one is used to working with and trust. If specialist NHS staff who regularly work with consultants can be involved in the treatment of private patients, it gives consultants confidence in the delivery of excellent care.
Few would argue that multidisciplinary healthcare is not optimal; something the NHS is very good at. Having one’s consultant colleagues available to discuss difficult cases is something not always available at another hospital and provides an extra level to the quality of care.
Trusts that support and develop private patient services will want their consultants to practise with them rather than go to the local private hospital. This provides consultants with the opportunity to organise their job plans to accommodate both their NHS and private work.
There is no doubt that certain days of the week and times of the day are more popular with private patients, so being available at those times will help facilitate the growth of a practice.
If the commitment is to see and treat private patients at the trust, then it is in the trust’s interests to look at how job plans can be arranged to suit the demands of both the NHS and private patients.
Support the NHS
During my time at Moorfields Private, the message that resonated most with potential referrers was that all monies generated from private patients in the trust went towards all patient care, education and research. GPs, optometrists, physiotherapists and other referrers generally want to support the NHS and the work it does.
Referring their private patients to the trust is one way of doing this. It is also another reason for consultants to base their private practices where they are employed.
But to get this message out there, it’s important there are resources and mechanisms to do so. Setting up private patient services is one thing, but having the right staffing to deliver and promote the services is essential if they are to prove successful and give consultants the confidence that seeing and treating private patients at their trust will be beneficial.
There are distinct advantages in having a private patient service within NHS trusts, both for the patients in terms of their care but also for the consultants. But if the opportunity is to be realised, there needs to be the right investment both in facilities and staffing.
Andrew Robertson (right) has spent his career managing private hospitals, for the last five years as director of private care at Moorfields Eye Hospital. He is now keen to support the development of other PPUs. Contact him at andrew@pripatconsulting.co.uk