NHS outsourcing more treatment to private firms
LONDON, UNITED KINGDOM — Services such as eye surgeries and ADHD assessments are increasingly being outsourced by the National Health Service (NHS) to private healthcare providers as part of efforts to reduce the care backlog.
According to an analysis by the campaign group EveryDoctor, NHS services have been outsourced to 2,495 sites so far in 2024, compared with 2,000 for the entirety of 2022.
The rise has been particularly pronounced in certain procedures, with more than half of NHS cataract surgeries now being delivered by the private sector compared to less than a quarter five years ago. NHS England asserts that the independent sector plays a crucial role in reducing the longest waits for care.
Mixed reactions from stakeholders
Patients have generally welcomed the move, citing faster access to treatments amid huge post-pandemic waiting lists, which have decreased from a record high of 7.8 million in December to 7.5 million.
Henry Shelford, CEO of ADHD UK, highlighted the life-changing impact of private outsourcing for ADHD assessments, stating, “We had someone come to us in desperate need… It was one of those private organizations that stepped up to help them, and they got help within four days. And it’s completely saved and changed their life.
However, some doctors have raised concerns about the potential risks associated with increased outsourcing. A recent BBC Panorama investigation revealed several deaths following surgeries at major private healthcare provider Spire Healthcare.
Dr. Julia Patterson, Chief Executive of EveryDoctor, criticized private firms for “cherry-picking” straightforward cases and lacking urgent or emergency care provisions, which places additional pressure on the NHS.
NHS outsourcing to offshore firms
In addition to domestic outsourcing, there is a growing trend of NHS services being outsourced to offshore firms.
The NHS has outsourced back office functions like payroll, procurement, and supply chain management to offshore firms to reduce costs. A government report mentioned that offshoring could provide cost efficiencies by accessing a more cost-effective workforce, though it notes potential issues around staff displacement.
For example, outsourcing firm Arvato CRM Solutions (Arvato) was recently appointed as a framework agreement supplier by the NHS Shared Business Services (NHS SBS).
Another area where the NHS has turned to offshore outsourcing is medical transcription services. According to a medical transcription company DICT8, over 80 NHS Trusts outsource their transcription work offshore to reduce costs by over 60% compared to in-house transcription.
However, this practice has sparked debate over the quality of care and the ethical implications of sending taxpayer-funded healthcare services abroad.
Critics argue that outsourcing to offshore firms can lead to a disconnect in care continuity and potential issues with regulatory compliance.
Calls for transparency and long-term solutions
The British Medical Association (BMA) expressed deep concerns about the lack of transparency in contracts between the NHS and independent firms.
Dr. Latifa Patel, BMA Representative Body Chair, stated, “The increased use of the private sector is fragmenting and destabilizing services, which threatens to put staff and patients at risk.”
An NHS England spokesperson emphasized the importance of the independent sector in reducing waiting times, noting that the Care Quality Commission (CQC) monitors and inspects private healthcare providers similarly to NHS providers.
David Hare, Chief Executive of the Independent Healthcare Providers Network, warned that patients would “lose out” if independent healthcare capacity and investment were removed from the NHS.
As the debate continues, it remains clear that while private sector involvement helps address immediate capacity issues, a longer-term strategy to increase NHS capacity and ensure high-quality care for all patients is essential.
