Carly Caton

The expansion of private patient units (PPUs) within NHS hospitals could help to solve the waiting list backlog as well as generate revenue for struggling trusts, according to healthcare leaders.

Speaking after Prime Minister, Kier Starmer, revealed his plans to develop a closer relationship between the public and private healthcare sectors, Carly Caton, a partner specialising in commercial healthcare at law firm, Browne Jacobson, said PPUs would be provide a long-term approach to help address long witing times.

She told Healthcare Property: “The Government’s stated ambition is to make facilities and resources with latent capacity in the private sector available to the NHS where it is most needed or in the ‘national interest’ to cut waiting times.

“But, if the Prime Minister really does want to form a stronger relationship between the private and public sectors, another, longer-term approach with the potential to generate additional revenue for the NHS itself while delivering better patient outcomes is to encourage NHS trusts to expand their private patient units (PPUs) by partnering with independent healthcare providers.

“Increasing private patient activity within NHS hospitals is also one of the easiest routes to develop further collaboration between the public and private sectors.

“Most trusts already run PPUs but, with the exception of a few, these tend to be relatively small, meaning they provide untapped potential in terms of raising additional income to plough back into NHS services.”

Research from Latchmore Healthcare Associates found that PPUs generated £634m of revenue in 2019 – a 14% share of the private patient market – and identified more than £500m of potential private care within NHS PPUs outside London that is treated in the NHS each year, due to most smaller private hospitals in the regions not having facilities for high acuity or high-complexity treatment.

Caton said: “PPUs are ideally placed to serve the high acuity and complex segment of the market as they can share resources within the NHS facilities. As the NHS is already treating these individuals as NHS patients, providing a private pathway would mean payment from insurers for work they are doing anyway, and effectively very high margins.

“There are numerous ways of expanding PPUs and it doesn’t necessarily require significant capital investment if a trust is willing to partner with a private provider.

“Partnership structures can extend from commercial agreements to developing some form of physical expansion to estates, and all while creating new income streams for NHS patients at no cost to the taxpayer – meaning everyone is a winner.”

Her comments came after Starmer revealed a new agreement had been struck with the independent sector as part of plans to end the hospital waiting list backlog.

As part of the new agreement, NHS England and the independent sector will:

• Work on aligning NHS and independent sector digital systems around a national set of standards so patients can more easily see appointments and results on the NHS App
• Encourage longer-term contractual relationships to be established, enabling further independent sector investment in NHS capacity
• Work together to grow and develop the elective workforce, including ensuring training occurs consistently in the independent sector

Starmer said: “Mission-led government is about doing things differently.

“When the waiting lists have ballooned to 7.5 million, we will not let ideology or old ways of doing things stand in the way of getting people’s lives back on track.

“As we deliver our Plan for Change to rebuild the NHS, it would be a dereliction of duty not to use every available resource to get patients the care they so desperately need.

“That’s why this agreement will make sure working people get greater choice over when and where they receive their treatment and provide more support to the areas in greatest need.”

The deal will set out how independent sector capacity can be used to tackle some of the longest waits in specialist areas of treatment, such as gynaecology, where there is a backlog of 260,000 women waiting more than 18 weeks for treatment.

Orthopaedics will also be a key focus, where over 40% of patients are waiting longer than the 18-week target.

The agreement will also give patients in more deprived areas, where NHS provision is more limited, a greater choice over where they are treated.

Health and Social Care Secretary, Wes Streeting, said: “Millions of patients are being forced to wait unacceptably long for treatment, failed by 14 years of neglect of the NHS.

“I’m not going to allow working people to wait longer than is necessary when we can get them treated sooner in a private hospital, paid for by the NHS.

“If the wealthy can be treated on time, then so should NHS patients.

“This new agreement will help to cut waiting time faster in parts of the country where the need is greatest, and in gynaecological care where women are left waiting far too long.”

Welcoming the announcement, David Hare, chief executive of the Independent Healthcare Providers Network (IHPN), said: “This new agreement is a clear statement from Government, the NHS, and independent sector that independent providers are a critical part of the NHS’s long-term recovery and renewal.

“Independent providers already treat millions of NHS patients every year, and this agreement builds on these strong foundations by making full use of existing capacity in the sector, ensuring that patients are offered proper choice of provider as well as supporting the sector to invest in, and deliver, an even wider choice of high quality services to NHS patients to bring waiting times down – all delivered free at the point of use and paid for at NHS prices.”