Treatment centres run by the private sector are profiting from NHS funding by taking on less risky patients while being paid the same rate as publicly funded hospitals, a study suggests.
Patients treated in centres that carry out thousands of planned procedures, such as hip and knee replacements, to relieve pressure on the NHS are less likely to come from deprived areas, have fewer diagnoses and undergo fewer procedures than those treated in NHS hospitals, according to analysis of more than 3.3 million patient records funded by the Department of Health.
The national system for funding hospitals for treatment - known as Payment by Results - pays hospitals and treatment centres the same average cost for carrying out particular types of operation.
The average cost of a hip operation, for example, is about £6,000. But the actual cost to a hospital can be much higher, meaning that ISTCs could be profiting by taking on only less complicated, less expensive cases.
The study, by the University of York and others, published in the journal Health Policy, found “evidence that hospitals are treating patients of greater complexity than treatment centres”. The authors add: “If these observed differences between hospitals and treatment centres drive costs, then payments should be refined to ensure fair reimbursement.”
The authors say: “If treatment centres routinely treat patients with less complex needs within a healthcare resource group, they may profit at the expense of NHS hospitals. If so, this would suggest that the prospective payment system is unfair.”
Keith Brent, deputy chairman of the BMA’s consultants’ committee, said that, unlike NHS hospitals, ISTCs could “cherry pick” patients who were less likely to need expensive treatment. He echoed the call for any centre with a selection policy to be paid a lower tariff.
Read more at The Times.
