Government announces independent health sector expansion to cut waiting lists
Independent hospitals that provide treatment for eye conditions, including Newmedica and Spire Healthcare, have welcomed the plans
04 August 2023
The Government has announced further expansion of the independent healthcare sector’s role within the NHS, in an effort to boost patient choice and increase capacity.
Ahead of the final report of the Elective Recovery Taskforce, which will be published today (4 August), MPs Steve Barclay and Will Quince announced the creation of 13 new Community Diagnostic Centres (CDCs), as well as a new process of referral for patients waiting over 40 weeks for treatment.
The CDCs should “deliver more than 742,000 additional scans, tests and checks a year,” the Department of Health said, adding that “the taskforce aims to form strong local relationships between NHS organisations and the independent sector.”
New CDCs will be opened in Southend, Northampton, Birmingham, Redruth, Devon and Torbay, Yeovil, Bristol, Weston-Super-Mare, Hornchurch, Skegness, Lincoln, Nottingham and Stoke-on-Trent.
Some will be NHS-led, while others will be managed by the independent sector.
The report also sets out plans for increased choice for patients at the point of referral, with a minimum of five “clinically appropriate” providers offered where possible.
By October 2023, patients who have been waiting more than 40 weeks for confirmation of their first outpatient appointment will be able to initiate a request to transfer to another provider.
The plans will “give commissioners of healthcare services more flexibility when selecting NHS and independent sector healthcare providers” and “help to promote collaboration across the NHS and wider healthcare system,” according to the report.
NHS England is tracking the number of outpatient referrals made to both NHS and independent hospitals, and is publishing the monthly numbers on its website.
NHS data shows that non-GP referrals made during May 2023 were up 16.3% per working day when compared to May 2019 – an increase of over 78,000.
The Elective Recovery Taskforce is a group of health policy advisers, patient and NHS England representatives, and private healthcare executives, established in December 2022.
It is chaired by health minister, Will Quince, and is tasked with looking at solutions to bring down NHS waiting times.
Rebecca Lythe, CEO of Newmedica, welcomed the Government’s plans.
“We share the objective of collaboration with commissioners and promoting patient choice at the point of referral,” Lythe said.
She added that “Newmedica is looking forward to continuing and strengthening its collaboration with the NHS that has developed over the past 15 years.”
Newmedica is a provider of independent ophthalmology services, currently operating 18 NHS contracts in the UK.
The company is supporting the NHS to deliver training, with eight of its sites hosting at least one trainee ophthalmologist.
Over 100 optometrists have also received training at Newmedica over the past year, the company said.
"We look forward to growing further capacity and treating those still waiting for care with chronic eye conditions,” Lythe added.
Justin Ash, CEO of Spire Healthcare, which offers treatment for eye conditions including glaucoma, cataracts and diabetic retinotopy, believes that “the best way to cut waiting times for patients is for the independent sector to be fully integrated as part of the solution, and to offer patient choice.”
“We welcome the Elective Recovery Taskforce’s recognition of this and are pleased that it has recommended some bold and far-reaching steps to encourage collaboration, promote patient choice and engage the independent sector to help deliver the NHS Long Term Workforce Plan,” Ash said.
Patients will “be able to choose where they can receive treatment most quickly, regardless of whether that’s at an NHS or an independent sector hospital,” he added.
Chief executive of Independent Healthcare Provider Network, David Hare, who sat on the taskforce, called the plans “a real, significant step forward to unlocking more of the capital, capacity and capability of the independent sector.”
Patient groups have also welcomed the plans. Rachel Power, chief executive of the Patients Association, said: “We are advocates of patients having choice and welcome today’s announcement. In particular, the news that GPs will tell patients, at the point of referral, of options for treatment other than the local hospital or clinic.
“Patients in England already have a right to choose where they are treated, but not all patients are aware of this right or exercise it.”
Deputy chief executive of NHS Providers, Saffron Cordery, also welcomed the plans, telling BBC Radio 4 that “at a time when resources are significantly constrained, looking beyond NHS resources in order to support trusts is very important.”
“What we do need to see is desperately needed additional capacity,” she added.
The political view
Speaking to Sky News on Friday morning (4 August), Conservative MP Maria Caulfield said that the independent sector is being used for its capacity, and that £19 billion is being spent in utilising it – which she called “good value for money.”
NHS England’s commissioning budget for 2022–2023 is £153 billion.
Caulfield later acknowledged that waiting lists, which currently stand close to 7.5 million in England, are likely to increase “in the next few months.”
“That’s why we’re making announcements like this now, so that we are getting that capacity and that infrastructure so that patients can get their treatments more quickly,” she told LBC, adding: “Yes, we’re being honest with people that the total number is likely to rise a little bit more before they start to come down.”
Shadow secretary of state for health and social care, Wes Streeting, has previously been vocal about the potential of the private sector to open up capacity in the NHS.
A Labour government would also utilise “spare capacity” in the independent sector, he said.
The independent healthcare sector has capacity to carry out around 30% more appointments than it currently does, according to the BBC.
The view from the membership sector
Carolyn Ruston, the AOP’s policy director, said: “We welcome the plan from the Elective Recovery Taskforce to find ways to reduce waiting times and treat patients more quickly.
“Ophthalmology is the second largest NHS backlog, with 628,502 patients waiting for appointments as of March 2023. Community optometrists, accessible on the High Street, can play a vital role in reducing this backlog through the consistent commissioning of primary eye care services that enable optometry led diagnosis, treatment and aftercare for patients.”
President of the Royal College of Ophthalmologists, Professor Ben Burton, also emphasised the number of ophthalmology patients waiting for an appointment, and welcomed the integration of eye services in community diagnostic centres – something he believes is “vital to help us prevent avoidable sight loss.”
“The recommendation that commissioners take a more strategic approach to delivering capacity across the NHS and independent sector is welcome, ensuring capacity is available where patient need is greatest,” Burton said. “We also are pleased that Government has listened to our representations and emphasised the need for independent sector providers to provide training where they are delivering NHS-funded procedures.”
Burton expressed concern, however, that “the Government risks seeing the independent sector as a panacea in its ambition to greatly increase its provision in the NHS.”
More than half of NHS-funded cataracts are now delivered by the independent sector, Burton said.
He noted that while this has helped to bring down the cataract backlog, the Government should learn lessons from dentistry, “where access to NHS services has become difficult, leading to growing health inequalities.”
“The Government must not forget that NHS services exist to deliver comprehensive care for all conditions, including rarer diseases,” Burton said.
“This means the primary focus needs to remain on investing in the NHS workforce and infrastructure to ensure we have comprehensive sustainable services into the future, which also provide training and world class research.”