London electives plan to shift care away from private providers

Vast swathes of elective orthopaedic surgery in north central London could be repatriated from the private sector as part of proposals to consolidate activity at seven NHS trusts into two partnerships.

Under the plans, The Royal Free London NHS Foundation Trust and North Middlesex University Hospital NHS Trust, along with Chase Farm and Barnet Hospitals, would form the ‘northern partnership’, the Whittington Hospital and University College London Hospitals (UCLH) NHS Foundation Trust would create the ‘southern partnership’.

All inpatient orthopaedic care, including that currently carried out at Aspen’s Highgate Hospital and BMI’s The Cavell and Kings Oak Hospitals, would transfer to new ‘cold’ sites at Chase Farm and UCLH. Patients needing very specialist care would continue to be seen at the Royal National Orthopaedic Hospital in Stanmore.

The three private hospitals currently treat around 1,700 inpatient and daycase patients a year from across the local NHS health systems.

The consultation document said both partnerships would ‘benefit over the medium term from a shift of activity from the private sector to the NHS’.

It estimates the northern partnership would deliver savings of £1.37m over the four years to 2024 from moving activity out of the private sector, while the southern partnership is expected to save £130,000 over the same period from the transfer.

‘It is anticipated that, having consulted on a new model of care for planned orthopaedics commissioners would look to cease directly commissioning work from the private sector, as they would expect directly commissioned orthopaedic work to flow through the new elective centres to gain the benefit of all the quality gains,’ said the consultation.

IHPN CEO David Hare told HM that although not widespread, there were moves to repatriate care away from private providers in some pockets of the NHS.

‘It is totally counter-productive. It drives a coach and horses through patient choice and is something that should be taken back to the drawing board. The aim of any commissioning system should be to use all the available capacity in the locality and these proposals smack of protectionism,’ he said.

The consultation runs until April.