Summary

This is IHPN’s second report on UK independent healthcare quality. Following on from our previous report, all information has been updated, and we investigate several new areas.

The report examines numerous aspects of how independent providers are delivering safe, high-quality services to patients. Key points include:

Supporting the NHS and tackling the waiting list

• Independent providers are delivering care for increasing numbers of NHS patients, with around one in five elective NHS operations now delivered by the sector, supporting patient choice.
• Despite this increase, there is evidence that patients are waiting more than necessary. On average, NHS patients wait longer at NHS providers compared to independent providers who treat NHS patients. Waiting lists are also longer at NHS providers compared to independent organisations as a proportion of activity, indicating that there remains capacity available in the sector which could be used to treat NHS patients sooner.

Regulation

• Over 5,000 independent healthcare organisations are registered by the CQC
• On average, over 89% of overall ratings for independent healthcare organisations are good or outstanding
• 94% of services run by IHPN members are rated good or outstanding

Working across the UK

• IHPN members in Scotland and Wales  
  • bring over 7,500 employed and contracted staff 
  • carry out over 750,000 treatments and consultations per annum 
• Over 25% of all hip, knee, shoulder, elbow and ankle replacements in Scotland are carried out by independent providers 

Safety, Openess and Culture

• Last year there was an increase of over 50% in the number of Freedom to Speak Up Guardians in the sector, with over 500 now safeguarding staff rights to speak up
• More providers submitting information to Learning From Patient Safety Events (LFPSE)
• Improved transparency around adverse event data

Outcomes, Audits and Registries

• Progress has been made but areas have been identified that need to be addressed in order to go further, including:
  • Addressing outstanding information governance issues
  • Incorporating the independent sector by design
  • Improving the flow of information back to providers to improve patient care
• Significant progress has been made in the availability of information about privately funded care with PHIN achieving its ‘bronze milestone’ towards fulfilling its mandate from the Competition and Markets Authority

Listening to patients

• Patient reported outcome data that shows:
  • Increased data submission levels
  • Over half of the top 10 providers treating NHS patients for both hip and knees are independent providers
  • Over 98% of privately funded hip replacement operations leading to a patient reported health gain and 99% positive outcomes for cosmetic surgery such as augmentation mammoplasty
• Around 98% of NHS inpatients treated by independent sector organisations would recommend their provider to their friends or family
• Overall, 97% of privately funded patients rated their experience positively at independent providers

Specialist Areas

Opthamology

• The mean waiting time for admitted ophthalmology by independent providers is just 8 weeks, compared to around 21 weeks at NHS providers
• High levels of transparency in data submitted by independent providers for audit
• National Ophthalmic Database (NOD) data that shows all independent providers have complication rates that are well below expected limits

Orthopaedics

• Increases in the volume of joint replacement data submitted to the National Joint Registry (NJR). Over the past 10 years volumes have risen from just under 74,000 in 2015 to almost 140,000 in 2024
• 57% of the National Joint Registry (NJR) gold award winners for data quality were independent providers
• High patient consent rates enable datasets to be linked – hovering around 90% since 2010

Endoscopy

• 106 independent sector providers are Joint Advisory Group (JAG) accredited (54% of relevant independent providers). By contrast, 35% of relevant NHS providers are JAG accredited
• Independent providers make up half of all JAG accredited sites in the UK

Breast and Cosmetics Implant surgery

• 74% of patients were treated in the independent sector
• The most common procedure is augmentation with 97% of these carried out by independent providers

Cancer Care

• 72 services run by independent providers currently hold the Macmillan Quality Environment Mark (MQEM) award which are independently awarded to cancer services that are:
  • welcoming and accessible to all
  • respectful of people’s privacy and dignity
  • supportive of the users’ comfort and well-being
  • gives choice and control to people using your service
  • listens to the voice of the user

Diagnostics

• Independent organisations represent over half of the bodies accredited by the UK Accreditation Service for Diagnostic Imaging Services.