IHPN statement on the Covid-19 partnership with the NHS

In March 2020, as Covid-19 first took hold in the UK, NHS England announced a historic partnership with the independent hospital sector. This meant that almost 30 independent hospital groups made their entire capacity (staff, estate, and equipment) available to the NHS on an at-cost basis. A recent report has led to media reporting that contains some important misconceptions about this partnership. This statement is intended to provide further context and information to promote better understanding of the issues.

Claim 1: few Covid-19 patients were treated in independent hospitals which means that the whole arrangement was poor value for money.

Private hospital capacity was first secured by the NHS as part of the overall strategy to free-up “the maximum possible inpatient and critical care capacity”, including an additional 30,000 hospital beds. As statements from March 2020 made clear, independent sector “staff and facilities will… be flexibly available to [the NHS] for urgent surgery, as well as [the independent sector] repurposing their beds, operating theatres and recovery facilities to provide respiratory support for COVID-19 patients”.

At this point, nobody knew how large or sustained the impact of Covid-19 would be and how much pressure this would place on the UK health system. It was therefore the right decision to secure all additional capacity to make sure that the UK could avoid the experience of other countries (such as parts of Italy) which had seen their health services completely overwhelmed by Covid-19. As it was, that catastrophe was averted thanks to the success of lockdown measures and the health system was able to provide care to all the Covid-19 patients who needed it.

This meant that relatively few Covid-19 patients were treated in the independent sector. Instead, since the early weeks of the pandemic the ask from the NHS was for the independent sector to create Covid-free ‘green’ pathways and sites so that urgent treatment for cancer and other conditions could continue while NHS Trusts cared for the majority of Covid-19 patients.

Additionally, many independent sector hospitals transferred large numbers of staff and significant amounts of equipment such as ventilators to NHS providers to increase their ability to care for Covid-19 patients. This won’t show up in activity figures about the number of Covid-19 patients treated but was an important contribution to the overall response.

Claim 2: only 2m NHS procedures were carried out in the independent sector over the first year of the pandemic

This is incorrect. 3.2 million NHS procedures were carried out under the national hospitals contract from March 2020 to March 2021. This figure is taken from official NHS England data This does not include the many NHS procedures carried out by independent providers not in the national hospital contract – including community, diagnostic and outpatient surgery providers.

Claim 3: the hospital contract did not provide good value because the capacity was not used

The capacity of independent sector providers was crucial to helping the NHS cope with the Covid-19 crisis. Throughout the period covered by the national hospitals contract theatre utilisation in independent sector hospitals ran at an average of 90% and independent hospitals consistently outperformed activity targets set by the NHS.

In addition, independent providers often took on more complex care that had previously been delivered by NHS providers including cancer treatment. Over 160,000 NHS cancer treatments were carried out in independent hospitals.

The contribution of the independent sector was recognised at the time.

Amanda Pritchard, now CEO of NHS England said: “The independent sector has been critical to our ability in particular to maintain cancer services throughout the pandemic. About half the beds we have been using in the independent sector have been for cancer patients”

The cross-party House of Commons Health and Social Care committee said: “We commend the efforts of the Government, NHSE/I and the independent sector for stepping up and securing independent sector capacity which has been crucial to supporting the NHS during the pandemic.”

Then Secretary of State for Health Matt Hancock MP said: “The independent sector has played a critical role in helping us get through the crisis… We could not have got through the crisis without the combined teamwork of the public and private sectors”

We are very proud of the part that the sector played in the Covid-19 response. Capacity was made available on an at-cost basis and the sector did everything that the NHS asked of it. With the NHS now facing a huge challenge in recovering from Covid-19, the backlog of care today would be much bigger without the contribution of the independent sector of 2020 and 2021.