Expanding choice

Recent moves to strengthen NHS patient choice could see more NHS patients treated in the private sector. King Edward VII’s Hospital’s head of operations Rebecca Sumner looks at how the agenda could open up new clinical pathways between the NHS and independent hospitals and introduce more patients to private treatment options.

The government has announced changes to NHS Patient Choice which are aimed at offering NHS patients greater flexibility in their healthcare journey.

From October 2023, NHS patients waiting more than 40 weeks who have not attended their first outpatient appointment will automatically be asked by their current provider if they would like to choose an alternative. GPs will also be required to offer patients a shortlist of at least five hospitals to choose from for their initial referral – including those in the private sector.

The core aim is to help reduce the backlog the NHS is facing, which comes at a time when waiting lists for elective procedures in England have increased 63% since 2019 and hit a record high of 7.2 million people. At King Edward VII’s Hospital we’re delighted to have been chosen as the alternative provider on offer in the Royal Borough of Kensington and Chelsea to help manage these delays. This arrangement will take effect in October this year.

The Patient Choice announcement will be of most benefit to two distinct groups. Firstly, there are those who already have PMI and are unaware they can self-refer from an NHS provider to an independent hospital.

“Research from Impact Marketing shows that currently 17% of people with private medical insurance are waiting for diagnosis and treatment on the NHS.”

The new pathway will encourage this group to use this benefit, which will enable them to be seen more quickly and in turn will help ease the burden on NHS services. In particular, individuals may choose to opt for this if their policy is company-funded.

Secondly, there are patients who may be encouraged to self-pay or look into PMI – either personally or via their employer – when offered an alternative to their normal NHS provider. Close to half-a-million people have taken out private health insurance over the past year due to the ongoing NHS backlog. And, as demonstrated by The King’s Fund’s recent report, this is not just limited to the super rich; people right across the income and wealth spectrum are making the choice to opt for private treatment.

Here at King Edward VII’s Hospital, we want to make the process of contacting an independent provider for a consultation directly, the simplest it can be. At the hospital, we’ve created a new contact centre and revamped the point of access for self-paying patients. This service is particularly helpful for those patients who are new to private care, allowing them to engage with a team of friendly advisors who can address any questions they may have.

Self-pay customers tend to refer themselves to an independent provider for the most worrisome issues in the first place – namely cancer screenings. The hangover of the pandemic has made patients increasingly more health anxious and impatient to have treatment expedited if possible, rather than sitting on a waiting list. According to recent NHS data up to 600,000 people are waiting longer than the two-week period to be seen after an urgent GP referral.

Being one of the providers supporting this initiative is part of our ongoing commitment to working alongside and supporting the NHS, particularly at a time when the Covid backlog is sustaining longer waiting lists. During the Covid-19 pandemic, we treated over 1,000 NHS cancer patients who needed treatment sooner than could be offered on the NHS due to the scale of the virus.

Equally, we have contracts with both King’s College London and Imperial College London to offer private treatment directly to NHS patients, for bariatric surgery and imaging diagnostics respectively. This allows the NHS some breathing space while we help to manage their patients.

In the short term, it is likely we will need to support the NHS more than ever as waiting lists return to target times. However, in the longer term, we could see another shift in patients’ attitude to private healthcare. We know that as the NHS begins to function at its best and waiting lists are managed, the public appetite for out-of-pocket expenditure on healthcare reduces.

As such, our current support system will act as scaffolding to strengthen the NHS and help it stand strong. We will continue to support the NHS for as long as needed, and truly believe with the Patient Choice agenda we can harmonise the clinical pathways between independent hospitals and the NHS whatever challenges it may face.