NHS England has announced it is to relinquish its access to more than 90% of private hospitals’ beds, staff and equipment.
When the pandemic hit, the health service struck a deal giving it access to the majority of England’s private sector capacity at cost price.
Now, local areas will pay by operation, as and when they need extra beds.
But doctors’ bodies have questioned why the NHS would give up beds when millions are waiting for operations.
NHS England acknowledged it would need to keep using private hospitals’ beds and staff in its efforts to get the health service back to normal.
However, it plans to move towards local agreements with the private sector in what it describes as the “next phase of the response to coronavirus”.
This will involve local commissioning groups paying for the number of extra beds and staff they think they’ll need, rather than having access to a block of beds on standby.
NHS England said it would still fund local spending on private hospitals.
At the start of the UK’s coronavirus outbreak, forecasters predicted the number of people needing hospital beds could be many times greater than the number of beds available.
Protecting the NHS from collapse became one of the government’s main priorities.
In March, the private sector agreed to make almost all of its bed and staff available to the NHS, as well as providing thousands of ventilators and other equipment.
In the end, numbers hospitalised were lower than expected and the NHS was able to cope.
Since then, though, a new problem has emerged – the cancellation of planned operations and tests has created a big backlog of people needing care.
As the coronavirus crisis was developing in March, NHS England signed what seemed a prudent deal at the time, gaining access to most of the private sector hospital beds with their staff.
But this block booking has cost about £400 million a month, whether or not the facilities were used.
Now in London, and some other parts of England, the NHS has started pulling out and reverting to the familiar pay-as-you-go model for operations in private hospitals.
It will certainly save money and the Treasury will have pushed for a more effective use of resources.
But one private sector source says it “came out of the blue” and appears to be at odds with the Prime Minister’s suggestion that some of a recent £3bn allocation for the NHS would be used for a continued deal with independent providers.
There is a backlog of millions of patients waiting for routine operations and procedures, such as hip and knee replacements.
It is not yet clear whether the latest change will help or hinder the process of reducing waiting lists.
Some of the private sector capacity available to the NHS was used for cancer and non-urgent operations between May and July.
But waiting lists are nevertheless predicted to reach 10 million by the end of the year, though NHS England aims to have non-urgent services back to 90% of pre-Covid levels by December.
Health charities and organisations representing doctors have stressed the need for non-Covid patients to receive care they may have missed over lockdown – and to make sure people don’t miss out of vital diagnostic tests including for cancer.
President of the Royal College of Surgeons of England, Prof Neil Mortensen said: “The litmus test of these new targeted, local arrangements will be whether the NHS hospitals affected can continue to work with local private hospitals as necessary to ensure patients get the care they need.
“Those who are languishing on waiting lists are in need and often in pain.
“Many experience reducing mobility and diminishing independence while they wait, and this has knock-on effects on their families, their employment and the economy. Neither the country nor the individuals can afford longer waits than they do already.”
A spokesperson said NHS England would it was continuing its agreement with the “vast majority of independent providers” until the autumn, meaning “tens of thousands more people will be able to benefit from quicker access to surgery and other treatments”.
After that, it said the health service would negotiate “a new deal available to all independent sector providers based more closely on activity to ensure taxpayers get full value from the expenditure”.
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