NHS patients in private hospitals for surgery had better outcomes
STAYS SHORTER AND CHANCES OF READMISSION LOWER, STUDY BY UNIVERSITY ACADMICS FINDS
NHS treatment provided in private hospitals left patients with shorter stays and a smaller chance of being readmitted, a study involving Leicester researchers has suggested.
The study looked at more than 3.2 million operations carried out in 734 NHS hospitals and just under half a million in 274 independent sector healthcare providers (ISHPs).
They focused on outcomes from 18 common surgical procedures performed between 2006 and 2019, including hip replacement and wisdom tooth removal.
Professors from the universities of Leicester and Birmingham said their findings could be useful at a time when the health service faces a lengthy backlog in procedures in the wake of the coronavirus pandemic.
Richard Lilford, professor of public health at the University of Birmingham, said: “There is limited capacity to deal with the backlog in NHS hospitals.
“It is hard to expand capacity rapidly even if money is provided. Therefore, there is an argument to use any unutilised capacity in independent hospitals.
“Our results suggest that it would be safe to do so.
“Had we found longer stays and more readmissions after care in the independent sector, then there would be principled arguments against such a policy.”
The researchers said NHS spending on ISHPs – private sector healthcare companies contracted by the health service – had increased steadily as a proportion of total NHS revenue spending.
The proportion rose from 3 per cent in 2006/07 to 7.5 per cent in 2015/16.
Their work, published online in BMJ Quality & Safety, showed that across all 18 operation types, the length of stay was “significantly longer” for patients treated in NHS hospitals compared with ISHPs.
They said the risk of readmission after a spinal surgery – lumbar decompression – in an ISHP was about a third of that in an NHS hospital.
The risk of readmission after gall bladder removal was 1.3 percentage points – one patient in 75 – lower for independent hospitals than for NHS hospitals.
They said: “There is evidence patients in ISHPs were more likely to be transferred to another hospital as an emergency, while inhospital death and non-emergency transfer were more likely
There is an argument to use any unutilised capacity in independent hospitals
Prof Richard Lilford
for patients treated in NHS hospitals.”
They said the risk of death was very low in both groups.
The researchers said there have previously been “plausible concerns” raised about whether NHS patients treated by ISHPs get the same standard of care, taking into consideration factors such as whether the person might need an emergency transfer from settings where there is no intensive care, and frequent reliance on a single on-call resident medical officer to provide care after an operation. But they said their findings should give “a measure of reassurance that independent sector healthcare providers are providing an acceptable service”.
They said: “In the context of meeting the backlog of cases following the Covid-19 pandemic, this may be a useful finding. “But our results stop short of total reassurance, and ongoing scrutiny of a richer set of outcomes and further investigation of practice is required in both the NHS and ISHPs.”
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