By Richard Johnstone | 21 October 2011
NHS patients having operations in dedicated private sector units tend to be medically fitter and to fare better than those being treated in health service hospitals, a study has found.
The Patient Outcome in Surgery audit revealed that patients admitted to independent sector treatment centres tended to be younger, fitter and from more affluent areas. NHS hospitals treated a higher proportion of patients with two or more other medical conditions.
The audit, conducted by the Royal College of Surgeons and London School of Hygiene & Tropical Medicine, looked at four common procedures provided by ISTCs – hip replacements, knee replacements, varicose vein treatment and inguinal hernia repair. Responses from 25,000 patients treated at 16 independent units and 53 NHS providers across the country in 2008/09 were analysed.
The audit found that the NHS hospital patients were 40% more likely to report poor treatment in hernia operations and three times more likely to need a further operation following varicose vein surgery.
Professor Norman Williams, president of the Royal College of Surgeons, said that study suggested that patients treated at units dedicated to elective surgery experience improved outcomes.
He added: ‘However, it also showed that independent sector providers have taken younger, fitter patients and we need to guard against any drift that could destabilise hospitals. Sicker patients have needs that only a comprehensive hospital can provide.’
The NHS Partners Network, which represents both commercial and not-for-profit independent health care providers, said that the report ‘recognises that for many patients the ISTC environment is a better one in which to carry out low-risk procedures’.
Network director David Worskett, said: ‘There is no one-size-fits-all solution. Individual patients have different needs which are best met by different types of facility and ISTCs respondwell to that patient-centred reality.
‘The facilities where patients are treated will always take into account any health conditions which may increase the risk of the procedure. It is right that patients with potential complications should always be treated at facilities with a wider range of back-up specialisms.’
Health minister Lord Howe said that ensuring that patients receive the best quality care, whoever provides it, was one of the aims of the government’s reforms to the NHS.
‘But this report also shows why we need a fair playing field, to make sure that NHS hospitals are not unfairly penalised for dealing with complex patients. That is why we want to see everyone providing NHS services paid on the basis of the complexity of the cases they are treating,’ he said.
