18 November 2005
More than 100 investigations into standards at five new private sector treatment centre providers were triggered between April 2004 and June 2005, a report for the Department of Health revealed this week.
The study examined the first five private treatment centres to begin treating NHS patients since the scheme to increase private sector competition and capacity was introduced in 2003.
The report, which was produced for the DoH by the National Centre for Health Outcomes Development based at Oxford University, assessed the centres against the 26 'key performance indicators' stipulated in their contracts.
The KPIs included a number of 'sentinel events' – such as return of patients to theatre after their initial operation and security breaches – which triggered a local investigation. Four out of the five providers examined had been subject to such investigations.
One provider, Partnership Health Group, which runs centres in the Trent and South Yorkshire regions, had 70 patients returned to theatre over the 13-month period, representing 2.15% of all patients treated.
The report's authors noted, however, that without details on the case mix of patients treated across the different centres (which would indicate the likelihood of clinical complications), it was impossible to judge what volume of returns should be expected.
The report did find, however, that the Partnership Health Group under-performed on clinical cancellations and unforeseen inpatient admissions.
Birkdale Clinic in Daventry and Netcare mobile ophthalmology units also reported clinical cancellation rates that were over their KPI thresholds.
The KPIs were also intended to measure emergency readmissions. However, the report authors said it would be 'inappropriate to consider a judgement of performance' on this score, as the reporting arrangements had been poorly designed.
The authors also noted that the data collected by the treatment centres did not include patients readmitted into NHS hospitals.
Health minister Lord Warner heralded the report as 'heartening', and said that the report showed that the private centres were subject to a more robust quality assurance system than their NHS equivalents.
However, although the report confirmed that the performance regime was 'demanding' in theory, the authors found that in practice, many indicators were badly formulated by the DoH and poorly reported on by the providers.
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