"There is no doubt that the whole of the independent healthcare sector has swung behind the COVID-19 response, including those delivering acute, primary, community, and diagnostics care, with providers going above and beyond and responding flexibly to deliver the services patients need" - this was the response from the CEO of the Independent Health Providers Network, David Hare when we interviewed him about the impact of COVID-19 pandemic.
The private healthcare sector has, without doubt, been considered historically as a thorn in the side of the NHS. Often seen as a medium for emphasising the shortcomings of the NHS, it has, without doubt, made a significantly positive difference to ensure continuing and elective care can be provided to many patients across the UK since the pandemic started earlier this year. What many have always failed to realise is that, regardless of who the employer is, all healthcare professionals are drawn to this sector because of their own personal values. So, when private sector organisations were asked to step up and support the NHS, they did so without question.
At the end of March, NHS England announced a partnership agreement which resulted in over 25 independent hospital groups (representing almost 200 individual sites) being effectively ‘block-booked’ by the NHS and deployed as it sees fit, in both treating COVID-19 patients, and those needing urgent NHS treatment. This includes the almost 8,000 hospital beds, 1,200 ventilators, and more than 10,000 nurses, 700 doctors and 8,000 other clinical staff in the independent hospital sector, which have been made available to the NHS ‘at cost’ meaning no profit will be made. The agreement will last for 14 weeks (from the end of March) initially but the sector has committed to supporting the NHS for as long as is required.
A similar agreement has been made with independent sector diagnostics providers whereby all CT scanning capacity in the sector has been made available to the NHS, including help to diagnose COVID-19 as well as monitor progression of the virus. In total, 33 scanners and over 300 radiographers and clinical assistants have been made available, with the scanners running 24 hours a day, 7 days a week. Independent primary and community providers have also quickly adapted to treat patients during COVID-19, for example switching from face-to-face to virtual consultations in community MSK care or repurposing their services to help support the NHS.
The ‘at cost’ arrangement will undoubtedly have a significant negative impact on financial targets, as well as presenting a variety of challenges for leadership teams. The level of usage has been very varied, with some hospitals having been extremely busy undertaking various services on behalf of the NHS. One such hospital group is HCA Healthcare UK which offered operating capacity and facilities to the NHS. Specifically, at The Princess Grace Hospital, staff are supporting the North Central and East London (NCEL) Cancer Alliance who are based at UCLH. The NCEL Cancer Alliance covers NHS Trusts who serve 12 Clinical Commissioning Groups and approximately 3.5 million residents. The Princess Grace is one of four hospitals performing cancer related surgery and involves existing and new consultant surgeons working at the hospital.
On the flip side, there are other providers who have been very underutilised which presents different challenges for leadership teams in terms of staff motivation and morale. Regardless of usage, the situation presents many workforce challenges and when we asked Adrian Brady, COO at The Princess Grace, he stated ”the response from clinical and non-clinical staff at The Princess Grace team across each of the clinical and non-clinical areas is unified. Everyone is aware the challenges facing us as a country and to play our part in supporting the fight against the pandemic gives us great pride. It has strengthened existing relationships with our NHS which will only be a positive going forward”.
KIMS Hospital in Kent has echoed the call to arms and has been working with three local NHS Trusts: Maidstone and Tonbridge Wells, Darent Valley, and Medway to support patient care in Kent. KIMS has provided specialist clinical practitioners to support the care of COVID-19 patients onsite in two of the Trusts’ critical care units and has overhauled their hospital operations to provide a broad outpatient and inpatient cancer service as well as admit patients who are in need of stroke rebab services by working in close collaboration with NHS occupational therapists and physio teams who have temporarily relocated to KIMS Hospital.
Simon James, CEO of KIMS Hospital couldn’t have spoken more highly of his team: ”The response has been exemplary, and everyone across the hospital has worked closely together with the local NHS Trusts to ensure we could overcome the administrative and clinical barriers and offer a safe service for patients. Our ODPs who left to work in the NHS all volunteered, and the team who remained have all stepped up to ensure continuity of safe service at KIMS Hospital. Our support (non-clinical) teams have needed to work flexibility and fast to ensure that safe patient pathways were agreed and in place before treatment could start, and this was managed in an environment of heightened confusion and personal anxiety. Staff members (both clinical and support) have been redeployed across the hospital, working with new team members to ensure we were resourced in a manner appropriate to the new patient cohort.”
With the prospect of the block contracts set to continue for many private providers for the next 6-12 months, once the peak of the pandemic has passed, there is no doubt there will be a significant backlog of patients needing care due to cancelled and delayed NHS treatment, particularly elective surgery and diagnostics testing. There will also be a need to treat those patients who have not been accessing care in the community due to social isolating. NHS waiting times for routine surgery, for example, were already at record highs prior to the COVID-19 pandemic with waiting lists expected to rise to almost 10 million by the end of the year. Independent healthcare providers will undoubtedly need to be part of the solution in dealing with this backlog.
The NHS will indisputably always be a much-loved institution but there is no doubt that it is in need of support from the private sector, before, now and going forward.