Intended for healthcare professionals

Feature BMJ Investigation

A sixth of hospitals in England have expanded private patient options this year, the BMJ finds

BMJ 2013; 347 doi: (Published 17 July 2013) Cite this as: BMJ 2013;347:f4524
  1. Gareth Iacobucci
  1. 1BMJ

As hospitals look for ways to boost their income, Gareth Iacobucci discovers that some are taking advantage of the rationing decisions being made by hard pressed clinical commissioning groups

A BMJ investigation shows that NHS hospital trusts in England are increasingly turning to income from private patients to generate additional funding, as cost pressures tighten restrictions on some services in the NHS.

Just a week after NHS England warned that the NHS might face a funding gap of £30bn (€35bn; $45bn) by 2020,1 the BMJ has shown that one in six hospitals have introduced new private treatment options this year.

A growing number of hospitals are introducing a new category of private patient, known as the “self funded” patient. Tariffs for this new category are based on estimates of what it costs the NHS to treat these patients and are considerably lower than the traditional rates charged to private patients.

John Appleby, chief economist at the healthcare think tank the King’s Fund, described the difference between the two categories as immaterial and the new category as a euphemism. “It is essentially paying privately to get some healthcare provided by the NHS. It is a private scheme.”

The BMJ investigation, which obtained data from 134 acute hospital trusts in England through requests made under freedom of information legislation, found that:

  • 119 trusts (89%) now offer private or “self funded” services

  • 21 (16%) added new self funding or private treatment options for 2013-14, and

  • 17 (13%) now allow patients to pay for one or more services at notional NHS rates, under the self funding scheme.

In the past year acute hospital trusts across England have added procedures in areas such as ophthalmology, radiology, and varicose vein surgery to their roster of services that patients can pay for at cheaper rates rather …

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