New elective contract ‘unworkable’, say providers

New national payment rules for private providers of elective care are “unworkable” and will undermine patient choice, the sector is warning.

Independent sector sources say NHS England’s proposed 2025-26 contract, which will cap the amount commissioners will pay for elective activity, will effectively force private hospitals to treat some NHS patients for free.

The proposed 2025-26 payment scheme says integrated care boards will set a “payment limit” for elective services, “above which [value] the commissioner is not required to make further payments” to providers.

However, it also says the limits do “not cut across patient choice rules, as providers would continue to be obliged to accept referrals and to offer patients choice on where they get their treatment”.

Private sector leaders told HSJ it effectively meant they could have to treat patients who choose them for free if their cap is reached. Sector sources said it was financially unviable for providers, and one branded the proposals “unworkable”.

Read full story (paywalled)

Source: HSJ, 21 February 2025