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Found 246 results
  1. Content Article
    In January 2025, the Republican majority in the House of Representatives’ Budget Committee offered a list of possible spending reductions to offset revenue losses from proposed tax cuts. In May, the Committee advanced a bill incorporating several reductions on the list. The Committee estimated that the 6 largest potential Medicaid cuts (for example, work requirements for some Medicaid enrollees) would each reduce the federal government’s Medicaid outlays by at least $100 billion over 10 years. On the basis of the Committee’s estimates of savings; Congressional Budget Office analyses; and peer-reviewed studies of the coverage, financial, and health impacts of past Medicaid expansions and contractions, the authors project the likely effects of each option and of the House bill advanced by the Budget Committee in May. Each option individually would reduce federal Medicaid outlays by between $100 billion and $900 billion over a decade, increase the ranks of the uninsured by between 600 000 and 3 900 000 and the annual number of persons forgoing needed medical care by 129 060 to 838 890, and result in 651 to 12 626 medically preventable deaths annually. Enactment of the House bill advanced in May would increase the number of uninsured persons by 7.6 million and the number of deaths by 16 642 annually, according to a mid-range estimate. These figures exclude harms from lowering provider payments and shrinking benefits, as well as possible repercussions from states increasing taxes or shifting expenditures from other needs to make up for shortfalls in federal Medicaid funding. Policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would accrue mostly to wealthy Americans.
  2. Event
    until
    The report “To Err is Human: Building a Safer Health System” is often considered a turning point in the history of patient safety, raising alarm both about the volume of “preventable” medical errors, and the state of safety management in healthcare relative to other industries. The report called for the adoption of a wide range of practices from other industries, in particular aviation, ranging through incident reporting and investigation policies, team training methods, management systems, and structured risk assessment methodologies. ‘To Err is Human’ exemplifies a phenomenon that to me is quite remarkable. Healthcare – one the best educated, professionalised skeptical and evidence-based domains – is willing to set aside its usual standards of critical thinking when adopting practices from other industries. In this talk, Dr Drew Rae makes the argument, illustrated with examples from projects across a range of industries, that to a certain extent safety problems are universal, with patterns repeating across domains. However, he will also present some reasons to believe that the problems are exacerbated rather than improved by the uncritical adoption of safety ‘solutions’ between industries. Register
  3. News Article
    The NHS handed private firms a record £216m last year to examine X-rays and scans because hospitals have too few radiologists. The amount of money NHS organisations across the UK are paying companies to interpret scans has doubled in five years as demand rises for diagnostic tests. Despite the growth in privatisation, the NHS in England failed to read 976,000 X-rays and CT and MRI scan results within its one-month target – the highest number ever. Scans play a crucial role in telling doctors if a patient has cancer or a broken bone, for example. The Royal College of Radiologists (RCR), which collated the figures from doctors across the UK, said the £216m given to private firms in 2024 was “a false economy” which it blamed on the NHS’s failure to recruit enough specialists to read all the scans patients have in its hospitals. The college said the growing outsourcing of scan analysis risked creating “a vicious cycle” in which NHS radiology services were increasingly weakened and its doctors drawn to private work. Dr Katharine Halliday, the RCR’s president, said: “The current sticking plaster approach to managing excess demand in radiology is unsustainable and certainly isn’t working for patients, who face agonising waits for answers about their health. “It is a false economy to be spending over £200m of NHS funds outsourcing radiology work to private companies, and evidence of our failure to train and retain the amount of NHS radiologists we need.” Read full story Source: The Guardian, 15 May 2025
  4. News Article
    NHS-funded access to private autism and ADHD services is “unsustainable” and “up to three times more expensive than our local provision”, according to an integrated care board’s review. Northamptonshire ICB found the use of independent providers under “right to choose” rules for diagnosis and treatment of autism and ADHD was expected to cost it £3m in 2024-25, according to the document obtained by HSJ. This represents an additional 66% on top of its £4.5m budget for its commissioned autism and ADHD services. Extremely long waits, rocketing demand, and a growing market nationally have seen a big rise in people exercising choice rules, which require commissioners to pay for treatment if a provider has a contract with at least one other ICB. In its review of community paediatric services, the ICB said its spending growth on the independent sector is “unsustainable” as “costs are up to three times more expensive than our local provision”. NHS funding of the same services is effectively capped as they are on “block” contracts. The review was completed in December and recently released after a Freedom of Information request. Government has deprioritised tackling long waits for these services, but NHS England last year launched a national taskforce on the issue. The ICB’s review warned any “national solution will almost certainly involve greater use of the independent provider market”, which it said was less cost-effective than its commissioned services. Read full story (paywalled) Source: HSJ, 6 May 2025
  5. News Article
    Young professionals are giving up on the NHS and going private for cancer checks and diagnostic scans, new data shows. A record one million people received health tests and scans privately last year, as the public grew increasingly disillusioned with long and stressful waits for GP appointments and checks. The report by the Independent Healthcare Provider Network (IHPN) found that demand for private health tests has soared among working-age professionals in their twenties, thirties and forties. Experts said this reflects a desire to get “peace of mind” for worrying symptoms quickly and on demand. Adults are placing a premium on being able to book appointments at a convenient time and location, often opting for private clinics near their workplace so they can pop out during lunch breaks. David Hare, the chief executive of IHPN, said: “This latest research from IHPN shows that going private for vital scans and tests is becoming increasingly normalised, with speedy access to appointments and the ability to receive results often within 48 hours a key attraction for patients looking for much-needed peace of mind and value for money. “This is particularly the case for younger people, who are accustomed to high quality, convenient and personalised services in many other aspects of their lives, and hugely benefit from the increasing number of private diagnostics services available near their homes and workplaces.” Read full story (paywalled) Source: The Times, 14 April 2025
  6. Content Article
    There is no surgical procedure which is 100% risk-free of problems. Hospitals, clinicians, consultants, and their teams are fully aware of the responsibility to treat patients safely. However, there are also several things that you can do as a patient to help support you own safety while having a surgical procedure, as outlined in this article from the Private Healthcare Information Network (PHIN).
  7. Content Article
    The Independent Healthcare Providers Network (IHPN), which represents independent providers delivering both NHS and privately funded care, have conducted research looking at a broad range of official datasets to evaluate quality and safety in key areas across independent healthcare. Part of this includes looking at patient access to timely healthcare which is increasingly being seen as an issue of quality given its profound impact on patients’ lives. While the volume of NHS activity carried out by independent providers has increased in recent years – with 1/5 of all NHS operations now delivered in the sector – waiting times remain considerably lower at independent providers compared to their NHS peers. Overall, 275 people are waiting at independent providers per 100 people treated each month, compared with over 500 people waiting for every 100 receiving treatment in the NHS. Swift access to NHS care in the independent sector can be seen most clearly in ophthalmology, where the average waiting time in an independent provider is just 8 weeks, compared to around 21 weeks at NHS providers. New analysis also shows that patients treated in independent providers are themselves reporting high quality outcomes. The NHS’ latest Patient Reported Outcome Measures (PROMS) data shows over half of the top 10 providers for both hip and knee adjusted health gain are from the independent sector, with PROMS data showing 98% of private patients reporting their conditions improved after a hip replacement, and 93% for knee replacements. IHPN’s report also notes the work the sector doing to help support and empower its staff to drive through improvements in patient safety and develop a culture of openness and learning, including: Increasing the numbers of Freedom to Speak Up Guardians in the sector by 50% in the last year to over 500 in total. Establishing new Patient Safety Specialists which are a requirement for all organisations delivering NHS-funded care with almost one third of all PSSs in the health service now found in the sector.
  8. News Article
    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
  9. Content Article
    This study in JAMA explored whether measures of patient care experience change after private equity acquisition of US hospitals. The study showed that patient-reported care experience, an important dimension of care quality, worsened after private equity acquisition of US hospitals.
  10. News Article
    A growing “exodus” of dentists willing to provide care on the NHS threatens to exacerbate the crisis in patients’ access to treatment, the profession’s leaders have said. Dentists are increasingly stopping doing NHS-funded work because their fees for many procedures do not even cover the costs involved, according to the British Dental Association (BDA). The fact that NHS payments had not kept pace with rising costs was forcing dental surgeries in England to “operate like a charity” when carrying out work for the health service, it said. The situation was so serious that dentists were in effect subsiding the NHS care they provided from their private work to the tune of about £332m a year, according to BDA analysis. Dentists lost £42.60 every time they fitted dentures and £7.69 on each examination of a new patient’s dental health when the NHS was paying for the treatment, it said. The findings come weeks after Wes Streeting, the health secretary, warned MPs that “NHS dentistry is at death’s door” and promised to take steps to save it from extinction. The inability to get NHS dental care, and the consequent emergence of “DIY dentistry” and “dental deserts” across swaths of England, has become a key public and political concern in recent years. Read full story Source: The Guardian, 13 February 2025
  11. Content Article
    Spire Healthcare’s cultural journey through 2024 highlights how any healthcare organisation can leverage frameworks like PSIRF, coupled with supportive initiatives like Quality Improvement and Freedom to Speak Up, to drive meaningful change and create environments where safety, trust, compassion and collaboration thrive. In 2024, Spire Healthcare took a bold step towards enhancing patient safety by implementing the Patient Safety Incident Response Framework (PSIRF) across its network of hospitals. This was a legal obligation for NHS patients in England, but Spire chose to implement for every patient – private and NHS – in England, Scotland and Wales. Developed by NHS England, PSIRF redefines how healthcare organisations approach patient safety incidents, shifting the focus from blame to system-wide learning and improvement. For Spire, this was not just a compliance exercise – it represented a cornerstone of cultural transformation, fostering openness, collaboration, and continuous improvement. This work culminated in Spire being named as a finalist at the 2024 HSJ Patient Safety Awards, in the ‘Developing a Positive Safety Culture’ category. This recognised Spire’s dedication to embedding safety principles into our DNA. Central to culture were two key enablers alongside PSIRF: a robust Quality Improvement (QI) strategy and the organisation’s commitment to the Freedom to Speak Up (FTSU) initiative, both of which were deeply integrated with PSIRF to support a positive cultural shift.
  12. News Article
    Women in Britain are paying up to £11,154 for a hysterectomy in a private hospital, amid huge delays for NHS gynaecological care, research reveals. The cost of undergoing the procedure privately has soared by 19% from £7,385 in 2021 to £8,795 last year, at a time when NHS waiting lists have risen sharply. The disclosure has prompted claims independent sector healthcare providers are taking advantage of long waits for health service treatment by increasing their prices. The number of women waiting for care in an NHS hospital for conditions such as fibroids and endometriosis more than doubled from 360,400 when Covid struck in 2020 to 749,329, the Royal College of Obstetricians and Gynaecologists has shown. In November 584,607 women in England were on an NHS gynaecological waiting list, with 20,809 of them being on the list for more than a year, which led to a growing number of women going private to beat delays. Dr Ranee Thakar, the RCOG’s president, said untreated conditions “have a devastating impact on almost every aspect of [women’s] lives, including their physical and mental health, and their ability to work and socialise. “Long NHS waiting times are certainly a factor in why some women choose to have their surgery privately,” she added. Read full story Source: The Guardian, 24 January 2025
  13. Content Article
    Hi, my name is Andrew Payne. In October 2019, my late wife Janice was in the palliative stage of her cancer when she was a victim of a dispensing error. This was caused in large part by an intransigent pharmacist who refused me an emergency supply of medication for my wife a few days previously. Failures by the pharmacy branch and Janice's GP meant she had to endure the side effects of ingesting the medication of a patient with the same surname as her. She will have suffered pain, discomfort and harm. This much has been admitted by the private pharmacy company involved. I would like to share the series of events leading to my wife's death and after, and the actors involved and the questions that need to be answered. The pharmacy As much as the pharmacy involved said "we take this kind of circumstance very seriously", the truth is that they worked very hard to see the case closed. The pharmacy did not mention to me the failures of their staff to observe the Duty of Candour. They did not direct me to the industry regulator. Instead, I was advised that this case was being reviewed by their ‘customer complaint process’ and I was sent a ‘customer charter’. Their process gave the pharmacy a 20-day cushion for them to thoroughly investigate the error and in this time they batted away my questions and queries. Their own internal investigation found nothing untoward apart from the terrible human error of a lady behind the counter who served me as the pharmacist refused (against company and industry guidelines) to come out herself to see if my request for the emergency medication had merit or not. I made a complaint to the General Pharmaceutical Council (GPhC) and they found sufficient evidence to open an investigation. A pharmacy executive was unhappy about this and made efforts to assure the GPhC that this was a simple case of human error despite knowing that this was in fact more than a simple case of human error. The pharmacy executive went on to convince the GPhC investigators that they did not need to question the pharmacy staff that they had identified to take statements from, and, instead, this ‘non-involved’ executive became the single witness representing everyone. The insurers I was witness to the harmful influence of insurers, who indemnify healthcare professionals causing them to question their actions in an error circumstance. When the pharmacy company introduced me to their indemnity insurer, I conducted an internet search and found a piece of advice to their pharmacist members on the National Pharmacy Association website on how to react in a dispensing error circumstance. In my opinion this advice was written by a legal executive and I suggest it is an invitation to their members to breach their professional duties to their patient. When I discovered this, I advised the pharmacy company that their branch team had followed this advice almost to the letter. This triggered unseemly actions by both the pharmacy and the insurer. I had many exchanges with them in which I invited them to remove this terrible advice from their website, but was told this is typical advice, and of course it is, but this comes in the form of ‘deny liability’ and represents a threat to all NHS patients. The National Pharmacy Association did eventually removed this when the Chief Pharmaceutical Officer for England at the time became involved. I was unable to convince the GPhC that their investigation was corrupted and, therefore, invalidated. The regulator The GPhC took 18 months to take statements from the pharmacy executive and myself, consider the factors and make their decision. I called their investigation ‘a parody’. I was beside myself with astonishment and despair to see that they did not include the breaches in the Duty of Candour in their investigation. I received an unsigned letter from the ‘outsourced’ solicitor company investigators. I was advised that they had found the pharmacy company to have acted positively to the error and that there were no grounds for further action. I wrote a strong letter of discontent, in which I reminded the CEO of the regulator that he was a signatory to the joint statement on the Duty of Candour in 2014. To his credit, he commissioned an outsourced review of the handling of the case. Unfortunately for the cause of finding the truth, learning lessons and doing the right thing, this review was poor. There were aspects of the review that the CEO did not agree with and he ordered that the case should be reviewed again. Seven months of ‘investigations' later, it came to the same conclusions as the first investigation, albeit with a more wordy outcome letter. Janice and I, as the ‘public being protected’ by this regulator, had been failed on a monumental scale. Putting patients in harm's way I have looked behind these fine words and promises to protect the public to find a different set of interests being placed before the public. I have seen the betrayal, not just of the GPhC but also of other regulators. I have seen the flaws in the authority tasked with overseeing these healthcare regulators and I have seen the depth of failure. I was forced by the GPhC to use the Freedom of Information Act to learn otherwise undisclosed details of my case. I found this Act a crucial mechanism as I was able to ask questions of the regulators. I have used the Act to ask the same questions to NHS Trusts and I have compared the results to see how much safer the public are when they are being cared for by the NHS. That is to say, if an error occurs and this happens within a facility operated by the NHS, are there are better systems in place. I am very fearful to see community services operating from NHS facilities. I see this as exposing patients to harm. I am committed to seeing changes introduced that will see the public made as safe as it is possible to be. Difficult questions asked I finish this story with the difficult questions I have asked. All of these queries resulting from one case. Why is it possible for two healthcare professionals working in the same NHS facility to be regulated differently when it comes to the Duty of Candour? For example, a nurse working in the NHS facility will be regulated by the Nurses and Midwives Council (NMC) and thus governed by the professional Duty of Candour. If a nurse breaches the Duty of Candour they will be investigated by the NMC and the Care Quality Commission (CQC) will be responsible for investigating the NHS facility as the organisation is responsible for its staff to adhere to the Duty of Candour. However, community pharmacies operating within the NHS facility are not regulated in the same way. The GPhC (and other regulators) are not mandated to ask whether the pharmacist under investigation was supported or trained by their employers. Why are there better systems in place for patients when their NHS services are provided by the NHS rather than by a private company? In the NHS the employers have a marked responsibility to ensure that their staff are updated, informed and observe their professional duties. This is because the CQC are policing a statutory duty and a breach in this duty is a breach in law. Why aren’t private companies providing NHS services, such as pharmacies, required to meet NHS standards? Why aren’t private companies regulated for the part of their business which provides NHS services to NHS patients? Why aren’t standard operational procedures standardised across the private companies providing NHS services to NHS patients? When ‘something goes wrong’ with an NHS patient receiving an NHS service from the private sector, why is it the NHS picks up the costs of ‘harm done’? Why are insurers allowed to undermine the integrity of professionals in the conduct of their duties? It is inevitable that when an error has occurred, a professional's thoughts turn to the possible impact on their future, and so it is not surprising that a call to an insurer is made before following employer standard operating procedures and professional guides. In our case, the GP failed to alert the coroner of the dispensing error and only did so following a call to his indemnity insurer. Why are unregistered professionals working in healthcare exempt from sanction? Why are regulators allowed to make false claims of ensuring public safety? Janice Payne needs to be the last NHS patient failed by needless neglect. We need to act now in the name of public safety. Further reading on the hub: How to make a complaint How do I make a complaint: Sources of help and advice
  14. News Article
    Private hospitals will provide NHS patients in England with as many as a million extra appointments, scans and operations a year as part of the government’s drive to end the care backlog. Keir Starmer unveiled the NHS’s growing use of private healthcare in a major speech on Monday in which he set out his new elective reform plan to address a waiting list for planned care on which 6.4 million people are waiting for 7.5m treatments. Private operators will receive an extra £2.5bn a year in government funding, taking the total to almost £16bn, if they deliver the uplift in care and treatment the prime minister outlined. The initiative is a key element in a plan intended to ensure that patients no longer have to wait more than 18 weeks for non-urgent hospital care by spring 2029. Starmer said in his speech that he would not let critics of NHS privatisation stop him relying more heavily on the independent sector, because people’s health needs must come first. “When the waiting lists have ballooned to 7.5m, we will not let ideology or old ways of doing things stand in the way of getting people’s lives back on track. “It would be a dereliction of duty not to use every available resource to get patients the care they so desperately need,” he said. But the co-chair of Keep Our NHS Public, Dr Tony O’Sullivan, said the private sector was a parasite that was damaging the health service and that it would lose out as a result of the deal because its own staff would provide most of the expansion of private care. “Just as in the 2000s, the NHS could provide those million appointments and build sustainable capacity if funding was invested to reopen theatres, provide equipment, support more NHS GPs, community and hospital staff,” he said. Read full story Source: The Guardian, 6 January 2025
  15. News Article
    The father of a seven-week-old boy who died after being breastfed in a baby carrier is calling for increased safety standards around baby slings. James Alderman, who was known as Jimmy, was being breastfed "hands-free" within a baby carrier worn by his mother while she moved around their home. Jimmy's father, George Alderman, told Sky News: "Baby slings are sold as being a lifesaver, allowing you to get on with your business while your baby's safe and close to you, but in this instance, we had our baby close, but not safe." The inquest into his death heard Jimmy was in an unsafe position too far down the sling. Mr Alderman said that while much of the available advice around slings focused on them not being too tight, few people were aware of the danger of the sling not being tight enough, and so allowing the baby to slump. Explaining what medical experts think happened to Jimmy, he said: "After he'd been feeding, he fell asleep and then he slumped forwards. Then, because his head was covered and he had his chin against his chest, he was facing downwards. "Nothing was covering his face, but because of the position he was in, that meant that not enough oxygen was going into his lungs because he was small and not fully developed, and that's why he stopped breathing." Mr Alderman said that while many brands of baby carriers said they were safe for breastfeeding, the lack of advice around how to safely do it meant that parents were "left to work it out by themselves". Read full story Source: Sky News, 30 December 2024
  16. Content Article
    In most developed countries, people don’t have to worry about sifting through a dozen different health plans—and they don’t live in fear of losing their health care after losing a job. They receive more affordable, higher-quality care than Americans do. The paradox of the world’s wealthiest nation having one of the weakest health systems among developed nations has long been a vexing policy problem—without an easy solution. In this article, Vox Senior Correspondent Dylan Scott looks at how the insurance-based healthcare system in the US developed from the 1920s onwards, and why it is so complex and compartmentalised compared to systems in other developed countries.
  17. News Article
    Weight-loss injections are being aggressively marketed to British consumers through often illegal promotions, in a practice experts have described as a “wild west” industry of drug selling. The booming market for jabs such as Wegovy and Mounjaro has triggered a price battle among online pharmacies, with even high-street chains cashing in on the soaring demand. Last month, the pharmaceutical company Novo Nordisk revealed global sales of Wegovy hit £1.94bn in the third quarter of the year, up 48% from the previous quarter and outstripping expectations. However, a Guardian review of reports by the watchdog that regulates medical advertising in the UK shows that many online pharmacies are flouting strict rules that govern how prescription-only drugs can be marketed in Britain. Read full story Source: The Guardian, 26 December 2024
  18. News Article
    Helplines that claim to offer “free” and “impartial” addiction support have been reprimanded by the advertising watchdog for hiding the fact they are paid thousands in commission by private rehabilitation clinics. Amid record drug death rates and high demand for services, one website is promising “free, impartial, expert” advice for those trying to find the best treatment. Another “advisory service”, listed high in Google search results, said it will help people “choose the best drug & alcohol rehab for you”. “We will give you guidance on the best options for your circumstances,” it claimed. But while they look like nonprofit services and claim to offer unbiased help, the websites are fronts for brokers that direct people to partner facilities in exchange for a referral fee. Last week, the Advertising Standards Authority (ASA) issued rulings against seven companies, accusing them of misleading vulnerable people about the true nature of their businesses. The ASA said that six brokers – Which Rehab?, Help 4 Addiction, Rehabs.UK, Rehab Guide, Action Rehab and Serenity Addiction Centres – had posed as direct treatment providers or impartial advice services when they were principally referral companies earning commission from partner facilities. Read full story Source: The Guardian, 22 December 2024
  19. News Article
    NHS spent more than two billion sending patients to psychiatric units last year, following decades of cuts to beds, new analysis reveals. The huge sum on private mental health hospitals in 2023 was a £279 million increase on the year before. A report by Laignbuisson, shared exclusively with The Independent, said the lack of beds within the NHS is a major driver of spending on private hospitals, warning healthcare leaders are “stuck between a rock and a hard place.” The two biggest private providers, Priory Group and Cygnet Health Care, took 509 million and 560 million in profits last year They account for more than 68% of the market, according to the report. Almost £200 million was spent on private children’s hospitals by the NHS in the same year, figures show. Tim Read, author of the report, said private mental health hospitals face stable conditions despite the move to more community care due to the “limited capacity” in NHS beds. “Despite being a policy priority, it is clear the system is struggling to get a grip on out-of-area placements. With NHS Mental Health Trusts’ seeing occupancy rates climb to nearly 90 per cent, commissioners are stuck between a rock and hard place – either admit locally to an overcrowded ward or place a vulnerable person a long way from the local support networks. “The NHS has seen its own bed capacity dwindle over decades and with significant re-investment unlikely given other priorities, the way that local areas engage collaboratively with the independent sector on how to best meet local need becomes ever more important.” Read full story Source: The Independent, 20 December 2024
  20. News Article
    Growing numbers of patients are requesting NHS-funded referrals to private providers “operating outside of agreed guidelines”, fuelled by long waiting lists and “aggressive direct marketing tactics”, GPs have warned. The GPs report the biggest problems are, increasingly, for weight management and for services to diagnose neurological disorders such as ADHD and autism — both of which have long and growing waiting lists with many NHS services. National NHS choice rules, known as the “right to choose”, mean all ICBs must allow and fund patients to use any provider of these services, regardless of location and as long as it has a contract with another ICB. Choice of NHS community service providers, however, is limited, partly because they are funded by block payments. The letter from Wessex LMC to ICB medical directors calls for “ICB action to address potential patient safety and quality issues relating to the ever-expanding market of ‘right to choose’ providers”. “It does seem that some providers are using ‘right to choose’ as a way to access the NHS market where there are long waits for local NHS services, and they sometimes use aggressive direct marketing tactics to encourage patients to choose their service. “The public would expect that if these providers are ‘available on the NHS’ then they would be practising in line with agreed guidelines and best practice but this doesn’t always seem to be the case.” Examples of such problems include providers diagnosing conditions based only on remote consultations and surveys and GPs being asked themselves to carry out physical assessments that should be part of the specialist work. The LMC says NHS specialist services were refusing to recognise some diagnoses made by the independent providers for accessing follow-up services and refusing to prescribe to the patients. Read full story (paywalled) Source: HSJ, 16 December 2024
  21. Content Article
    Hundreds of millions of people are denied health care every year by their private insurers. As a result, people stay sick or injured, and sometimes die. People are stuck with bills they can’t pay, take money from rent and food, and go bankrupt. Care Over Cost helps everyday people fight to get the care they deserve. Has a private insurer denied you care? Share your story with Care Over Cost and read other cases. 
  22. Content Article
    At Patient Safety Learning we often get asked by patients and families who have received poor healthcare what they need to do to make a complaint. Although we cannot get directly involved in individual cases, we have put together a simple guides on the steps you can take if you need to make a complaint about your private healthcare. We also have the following guides: How do I make a complaint about my NHS care in England: a simple guide for patients and families How do I make a complaint about my NHS care Northern Ireland: a simple guide for patients and families How do I make a complaint about my NHS care in Scotland: a simple guide for patients and families How do I make a complaint about my NHS care in Wales: a simple guide for patients and families How do I make a complaint: Sources of help and advice By law, the Parliamentary Health Service Ombudsman (PHSO) cannot look into complaints about privately funded healthcare services. This includes care provided by Private Patient Units within NHS Trusts. However, they will look at complaints about healthcare services provided in a private hospital if the NHS paid for it. They will also look at complaints about NHS-funded healthcare services which privately funded patients get in an NHS hospital. See our ‘Making a complaint about your NHS care' guides above if this applies to you. If you are unhappy about treatment you have received in a private hospital or clinic, it is your right to: Make a complaint. Have the matter investigated. Receive a full and prompt response to your complaint. If you are concerned with the outcome of your treatment, then you should first talk to your treating consultant in order to obtain an explanation and advice. If your consultant is unhelpful or unresponsive, and you believe you are in need of further treatment, you should talk to your GP about your concerns and possible treatment options. This may include obtaining a referral for a second opinion. Making a formal complaint to the hospital or clinic If you are unhappy with the response, you can make a complaint using the Independent Sector Complaints Adjudication service (ISCAS) who have a code of practice for handling patients’ complaints. However this will only apply to private healthcare providers who are ISCAS subscribers or to patients treated by an Independent Doctors Federation Member ISCAS is one of the recognised independent adjudication services of complaints for the private healthcare sector. ISCAS has produced a patients’ guide with input from the Patients Association which explains how to make a complaint about using the ISCAS Complaints Code of Practice. Here are the stages to take if you would like to make a complaint about private care you received. More information on each step is given below. See the full Patients’ Guide to the ISCAS Code for more information. Stage 1: Complaint raised directly with the clinic or hospital where care was provided Complaining can be stressful, so the aim should always be to try and sort out any problems as quickly and informally as possible. If your complaint is responded to effectively when you first raise your concerns, then it is unlikely that matters will need to be escalated through stages 2 and 3. Before you make a formal complaint, ask the provider for a copy of their complaints procedure. If you do not wish to speak to a member of ‘frontline’ staff, or if you are unhappy with how they have responded, you can take your complaint to someone more senior within the organisation, such as the unit Manager or Hospital Manager. You should normally make your complaint within six months. The provider may be willing to investigate complaints after this time where there is a realistic opportunity of conducting a fair and effective investigation, and if you have a good reason why you could not act sooner (for example, if you were unaware of the matter, if you were unwell or grieving). If you are not satisfied with the outcome, you can escalate your complaint to stage 2. Stage 2: Internal review of complaint by someone who was not involved at stage 1 If you wish to escalate your complaint to stage 2, you should do so in writing, within 6 months of the final response at stage 1. Normally the complaint review at stage 2 will be conducted by a senior member of staff who has not been involved in the handling of the complaint up to that point and is not involved in the daily operation of the hospital/clinic. The person conducting the complaint review is expected to send you a full, written response on the outcome of the review within 20 working days. Where the investigation is still in progress, you should receive a letter explaining the reasons for the delay. The aim is to complete the review at stage 2, in most cases within 3 months. Stage 3: External review If you are not satisfied with the complaint review at stage 2, you have the right to refer the matter to stage 3 independent external adjudication through ISCAS (for subscribing providers). Please see the providers who are covered. You need to do this within 6 months of receiving the final response at stage 2 and ISCAS aims to complete its adjudications within 3-6 months. The person making a complaint does not pay for the complaints process. Stage 3 adjudication will not consider ‘new’ issues that have not previously been raised with the provider, with the exception of concerns raised about the way the private healthcare provider has handled the complaint, which may not surface until after a response has been made at stage 2. If you wish to escalate your complaint to ISCAS at stage 3, you should do this in writing. Your letter should include the information in the Patients’ Guide to the ISCAS Code, which also provides more information on prompts to help you think through what you want to achieve, and whether it is achievable under the ISCAS Code. The Independent Adjudicator will decide to uphold or not uphold each aspect of your complaint. They have the discretion to award a goodwill payment up to a limit of £5,000, in accordance with the ISCAS Goodwill Payments Guide. There is no appeal to Stage 3 adjudication and the Independent Adjudicator’s decision is final. However you can seek legal action at any point during or after the ISCAS complaints process and your statutory rights are not affected. If you are not satisfied with the way ISCAS has managed the stage 3 process you are entitled to make a complaint about ISCAS. AvMA (Action against Medical Accidents) have a number of self-help guides that provide clear and straightforward explanations of the procedure and guide you through making a complaint about your treatment. Unlike PHSO for the NHS, ISCAS cannot deal with complaints related to clinical negligence (e.g. injuries caused by poor hospital hygiene or failure to follow proper procedures). Clinical negligence complaints should go straight to the relevant professional regulator, or patients should seek accredited legal advice. Patients with private medical insurance can take their financial (but not clinical) complaints directly to their insurer, and escalate to the Financial Ombudsman Service. These routes to resolution should always result in satisfying a patient’s reasonable demands without needing to resort to the civil courts. Complain to the Care Quality Commission Under the Health and Social Care (Community Health and Standards) Act (2003), the Care Quality Commission (CQC) is now responsible for regulating and inspecting independent healthcare in England. If for any reason you are unable to get the private health provider to respond to a complaint, or if you are unhappy with their response, you can make a complaint to the CQC (or the equivalent body in Scotland Northern Ireland and Wales). England: Care Quality Commission; Telephone: 03000 616161 Northern Ireland: The Regulation and Quality Improvement Authority; Telephone: 028 9051 7500, Email: [email protected] Scotland: Healthcare Improvement Scotland; Telephone: 0131 623 4300, Email: [email protected] Wales: Healthcare Inspectorate Wales; Telephone: 0300 062 8163, Email: [email protected] It is a statutory duty on providers registered with the CQC to have a complaints system in place that is brought to the attention of service users, which provides complainants with support where necessary and which should ensure that the complaint is fully investigated to satisfy the service user as far as reasonably practicable. Complain to the professional regulating body If the issue is about an individual health professional’s fitness to practise, make a complaint to the relevant professional regulating body, such as the General Medical Council (for doctors) or Nursing and Midwifery Council. AvMa has a self-help guide. Complaint about private dental care If your complaint is about privately funded dental care, contact the Dental Complaints Service. Complaint about private eye treatment If your complaint is about privately funded eye treatment, contact the Optical Consumer Complaints Service.
  23. News Article
    Women waiting in agony for vital gynaecological treatment are turning to the private sector in the hope of being referred urgently to the top of the NHS waiting list. The heads of 11 leading women's health organisations have signed an open letter, external urging the public and health professionals to participate in their "Change NHS" conversation. They said: "Women and girls have repeatedly been left to 'fall through the gaps' of fragmented government policy." The Royal College of Obstetricians and Gynaecologists says the discussion around the government's 10-year health plan, external is a chance to lobby for "much needed" funding and system-wide support essential to transforming women's health. An NHS spokesperson said: "While latest data shows NHS staff are making progress to cut waiting lists and tackle the backlog, we know there is much more to do to bring down long waits for care, particularly for women who are waiting for crucial appointments and treatment. "We welcome feedback from the public and those working in women's health services via Change NHS to build on our work on improving services for women - which includes developing a network of women's health champions in every local care system and expanding neighbourhood women's health hubs across the country - giving thousands more women access to specialist women's health teams in the community." Read full story Source: BBC News, 9 December 2024 Related reading on the hub: One hour with a women's health expert and finally I felt seen
  24. News Article
    When Alexandra McTeare was told she might have to wait three years for knee replacement surgery, she felt desperate. “Because of how miserable your life is, how small it has become,” she says. The problems with her knee started in 2017. “It was painful and would swell up, particularly in the heat.” She would take painkillers and keep her leg elevated when she was sitting down, and did stretching exercises for her muscles. But over the next few years, “it gradually got worse, the intervals between swelling episodes reduced and the pain increased”. It reached a point where it was no longer bearable. Ten years ago, McTeare could get a GP appointment within a week. “Now, you phone up and you’re lucky if you get an appointment within a month, and nine times out of 10 it’ll be a nurse practitioner.” McTeare has nothing against nurse practitioners; she used to be a nurse herself and she was working for the NHS when they were introduced to GP practices. “But they’re not appropriate for everything,” she says. “People do need to be able to see a GP.” Her knee didn’t get better. The opposite happened. “I didn’t believe it was a torn meniscus, it was going on and on, so I decided: to hell with it, I’ll pay and see somebody privately.” In March 2023, she saw an orthopaedic consultant, got an X-ray, was told she had arthritis in her knee and needed a total knee replacement. It took no more than half an hour and cost her £400. McTeare says she is lucky she could raise the money for a private consultation. But she wants to make something clear: “I have always despised private medicine.” Read full story Source: The Guardian, 27 November 2024 Related reading on the hub: One hour with a women's health expert and finally I felt seen
  25. News Article
    The son of a man with motor neurone disease who died while waiting for a wheelchair from the NHS’ leading provider has accused them of "sincerely failing his dad". John Clarke, 67, was diagnosed with the disease in April. The NHS integrated care board in Stoke-on-Trent told him that AJM Healthcare would be providing his wheelchair and, following an assessment in May, he was told that it would be delivered in July. His family said they were then offered a different wheelchair, which was far too heavy, and instead resorted to buying him a second-hand wheelchair from eBay. Ben Clarke, John's son, told ITV News: "It’s not something anyone should have to face. "If you’re faced with a terminal illness and you’ve got limited time left, you don’t want to be fighting what you take to be the professionals from the off. Eight-year-old Summer Calvin is struggling at the hands of the same provider. She has a rare genetic condition which means she can’t walk or speak. It means that Summer is abnormally tall for her age and she grew out of her wheelchair in September 2022. But her family say the replacements being offered by AJM Healthcare haven’t been suitable. "We were told that they had a certain list of chairs that they could pick from, and they were only allowed to use those ones," Summer's mother Larissa Evans told ITV News. AJM Healthcare describes itself as the NHS’ leading provider of wheelchair services. The company supplies approximately 150,000 registered users, representing around 20% of all wheelchair service needs for NHS England. Yet over the past 12 months, the Parliamentary and Health Service Ombudsman (PHSO) has seen a sharp rise in complaints. Most relate to people not receiving new wheelchairs or the correct parts, and the waits range from a month to two years. Read full story Source: ITV News, 8 November 2024
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