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May 2012

The hidden cost of Independent sector treatment centres

Since 2003, private treatment centres have been providing care for NHS patients under the Choose and Book system. The purpose of the scheme was to reduce waiting times and allow NHS patients more choice as to where and when they would undergo routine / non emergency treatments. The scheme has attracted wide spread criticism due to its cost to the NHS. In addition to the more obvious financial costs noted in the media, Thompsons Solicitors have seen an increase in the number of cases being brought against the NHS for treatment received at Independent Sector Treatment Centres (ISTC).

The Choose and Book system was introduced to give patients more control over where they received treatment for many elective procedures, for instance knee or hip replacement surgery. Once a patient has been referred to a specialist for knee surgery, for example, under the Choose and Book scheme, the patient is able to select at which treatment centre they would prefer their treatment to be undertaken. GPs have a range of NHS hospitals and private treatment centres to which they are allowed to refer their patients. The idea is that the larger the number of available centres to which a patient may be referred, the more likely it is that the patient will be offered an appointment or operation date which suits them.

The reaction, particularly in the media, to the Choose and Book system has not always been favourable. Criticism has focused on the agreements that were made between the NHS and private treatment centres regarding the use of Independent Sector Treatment Centres for NHS patients. The NHS initially offered the private sector providers fixed amounts to agree to treat NHS patients, whether that treatment went ahead or not. The NHS wrongly assumed that the Choose and Book system would result in private centres doing large numbers of operations. This resulted in the NHS paying out hundreds of millions of pounds to private companies for operations that never took place.

Over the past few years, Thompsons Solicitors have seen a significant increase in the number of claims being brought by NHS patients who received treatment at Independent Sector Treatment Centres. Often claims are made because there was poor liaison between the NHS who provided treatment leading up to an operation and the private treatment centre who were contracted solely to undertake the operation. In one such case, our client had been receiving treatment through the NHS for her knee. Following six months of physiotherapy, it was decided that our client should undergo an arthroscopy so that the cause of her knee pain could be investigated further. The operation was arranged through the Choose and Book system and our client was referred to a private treatment centre to undergo the arthroscopy. Unfortunately, there was some confusion between the NHS and the private treatment centre as to the procedure to be performed. Instead of an arthroscopy, the private surgeon performed a much more invasive procedure. As a result of the treatment provided by the private centre, our client has had to retire from her job. The Trust has admitted that the treatment centre were at fault and have so far paid our client tens of thousands of pounds with the case expected to settle in the near future for several hundred thousand pounds.

Another issue which can arise when NHS patients are treated at private hospitals is the lack of clarity as to who is responsible to provide aftercare for the client. This was exemplified in a case which was brought after our client underwent knee replacement surgery at a private hospital following a referral from our client’s NHS consultant. The operation was, in this instance, a success, however, our client suffered a post operative infection. Neither the NHS nor the private treatment centre took responsibility for dealing with our client’s infection. The infection progressed to the extent that our client required an above the knee amputation. Whilst the Trust and the treatment centre each blamed the other for what happened, the claim eventually settled for a substantial figure.

It is recommended that if you are being offered treatment with a private healthcare provider through the Choose and Book system, you should ensure that all of your notes have been reviewed by the treatment centre prior to the operation and it is understood exactly what procedure you have been referred for. It is also advisable to check to whom you should seek assistance should there be any issues during your recovery.

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