Headlines: February 22nd, 2006

The Department of Health programme for procuring operations and diagnostic services from the independent sector was launched in 2002 to give patient choice, promote innovation and provide an incentive to NHS trusts to improve performance. Independent sector treatment centres provide a variety of health services more usually located in hospitals, undertaking the most common types of surgery such as hip, knee and cataract operations. The programme is now being expanded with the addition of new centres and extending their role to include training of medical staff.Currently 21 centres are operating and they have treated over 250,000 patients. The Health Care Commission assesses each centre and surveys 10% of their patients. Satisfaction rates across the programme consistently run at over 94%.

Treatment centres are generally separate units and so are unaffected by emergency or seasonal demands that can affect other non-treatment centre providers in the NHS. Consequently they are able to offer patients scheduled procedures at prebooked times with many procedures being completed during the day.

The expanded programme which will be delivered over the next two years is expected to provide approximately two million additional diagnostic procedures per year. The additional capacity will help cut ‘hidden waits’ brought about by patients waiting for diagnostic tests ahead of any further treatment required. It will also help the NHS to meet the Government’s target that by 2008 all NHS patients should be treated within 18 weeks of their GP referral.

The role of centres is now being expanded to provide training. Local training committees are being established to developing training contracts. When fully established the contracts will include provision for junior doctor, nurse or allied health professional training. They will cover operative techniques, general nursing care of the surgical patient and clinical techniques for allied health professionals.

The centres, which are barred from recruiting staff from the NHS, have demonstrated their value in promoting innovation. New practices developed include mobile solutions where the provider supplies clinical services from mobile units, administering local anaesthetic instead of general anaesthetic for primary joint replacements to reduce the anaesthetic risk and speed discharge and by pain management techniques to allow postoperative physiotherapy to commence sooner.

When the programme is completed the centres will account for less than 1% of the total NHS budget and only about 10% of all elective procedures.