NHS chiefs may ask private health firms to help if there is a patient surge Medical director Bruce Keogh says private sector could carry out operations to relieve pressure on hospitals in case of cold snap.
Private firms will be asked to take on some of the NHS's workload if the service cannot cope with demand this winter, it has emerged, as hospital bosses warned that emergency services were on a knife edge.
Professor Sir Bruce Keogh, NHS medical director, said private companies would be asked to carry out planned operations in order to relieve pressure on hospitals "when the going gets rough in winter".
Dame Barbara Hakin, NHS England's deputy chief executive, has talked to private companies about the possibility of them providing "spare capacity" to help the service deal with a potential surge in the number of patients ending up in hospital if very cold weather occurs.
Keogh told the Commons health select committee: "We've started to look at how the private sector might be engaged in the event of a surge through hospitals, coming through A&E. One of the issues under consideration is when the going gets rough in winter, often one of the impacts is on elective care, so waiting lists start to drift out, so could more elective care be shifted into the private sector?"
While the NHS has used private firms before – to clear backlogs of patients waiting for operations – it would be very unusual to bring them in to handle routine operations, even temporarily. Keogh said that Hakin "has had meetings not only with the private sector but with the voluntary sector to see what they could do to help" if the NHS found itself struggling.
An NHS spokesman said that could mean any of the 211 GP-led clinical commissioning groups in England outsourcing cataract removals or hip or knee replacements to a private firm, but that none were thought to have signed any contracts so far.
The potential use of private firms emerged as the NHS Confederation voiced serious concern that hospitals, especially A&E services, may not be able to handle a sudden spike in demand caused by a bout of cold weather.
In a briefing sent to MPs on the select committee, the Confederation, which represents hospitals, warned: "It is clear from our members that urgent and emergency care is on a knife-edge. There are considerable concerns about a lack of capacity in the system to respond to a sudden increase in demand for care.
"For example, while this winter has so far been relatively mild, our members are concerned about the consequences of any sustained drop in temperatures."
Too many hospitals remain understaffed, it said. "Our members continue to express serious concerns about lack of capacity, particularly in terms of staffing. Many expressed the view that urgent and emergency care is on a knife-edge.
"While the situation feels under control at the moment, there is anxiety about the consequences of a sudden change in the weather, given how mild winter has been so far. A cold spell could lead to greatly increased pressure on our members when there is little slack in the system."
While hospitals have welcomed the £400m of extra funding for this winter that the health secretary, Jeremy Hunt, has announced, they believe it has come too late to allow them to hire extra staff this winter, it said.
"Our members are still concerned about the relatively late release of winter pressure funding. This makes planning and recruitment very difficult."
The Confederation also warned that injections of extra cash for emergency care – what it called "sticking-plaster solutions" – were not enough to tackle "the long-term problems the system faces".
Despite the generally mild winter so far and low levels of flu and norovirus, some hospitals have still found themselves under intense pressure since Christmas, with both the social-care services and community-based health services needed to help keep patients out of hospital inadequate, the briefing warned.
An NHS spokesman said that deals with private firms could include beds in care homes for elderly people who were medically well but not yet fit to go home, to help ease pressure on hospital beds.
The influential King's Fund health thinktank further warned that more health organisations were running into financial problems, with 22% of hospitals and 13% of clinical commissioning groups set to end the financial year in deficit in late March.
Professor John Appleby, the King's Fund's chief economist, said: "The growing number of hospitals set to overspend their budgets shows that for some it is no longer possible both to maintain the quality of services and balance the books."
Andy Burnham, the shadow health secretary, said: "David Cameron promised not to cut the NHS but that is precisely what is happening across the country as NHS organisations struggle to balance the books. As financial panic spreads, services are going downhill." The coalition's unpopular £3bn reorganisation of the NHS in England had led to many of the problems now being seen, he said.
The Department of Health said the NHS had to provide better care despite also having to save £20bn by 2015. "We've increased the NHS budget in real terms, but the NHS must also become more efficient if it is to meet the rapid rise in demand, while ensuring compassionate care for all in the wake of the Francis inquiry.
"Having 3,300 more nurses on our wards now than in 2010 is a good thing for patients," the spokeswoman said.
Most hospital trusts were in a healthy financial position, though some were being helped to "get back on track and continue to provide first-class services", she said. The Guardian
Private firms will be asked to take on some of the NHS's workload if the service cannot cope with demand this winter, it has emerged, as hospital bosses warned that emergency services were on a knife edge.
Professor Sir Bruce Keogh, NHS medical director, said private companies would be asked to carry out planned operations in order to relieve pressure on hospitals "when the going gets rough in winter".
Dame Barbara Hakin, NHS England's deputy chief executive, has talked to private companies about the possibility of them providing "spare capacity" to help the service deal with a potential surge in the number of patients ending up in hospital if very cold weather occurs.
Keogh told the Commons health select committee: "We've started to look at how the private sector might be engaged in the event of a surge through hospitals, coming through A&E. One of the issues under consideration is when the going gets rough in winter, often one of the impacts is on elective care, so waiting lists start to drift out, so could more elective care be shifted into the private sector?"
While the NHS has used private firms before – to clear backlogs of patients waiting for operations – it would be very unusual to bring them in to handle routine operations, even temporarily. Keogh said that Hakin "has had meetings not only with the private sector but with the voluntary sector to see what they could do to help" if the NHS found itself struggling.
An NHS spokesman said that could mean any of the 211 GP-led clinical commissioning groups in England outsourcing cataract removals or hip or knee replacements to a private firm, but that none were thought to have signed any contracts so far.
The potential use of private firms emerged as the NHS Confederation voiced serious concern that hospitals, especially A&E services, may not be able to handle a sudden spike in demand caused by a bout of cold weather.
In a briefing sent to MPs on the select committee, the Confederation, which represents hospitals, warned: "It is clear from our members that urgent and emergency care is on a knife-edge. There are considerable concerns about a lack of capacity in the system to respond to a sudden increase in demand for care.
"For example, while this winter has so far been relatively mild, our members are concerned about the consequences of any sustained drop in temperatures."
Too many hospitals remain understaffed, it said. "Our members continue to express serious concerns about lack of capacity, particularly in terms of staffing. Many expressed the view that urgent and emergency care is on a knife-edge.
"While the situation feels under control at the moment, there is anxiety about the consequences of a sudden change in the weather, given how mild winter has been so far. A cold spell could lead to greatly increased pressure on our members when there is little slack in the system."
While hospitals have welcomed the £400m of extra funding for this winter that the health secretary, Jeremy Hunt, has announced, they believe it has come too late to allow them to hire extra staff this winter, it said.
"Our members are still concerned about the relatively late release of winter pressure funding. This makes planning and recruitment very difficult."
The Confederation also warned that injections of extra cash for emergency care – what it called "sticking-plaster solutions" – were not enough to tackle "the long-term problems the system faces".
Despite the generally mild winter so far and low levels of flu and norovirus, some hospitals have still found themselves under intense pressure since Christmas, with both the social-care services and community-based health services needed to help keep patients out of hospital inadequate, the briefing warned.
An NHS spokesman said that deals with private firms could include beds in care homes for elderly people who were medically well but not yet fit to go home, to help ease pressure on hospital beds.
The influential King's Fund health thinktank further warned that more health organisations were running into financial problems, with 22% of hospitals and 13% of clinical commissioning groups set to end the financial year in deficit in late March.
Professor John Appleby, the King's Fund's chief economist, said: "The growing number of hospitals set to overspend their budgets shows that for some it is no longer possible both to maintain the quality of services and balance the books."
Andy Burnham, the shadow health secretary, said: "David Cameron promised not to cut the NHS but that is precisely what is happening across the country as NHS organisations struggle to balance the books. As financial panic spreads, services are going downhill." The coalition's unpopular £3bn reorganisation of the NHS in England had led to many of the problems now being seen, he said.
The Department of Health said the NHS had to provide better care despite also having to save £20bn by 2015. "We've increased the NHS budget in real terms, but the NHS must also become more efficient if it is to meet the rapid rise in demand, while ensuring compassionate care for all in the wake of the Francis inquiry.
"Having 3,300 more nurses on our wards now than in 2010 is a good thing for patients," the spokeswoman said.
Most hospital trusts were in a healthy financial position, though some were being helped to "get back on track and continue to provide first-class services", she said. The Guardian
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