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Private concordat. Flexible friends.

Jon Sussex1, Maria Goddard

  • 1Office of Health Economics.

The Health Service Journal
|June 19, 2002
PubMed
Summary

Private sector spending in the National Health Service (NHS) has doubled but remains low. High prices in the independent sector hinder collaboration and long-term partnerships.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Public Health Policy

Background:

  • The National Health Service (NHS) has explored private sector engagement.
  • A concordat signed in October 2000 aimed to guide this collaboration.
  • Understanding the extent and nature of private sector expenditure is crucial.

Purpose of the Study:

  • To assess the changes in private sector expenditure by acute trusts and health authorities.
  • To identify the primary drivers for utilizing independent sector services.
  • To explore barriers to greater collaboration between NHS and independent sector providers.

Main Methods:

  • A survey was conducted among acute trusts and health authorities.
  • Data on expenditure in the private sector was collected and analyzed.
  • Motivations and barriers to collaboration were investigated through respondent feedback.

Main Results:

  • Private sector expenditure has more than doubled since October 2000.
  • This expenditure still constitutes less than 1% of total acute spending.
  • Orthopaedic surgery accounted for most spending, often via short-term, cost-per-case contracts.
  • The primary motive for using the independent sector was to increase capacity.
  • Over 75% of respondents identified pricing in the independent sector as a barrier to increased collaboration.

Conclusions:

  • While private sector spending has increased, it remains a small fraction of overall NHS acute expenditure.
  • The use of the independent sector is largely driven by capacity needs, particularly for orthopaedic surgery.
  • High costs and a lack of long-term partnerships characterize the current relationship between the NHS and the independent sector.
  • Further investigation into sustainable partnership models is warranted.

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