Private concordat. Flexible friends

A survey of acute trusts and health authorities suggests that expenditure in the private sector has more than doubled since the signing of the concordat in October 2000. But it still represents less than 1 per cent of total acute spending. Most of the spending was for orthopaedic surgery, made under short-term, cost-per-case deals. The need for increased capacity was the main motive for using the independent sector. More than three-quarters of respondents cited prices in the independent sector as a barrier to greater collaboration. There is little evidence of NHS organisations and those in the independent sector forming partnerships for long-term service planning.