Patients undergoing operations in private hospitals may be put at risk from inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record-keeping according to a new report from the Centre for Health and the Public Interest.
The report reveals that over 800 people have died unexpectedly in private hospitals in England during the last four years. Private hospitals are not required to make data on hospital deaths publicly available – unlike their NHS counterparts – making it difficult for the public to understand how safe private hospitals are.
The CHPI report for the first time brings together what is known about patient safety in private hospitals in England:
- Between October 2010 and April 2014 802 patients died unexpectedly in private hospitals, and there were 921 serious injuries.
- The majority of private hospitals have no intensive care beds, some have no dedicated resuscitation teams, and surgeons and anaesthetists usually work in isolation – without assistant surgeons and anaesthetists in training present.
- Although the private hospital sector now gets over a quarter of its income from treating NHS-funded patients, there is significantly less information available to patients about the performance of private hospitals than about the NHS.
- It is not possible to establish whether all private hospitals providing NHS care are fulfilling their legal obligation to publish Quality Accounts letting the public know how they are performing.
The report also confirms that the NHS serves as a ‘safety net’ for the private sector. Thousands of people are regularly transferred to NHS hospitals following treatment in private hospitals, with over 2,600 emergency NHS admissions from the private sector in 2012-13.
Report co-author Professor Colin Leys said:
“The public and regulators have access to more information than ever before about how NHS services are performing but this report shows that the same cannot be said for private hospitals. The Government has recognised the crucial role of transparency in making hospitals safer but reporting requirements should apply wherever patients are treated. With the taxpayer now providing over a billion pounds a year to private hospitals, this is too important to be left to the industry to address.”
Report co-author Professor Brian Toft said:
“The report highlights some sobering examples of what can happen to patients without the right staffing, equipment and facilities. When patients choose to have an operation in a private hospital they may be unaware of the difference in terms of risk between a big NHS hospital with surgical teams and intensive care beds and a private hospital with neither. Consent forms should make clear to patients the inherent potential risks in the way these facilities are run.”
The report makes a number of recommendations, including:
- Private providers should be subject to the same requirements as the NHS to report patient safety incidents, and to report on their performance.
- Consent forms given to patients in private hospitals should detail not only risks inherent in the procedure offered but also any that stem from the facilities, equipment or staffing of the hospital.
- Regulations governing provision of care in private hospitals should require an on-site registrar-level surgeon or doctor for every specialty for which NHS patients are treated, for an anaesthetist to be on call, and for medical records to be kept on the ward.
- The Department of Health should carry out a review of the nature and cost of admissions to the NHS from private hospitals, and the NHS should have the power to recoup costs resulting from a failure by a private hospital.