Private hospital groups negotiating with NHS England on new stopgap contract

NHS England has contracted with independent sector providers on a block-contract basis since the start of the pandemic, but this was due to change this month with the launch of a new four-year framework deal, under which local organisations would commission elective work from a nationally approved list of providers.

However, Spire Healthcare has now confirmed it is “in advanced discussions” with NHSE to deliver “a volume-based commitment” for three months from the start of 2021. It said this would provide a “smooth transition” to the framework deal.

In a statement, the £980m-turnover company said: “Spire Healthcare, along with other independent providers, at the request of NHS England, is in advanced discussions to provide a volume-based commitment to help manage NHS waiting lists when the existing contract ends.

“This new contract is expected to have a definitive end date of 31 March 2021 and aims to provide a smooth transition for NHS services from the current cost-based contract to the new NHS framework…”

HSJ understands one of those other providers involved in the talks is Circle Health, which operates BMI Healthcare. Spire and Circle/BMI did almost half of the NHS work sent to the private sector in the first stages of the pandemic.

The other largest private providers, Ramsay Health Care UK and Nuffield Health, have not responded to requests for comment.

The block contracts in place since the start of the pandemic have been criticised after HSJ revealed much of the capacity has been substantially under-utilised.

However, there have also been concerns in some quarters over the new framework contract, which was expected to be worth £10bn over four years.

Slides seen byHSJ from an internal NHSE webinar in October said the framework was a mechanism to return to local commissioning, with the ambition of recovering elective care. It said funding had been committed by the Treasury until the end of March.

Clarification sent to webinar attendees confirmed only contracts made under the new framework were guaranteed additional funding.

A commissioner working in the South East, who wished to remain anonymous, said last month: “I have heard stories of many private providers choosing not to engage in this [framework] tender as they predict enough demand from the private sector.”

They said there was a risk of local services “losing access to sorely needed independent sector capacity at the NHS’ most desperate hour”.

There were concerns in their region about “sensitive services”, such as cancer, having to “repatriate” to NHS sites heavily occupied by covid patients. The commissioner said: “You’re squeezing immunocompromised patients back into an acute site.”

Other sources suggested the framework was unlikely to have private sector capacity in place quickly enough for its launch at the end of November.

NHS England was approached for comment.

An Independent Healthcare Providers Network spokeswoman said: “The independent sector is committed to maintaining its support for the NHS through this incredibly challenging period and to ensuring that as many NHS patients as possible receive the care they need this winter and beyond.”

In March, the NHS block booked almost all private sector capacity in an unprecedented deal to help the health service cope with the covid surge and continue to provide urgent electives.

According to the NHSE webinar, this was for a period of 14 weeks, after which each region had to provide plans for elective work until the end of November. It also heard a number of providers were removed from the contract because of “poor utilisation”, with 17 remaining.

HSJ understands private providers had been keen to roll out the national deal beyond December, but moving to the new framework was an NHSE decision.