David Hare shares his insights on how the agreement between the NHS and independent hospitals has worked out after a month and the long-term ramifications on the relationship between the two sectors.

They say a week is a long time in politics. But this past month since a full lockdown was announced in England feels like several lifetimes have passed in terms of the NHS, with some seismic changes to health policy that will no doubt have long lasting repercussions once the pandemic ends.

It is also a month since the announcement was made by NHS England and the Independent Healthcare Providers Network that virtually all independent hospital capacity would be block-booked by the NHS to be used as it sees fit in both treating covid-19 patients and ensuring other urgent NHS treatment can continue.

During this period the relationship between the NHS and the independent sector has changed before our eyes and it is worth reflecting on what that has meant in practice and what the programme has achieved so far.

Partnership in action

Since the middle of March, the NHS and the independent sector have worked hand-in hand at national, regional and local level to ensure that the clinical, operational, legal and staffing challenges associated with putting the independent hospital capacity (including, staffing, beds and ventilators) at the disposal of the NHS could be achieved.

And already we are seeing some fantastic examples of partnership working in action to help the NHS meet the growing demands it faces.

For example, in Plymouth, the oncology department at the University Hospitals Plymouth Trust has been transferred to the local Nuffield Health hospital which is providing facilities and staff to treat cancer patients and is helping to free up resources in the local Derriford NHS Hospital.

Similarly, in Southampton, the Spire Hospital is now hosting the local trust’s entire oncology and haematology services. Since taking on these services at the end of March, it has carried out over 1,000 patient treatments and delivered more than 100 time-critical operations.

And in the capital, Bupa Cromwell and HCA hospitals have joined forces with the London “Cancer Hub” to help deliver time-critical cancer treatment to NHS patients.

The London Clinic, one of the UK’s largest independent charitable hospitals, has also transferred more than 20 pieces of medical equipment, including six ventilators, and over 20 members of staff to the Nightingale Hospital in London – a picture replicated across the country with staff from independent providers stepping up and making themselves available to the NHS at what is an incredibly stressful time for patients, families and staff alike.

Mobilising virtually the entire independent hospital sector to be put at the disposal of the NHS has been a huge task and has required parties in both the NHS and the independent sector to work differently

Of course, as is the case with several NHS trusts, some of this “buffer capacity” provided by the independent sector has not yet been needed.

This should be seen as a sign of success and NHSE should be congratulated for ensuring that sufficient headroom was made available across the NHS to cope with the surge of patients that have needed treatment.

As more urgent and possibly even routine elective care takes place under the instruction of NHSE, however, then it is clear that many independent hospital facilities can be used as “clean” non-covid sites, ideally placed to help mitigate the inevitable backlog of patients that will build up over this period, guided of course by appropriate clinical guidance.

The Royal College of Surgeons have recently made clear that dealing with the increased waiting list caused by covid-19 could take many years to achieve, and again the independent sector will be crucial here, with the relationships and understanding that NHS and independent sector providers are developing now being invaluable over the longer term.

Mobilising virtually the entire independent hospital sector to be put at the disposal of the NHS has been a huge task and has required parties in both the NHS and the independent sector to work differently, adapt and develop new ways of working. But this presents an opportunity for a new approach to partnership between the two sectors, benefitting patients both now and long into the future.