Specialist cancer hospital The Christie Foundation Trust is considering plans which could see it open branded treatment and diagnostic centres across England, in partnership with a private sector provider.
If the proposal goes ahead, the Manchester-based hospital could become the first in a wave of high profile FTs to use joint ventures with the private sector to develop national “chains” of providers.
Chief executive Caroline Shaw said the NHS reforms offered the Christie the opportunity to use its joint venture with private hospitals group HCA International to expand beyond its regional boundaries.
“If this plan goes ahead, we could become the first national chain of providers of cancer services within the NHS,” she told HSJ.
“[Any Qualified Provider] gives us the opportunity to manage care in different parts of the pathway. We can get into diagnostics; we can manage satellites all over the country.”
The Christie, like other specialist trusts, already runs “satellite” units on the sites of other NHS providers. London and Surrey based cancer specialist The Royal Marsden FT runs a satellite in the grounds of Kingston Hospital Trust, in joint venture with the hospital and Macmillan Cancer Support. The Christie has satellites at the Royal Oldham Hospital and Salford Royal FT.
But Ms Shaw said the foundation’s joint venture with HCA – formed to develop and run the private patient unit the Christie Clinic, which opened in September 2010 – could provide “instant capital” to drop stand-alone centres into new areas.
These centres would first be focussed on private patients, but as the government expanded its policy of commissioning from “any qualified provider” they could compete to offer specialist diagnostic services to NHS commissioners, she explained.
The first stage of the plan would be to open new satellites in the North West, before seeking opportunities to expand further afield. Ms Shaw emphasised that nothing had been “agreed or signed”, but said she hoped to “see some of this vision implemented in the next 24 months”.
Asked if she was concerned that setting up specialist diagnostic centres risked financially destabilising traditional NHS providers of diagnostic services, she argued it would cut costs and improve patient care. Referrals to the Christie – a tertiary centre that treats patients referred on from secondary care providers – were currently “complex, and pretty delayed”.
“We could work with GPs and [clinical commissioning groups] to help diagnose patients and refer them to the right provider,” she said. “We wouldn’t want to do all the surgery ourselves.”
She added: “[This is] about being innovative and using the policy [of any qualified provider] to the best advantage of our patients and staff.
“I love the NHS. I believe in it and it’s what we’re here for. But this policy has come in and we’ve got to work with it. I want more people to be able to access top quality cancer care.”
Jocelyn Ormond, a partner at law firm Beachcroft, said a number of FTs were “actively considering” private sector joint ventures, either “around their private patient units” or “those clinical services that are more easily outsourced, like diagnostics”. In many cases, he said, the ultimate intention was to create a vehicle which would allow the FT to expand to other parts of the country.
“While some FTs have set up outposts outside the UK, foundation trusts are only now taking the first tentative steps in England towards expanding beyond their geographical boundaries,” he added.
He estimated that the number of new joint ventures under discussion or completed in the next six to 12 months would be “in double digits”.
“I think this will ultimately lead to those FTs with strong brands that are thinking innovatively about the future doing very exciting things, which [will] mean they’re no longer seen purely as serving their local areas,” he added.