EXCLUSIVE Sir Nigel Crisp opens the door to wider independent provider involvement

Published: 17/03/2005, Volume II5, No. 5947 Page 5

The UK's established private healthcare providers will be invited to bid for a place on choice menus, NHS chief executive Sir Nigel Crisp has revealed.

In an extension of the independent sector's role, a national procurement process will see 'the BUPAs of this world' encouraged to supply treatment in all areas of elective care where choice is to be offered.

Speaking exclusively to HSJ about the blueprint for the next stage of NHS reform, Sir Nigel also announced an end to volume contracts with independent treatment centres and the effective abandonment of the controversial 8 per cent target (see page 7).

The measures are contained in A Patient-led NHS: delivering the NHS improvement plan, published today, which sets out the next stage of delivery for NHS organisations.

As HSJ reported last week, the size of primary care trust choice menus will be boosted by the inclusion of foundation trusts and independent treatment centres from April 2006.

The Department of Health now plans to increase patient choice further by potentially making a large proportion of the UK's existing private healthcare capacity available to NHS patients undergoing a wide range of elective procedures.

In the past, deals with the private sector have been dominated by nationally procured contracts for a specific operation, such as the ITC programme, or locally struck 'spot purchases' to fill in short term gaps in NHS capacity.

Independent providers will have to meet NHS standards and be able to provide care at the NHS tariff.

They will also have to guarantee availability. 'You cannot be on the list and just take one patient, ' explained Sir Nigel.

He added that he expected to see the NHS using the independent sector exclusively through these nationally procured contracts and that, as a result, this would 'finish spot purchasing' of private sector capacity, significantly improving value.

Sir Nigel said he believed that contracts would prove 'reasonably attractive' to the independent sector, but also cautioned: 'We will not accept everybody.' He also explained that, 'over time', all independent providers supplying NHS care would be expected 'to display the NHS logo as a sort of kitemark'.

Setting out more detail on the creation of choice menus, Sir Nigel said that all foundation trusts and independent treatment centres would be 'entitled to be on any [PCT] list.' However, he expected that most would choose PCTs from the same part of the country.

Independent providers would be placed on a national list and added to individual PCT lists by the DoH.

Sir Nigel said the move was partly a response to concerns that PCTs - which have all been told to include a independent sector supplier on their choice lists - would end up 'signing 300 different contracts, several of which would be with the same organisation'.

Although the new arrangements come into force from April 2006, Sir Nigel acknowledged there would have to be 'some phasing', partly as a result of the 'big piece of work' needed to make sure that patients would have access to the necessary information about providers.

BUPA medical director Andrew Vallence-Owen welcomed the policy shift: 'We are awaiting an announcement as to what we can bid for. We and our colleagues in the sector are very keen to bid for the work, whether through national contracts or local commissioning.' He added: 'We are in the private sector; competition is what keeps us fit. Customers can walk if they do not like what we do. Most private hospitals are already doing a lot of work for the NHS, so why should [PCTs] not offer choice of another private hospital that has the capacity?'

A blueprint for the future

Among the proposals set out in the Department of Health policy document A Patient-led NHS, published today, are:

Allowing independent providers like BUPA to 'bid' to be included on the choice menus offered by primary care trusts.

A development programme which could see the introduction of regional or even national NHS contracts with providers.

An end to volume contracts with all independent treatment centres.

A decision to move all acute trusts to the foundation trust accounting regime.