• NHS-funded work declines at Ramsay and Spire
  • Growth in self-pay buoys revenues overall
  • Spire said direct referrals, avoiding NHS outsourcing deals, accounted for bulk of its NHS work

NHS revenues have fallen year-on-year at two large private providers, according to financial results released this week.

Spire Healthcare and Australian-owned Ramsay Health Care UK both reported lower levels of NHS income, year-on-year.

Spire’s overall turnover increased 0.6 per cent to £932m in the last financial year, but its NHS-funded income fell 1.9 per cent to £287.8m, it reported this morning.

Ramsay’s results released earlier this week did not include a breakdown of NHS-funded turnover but overall revenues are down 4.8 per cent year-on-year to £208m. The majority of the company’s revenue is for NHS work and its financial report said: “NHS demand management strategies are currently impacting volume significantly”.

Private hospital groups can be referred NHS-funded work direct from NHS providers, under outsourcing arrangements with commissioners or from patients selecting them under a choose and book system at their GP surgery.

Both groups expect their position to improve when NHS tariffs for some procedures go up in April, and both said there had been increases in self-funded patients.

Spire Healthcare’s chief executive Justin Ash said: “In 2017, despite challenging trading conditions in the NHS segment and a relatively flat insurance market, Spire managed to grow underlying sales.

“In addition, eReferrals [from choose and book] accounted for 86 per cent of our NHS revenues, which offset some of the impact from local contract reductions.”

He said he expected the company’s NHS business to “remain subdued” in 2018 but that “the opportunity in private provision will grow correspondingly”.

Both companies predicted that the NHS work would recover as the pressure on waiting lists grows. NHS England data shows there are more than 4 million people on elective waiting lists.

The other major independent providers of NHS-funded work are charity Nuffield Health, which does around 40,000 publically funded procedures a year - roughly 20 per cent of its total - and BMI Healthcare.

Care UK and Circle Health also provide some elective acute services.

A spokesman for the Royal College of Surgeons said: ”Continued increases in patients paying privately for treatment, especially hip and knee surgery, is likely to be further evidence that the NHS is significantly short of the funds it needs to maintain provision.

”Growing waiting lists, and rationing of hip and knee surgery, will only worsen the ready availability of surgery on the NHS and turn people towards private healthcare.”