• Vast majority of NHS private patient units not signed up to independent adjudicator
  • Concerns raised private patients face expensive legal action if complaints not resolved
  • Some trusts say they have alternative arrangements in place

Just six of the English NHS’ more than 200 private patient units are signed up to the independent complaints adjudicator, HSJ has learned.

The figures, shared with HSJ by the Independent Sector Complaints Adjudication Service, follow the publication of the Paterson Inquiry earlier this month. The inquiry’s report warned patients treated in private units, including PPUs, which are not regulated by the ISCAS “will not have access to independent investigation or adjudication of their complaint”.

ISCAS is the main independent adjudicator for the private healthcare sector and takes on approximately 125 adjudications each year on unresolved patient complaints. Most standalone independent providers have signed up to the watchdog.

However, ISCAS membership is not mandatory and it is concerned patients wishing to complain about care at PPUs will have little choice but to pursue costly legal action. 

Patients wishing to complain about their NHS treatment can go to the Parliamentary Health Service Ombudsman, but the PHSO does not cover PPUs, unless the care has been funded by the NHS. 

The government is now considering the inquiry’s recommendation that all private patients are given the right to a mandatory independent resolution of their complaint.

‘Sorry, there’s nothing we can do’

Sally Taber, director of ISCAS, told HSJ: “Patients can find themselves in a difficult position. If they have a complaint the provider cannot deal with, there’s no recourse to an external review stage where their complaint can be looked at by an independent organisation like ISCAS.

“We really want to help, and we don’t want to be saying to patients ‘I’m sorry, there’s nothing we can do,’ because that shouldn’t be the situation in 2020 in this country.”

PHSO Rob Behrens added: “Complaints about the private sector are in the public’s interest, so there is a strong argument for private healthcare complaints to be handled by a public service ombudsman.”

Ted Baker, the Care Quality Commission’s chief inspector of hospitals, has also previously highlighted “the need for an independent third stage complaints process for private patient units in the NHS” because privately-funded patients can’t access the ombudsman. 

According to the Private Healthcare Information Network, a government-mandated organisation which collates information about private healthcare, there are at least 211 NHS sites which treat private patients in England, run by 109 trusts.

Other arrangements

Some trusts told HSJ they had other arrangements in place to ensure complaints were dealt with independently.

The Royal Marsden Foundation Trust, which has a PPU not signed up to ISCAS, said it can refer complaints to another NHS trust for external review, although, to date, “this has never been necessary”.

A trust spokeswoman added: “Our system for complaints handling was discussed with the CQC during their recent inspection, who were satisfied with our procedure and rated the trust as ’outstanding’. We review our procedure regularly to ensure we continue to follow the best practice for handling complaints.”

Moorfields Eye Hospital FT, which also has a PPU not signed up to ISCAS, said patients could refer to the General Medical Council or seek legal redress. 

A spokesman for the trust, which saw 38,000 private outpatients in 2018-19, added: ”There is a robust complaints process in place for our private patients, which closely mirrors the processes in place for our NHS patients.”

ISCAS also told HSJ Chelsea and Westminster Hospital FT, Epsom and St Helier University Hospitals Trust, the Royal National Orthopaedic Hospital Trust, Portsmouth Hospitals Trust, and University Hospitals of Derby and Burton FT all had PPUs which were not signed up to ISCAS. HSJ approached all these trusts, but did not receive a substantive comment before publication.

The Department of Health and Social Care said it is considering the Paterson report’s recommendations and “will provide a full response in due course”.

A DHSC spokesman said: “Patients should be confident the care they receive is safe and has appropriate protections, regardless of where they are treated and how it is funded, and that includes having an effective and accessible complaints system in place.”