Hunt warned over private hospital safety after NHS patient death (HSJ: 23 April 2018)

The safety of NHS patients treated in private hospitals has been raised directly with health secretary Jeremy Hunt following the death of an NHS patient.

Assistant coroner for Manchester West Simon Nelson has written to the health and social care secretary warning about poor processes for emergency transfers, the lack of responsibility private companies have for consultants they use, and junior doctors working alone for 24 hour shifts with a lack of training and monitoring.

He has given Mr Hunt until next month to respond, following his investigation into the care of 77 year old Peter O’Donnell. 

Mr O’Donnell, who was an NHS patient, died in January 2017 after hip replacement surgery at BMI Healthcare’s Beaumont Hospital in Bolton. His hospital-acquired pneumonia was not properly recognised by staff, who dialled 999 to rush him to the Royal Bolton Hospital four days after his surgery, where he suffered a cardiac arrest resulting from organ failure and sepsis. He died a few days later having never regained consciousness.

The coroner said Mr O’Donnell showed signs of a chest infection which were not acted on. He said: “Thereafter, by reason of ineffective communication between professionals, irregular observations and inadequate documentation, opportunities to escalate his care were missed. Antibiotic therapy was significantly delayed.” more


IVF clinics 'should pay NHS if their treatments cause complications' (The Guardian, 26 February 2018)

A leading British fertility expert is calling for IVF clinics to foot the bill when assisted reproductive treatments result in their patients requiring care in NHS hospitals.

Geeta Nargund said the public sector should not have to shoulder the financial burden of treating women who are hospitalised with severe ovarian hyperstimulation syndrome (OHSS) or other complications because clinics have used excessive drugs or outdated protocols.

She said by making the clinics pay, hundreds of thousands of pounds could be recouped and used to fund more IVF cycles on the NHS for couples struggling to conceive.

“The time has come when we need to take some radical actions in order to reduce the risks faced by women undergoing IVF and protect our ever-shrinking NHS resources,” Nargund said.

It should be mandatory for all IVF clinics to submit details of hospital admissions to the fertility watchdog, said Nargund, who is the medical director of Create Fertility, a UK-wide private clinic specialising in natural and mild IVF treatments.

“Clinics’ success rates are usually measured in terms of live births per embryo transferred, but the health outcomes for women are of equal importance and there needs to be more transparency around that,” she said. more


Private health firm gives GPs operation price list for impatient patients (The Guardian: 5 December 2017)

A private healthcare company has sent letters to hundreds of GPs setting out a price list of operations they could offer their patients to beat NHS delays and restrictions.

Care UK, which runs nine centres offering treatment on the NHS, said it intended to use spare theatre time to provide “self pay” procedures ranging from earwax removal to hip replacements.

The company said it was trialling the scheme at two treatment centres in the west of England but insisted core work at the sites would remain NHS referrals.

The move has, however, alarmed some GPs and health campaigners who fear it is another example of creeping privatisation in the more


Inquiry announced into case of rogue surgeon Ian Paterson (The Guardian. 7 December 2017)

The government will launch an independent national inquiry into the actions of the rogue surgeon Ian Paterson, who was sentenced to 20 years in jail in August after carrying out needless surgery on patients who were left traumatised and scarred.

The inquiry will begin in January and report in the summer of 2019, and will be chaired by the Right Rev Graham James, the bishop of Norwich.

Paterson, a consultant breast surgeon at the Heart of England NHS foundation trust (HEFT) who practised privately at Spire Parkway and Spire Little Aston, was found guilty in April of 17 counts of wounding patients with intent.

The NHS has paid out almost £10m in compensation to more than 250 patients, and Spire healthcare agreed in September to settle a further 750 cases.

The government said the scope of the investigation would include the independent sector, and it would examine whether the Care Quality Commission’s inspection regime needed to be more


CQC flags up 'deep concerns' with independent rehab providers (HSJ: 30 November 2017)

People with drug and alcohol addiction are being put at risk of harm at many independent residential rehabilitation units, a new report has warned.

The Care Quality Commission published the report today revealing nearly three-quarters of private clinics were failing to hit regulatory standards of care.

The briefing was based on inspections of 68 independent services providing residential detoxification services over the last two years.

The CQC required 49 providers (72 per cent) to make improvements because they had breached regulations of the Health and Social Care Act 2012 and failed to meet fundamental standards of care.

It took enforcement action against eight providers. Forty-one providers breached two or more regulations and 25 breached three or more


Call for tighter checks on private hospitals used by NHS after MRSA case (20 July 2017)

Theresa May has been urged to tighten checks on private hospitals used by the NHS after a Labour MP raised the case of a young patient with an open wound who contracted MRSA on a private mental health ward.

Louise Haigh, a Labour frontbencher, called for the NHS to thoroughly investigate the quality of care before it commissions beds and treatment from private providers.

She cited the case in her of a “young women with MRSA with open wounds” on a child and adolescent mental health ward at Cygnet hospital Sheffield, which a report by a healthcare watchdog rated as inadequate in terms of safety.... read more


Briggs: NHS must stop 'leaking' money to private sector (HSJ: 28 June 2017)

Professor Tim Briggs has said the NHS must stop “leaking” £1.4bn to private providers to ensure its survival.

Professor Briggs, who is leading the Getting It Right First Time programme to reduce unwarranted variation in the NHS, said today the service must become more competitive by reducing unwarranted variation, improving efficiency and driving up care standards.

‘We have to do things differently and we don’t have a lot of time,’ Tim Briggs said

He said: “£1.4bn of our money, taxpayers’ money, which could be used in the NHS is being invested in ‘any qualified provider’.

“We have to compete for that work and get it back to the NHS. That is the way we are going to be solvent.

“We have allowed money to leak away and we have to drag that back into the NHS to make it sustainable.”

Professor Briggs, a leading consultant orthopaedic surgeon, was speaking at a King’s Fund event in London to launch its report into GIRFT, which now covers more than 30 medical and surgical specialties.... read more


Private provider beats trusts and GP federation to community contract (Nursing Times: 23 August 2016)

Virgin Care has been named preferred provider to provide adult community services in the South of England as part of an alliance contract, ahead of a bid from local trusts and a GP federation.

The decision was made on 10 August by Guildford and Waverley Clinical Commissioning Group.

The alliance contract involves Virgin Care in partnership with Royal Surrey County Hospital NHS Foundation Trust, Surrey and Borders Partnership NHS Foundation Trust, Age UK Surrey and Surrey County Council.

A joint bid for the contract was also made by local GP federation Procare, Sussex Community NHS Foundation Trust and again Royal Surrey County Hospital, but was subsequently rejected by the more


GPs told to refer patients to private sector in bid to cut local trust’s waiting times (Pulse: 19 August 2016)

GPs in Hertfordshire have been told to refer patients to private hospitals in a bid to control soaring waiting times at the local NHS trust, Pulse has learned.

NHS Herts Valley CCG has told GPs to refrain from referring patients to West Hertfordshire NHS Trust (WHHT) for non-urgent appointments wherever possible, and has particularly encouraged GPs to not refer for certain specialties, including cardiology, ENT, urology, pain, and general surgery.

Instead GPs have been told to refer patients to alternative hospitals, including local private providers, while the Trust is in the process transferring existing referrals to the private hospitals. The referrals will be funded by the NHS.

This is in a bid to cut waiting times at the trust, which has failed to meet national 18-week referral to treatment more


Child deaths in Priory hospitals provoke calls to cancel NHS contract (The Observer: 4 June 2016)

It was a heartbreaking moment. Tearful jury members embraced a bereaved mother after hearing how her 14-year- old daughter had died neglected at the Priory Ticehurst House hospital in East Sussex, one of the country’s most expensive private hospitals, which was being paid to care for her by the NHS. It is the latest indictment of the state of child mental health care in this country. Questions are now being raised about both the Priory Group – Britain’s biggest private mental health provider – and the way private companies are receiving millions of pounds from public funds each year to care for nearly half the NHS’s child mental health patients.

Amy El-Keria’s death was the culmination of months of serious failings at the hospital. Staff failed to pass on the fact that she had spoken of wanting to end her life, and in November 2012 the girl was found with a football scarf tied around her neck. Even though she had a history of using ligatures, opportunities to remove the scarf had been missed, and it had not been placed on a list of banned items. Also, her risk level had mistakenly been downgraded from high to more


NHS patients sent for treatment at smaller private hospitals 'put at risk due to unsafe staffing and facilities' (Independent: 30 November 2015)

Serious problems found even in private hospitals rated 'good' by the regulator

NHS patients sent for treatment at smaller private hospitals are being put at risk because of unsafe staffing and facilities, according to a report by an anti-privatisation think-tank. 

Nurses without specialist training, high levels of agency staff on post-operative wards and hygiene weaknesses were among the alleged risks identified by the Centre for Health and the Public Interest.

Analysis of 15 Care Quality Commission investigations into hospitals from each of England’s six main private chains found serious problems even in hospitals rated “good” by the regulator.

For example, Care UK’s Barlborough NHS Treatment Centre in Chesterfield, Derbyshire, was given an overall rating of “good”, and also a “good” rating for surgery. Yet in the previous 12 months there had been four “never events” – serious patient safety incidents that should not occur. Similarly London’s Harley Street Clinic, run by HCA International, was rated as good overall, even though it “requires improvement” for both safety and the treatment of children. 

“In these cases safety risks appear not to have been prioritised in the overall ratings,” said the report from the think-tank, which was set up to challenge the growing role of competition and markets in the health service.... read more


Nottingham dermatology privatisation 'unmitigated disaster' (4 June 2015: BBC News)

The privatisation of a renowned dermatology centre which led to its near-collapse, was an "unmitigated disaster", a report has said.

Nearly all consultant dermatologists in Nottingham left when forced to transfer from the NHS to Circle.

The unit, previously a national centre for excellence at the Queen's Medical Hospital, now has a reduced service with some patients sent to Leicester.

The report said no one organisation was to blame but lessons had to be learned.

All three organisations involved - Circle, Nottingham University Hospital Trust (NUH) and Rushcliffe Clinical Commissioning Group (CCG) - accepted the findings of the independent report and have promised to work together to find a solution.... read more


NHS patients have cataract operations reviewed after private treatment (The Guardian: 1 September 2014)

Nineteen NHS patients have had the outcome of their cataract surgery reviewed after at least two had problems with their eyes following operations at a private hospital. The incident will intensify the political debate over outsourcing NHS services.

The problems arising from a new contract between NHS and private hospitals in south Devon came just weeks after it emerged that dozens of people who underwent similar procedures at a private provider in Somerset in May had suffered complications following their operations.

Although the hospital and private company involved this time are different, the incident involving operations at Mount Stuart hospital in Torquay, part of Ramsay Health Care, will reignite debate about the increasing use of private companies in the state health service.

The problems emerged on the first day of operations conducted under a contract to perform cataracts between the NHS's South Devon Healthcare Foundation trust, which runs Torbay hospital, and Mount Stuart.

No further patients will be referred for such surgery while investigations continue into what happened on 26 July, when 19 NHS patients, including four who went via the NHS's 'choose and book' system, underwent operations.

No patients have yet required further corrective surgery but most cases are still being reviewed. Some involved in the initial follow-up appear to have recovered normally, according to the trust, which has had a relationship with Mount Stuart for 10 years. Over the past year some patients needing orthopaedic, urology or general surgery have had their operations at Mount more


NHS faces legal bill as dozens suffer problems after private eye operations (The Guardian: 14 August 2014)

Dozens of people have been left with impaired vision, pain and discomfort after undergoing operations provided by a private healthcare company at an NHS hospital. One 84-year-old man claimed he has lost his sight and his family is calling for a full independent inquiry after it emerged that half of the 60 patients who underwent surgery suffered complications.

The routine cataract operations were carried out by the private provider, Vanguard Healthcare, in May to help to reduce a backlog at Musgrove Park hospital in Taunton, Somerset. But the hospital's contract with Vanguard Healthcare was terminated only four days after 30 patients, most elderly and some frail, reported complications, including blurred vision, pain and swelling. Some of those who suffered complications, including the 84-year-old man, have contacted lawyers to discuss seeking compensation, which raises the prospect of an NHS hospital picking up the bill for procedures done by a private health company.

The trust refused to talk in detail about what happened pending the conclusion of its own investigation. It also refused to discuss who would pick up any bill for compensation or details of its contract with more


NHS watchdog says Virgin Care-run clinic put patients at risk through untrained reception staff (The Guardian: 4 February 2014)

The NHS watchdog has accused a privately run urgent care centre of putting patients' health at risk by using receptionists with minimal medical training to assess how unwell arrivals were. A Care Quality Commission (CQC) report has criticised the operation of the urgent care centre at Croydon hospital in south London, which is run by Virgin Care. CQC inspectors found the centre was in breach of four basic standards of care and have told Virgin Care to outline by next week the remedial action it is taking. New reception staff received only a few hours of training before starting to assess patients with a wide range of symptoms, did not cover streaming as part of their induction and underwent no competency checks afterwards, the CQC found. Although the centre was meant to assess 95% of patients within 20 minutes, most patients had to wait over an hour to see a doctor and "at busier times the wait could be double this".Labour said the "huge failings in a privately run service" found by the CQC should make its chair, former Conservative MP David Prior, rethink his belief that more privatisation would benefit the NHS.... read more


Contract row leads to private firm’s departure from Leeds NHS walk-in centre (Yorkshire Evening Post: 31 January 2014)

A private firm pulled out from the running of a Leeds NHS walk-in centre and GP practice over a row about money. As reported in the YEP last week, health bosses are urgently seeking a new provider to operate the Shakespeare Medical Practice in Burmantofts. Current operator Care UK decided not to extend the contract after negotiations between it and NHS chiefs broke down. Now councillors have been told that the firm had asked for more money to provide the same service and for performance targets to be scrapped. After NHS heads refused, Care UK invoked an exit clause to leave the contract when it runs out at the end of February.

Nigel Gray, chief officer of Leeds North Clinical Commissioning Group (CCG), told a meeting: “We were in a strange and abnormal situation just before Christmas because they wanted to increase the financial value but not the activity and also a suspension of key performance indicators.

“We were not in a position to do that. It’s not in the patients’ interests or the financial interests of the NHS.” Members of Leeds City Council’s Health Scrutiny Board heard that Care UK had run the centre since it opened and their contract was due to end on February 28 this year. However negotiations with NHS bosses over extending it began last August.

Kathryn Hilliam, from NHS England, said: “Unfortunately discussions came to a halt when Care UK asked for something which we did not feel was acceptable. That was an increase in contract value and a removal of the key performance indictors.”... read more


Three private companies in running to take over NHS trust (BBC News: 23 December 2013)

Five organisations have been shortlisted to takeover the running of a Warwickshire hospital. The NHS Trust Development Authority (NTDA) said in September George Eliot Hospital could be administered by "a non-NHS organisation" or another trust. It was put in special measures earlier this year because of major failings. The two trusts and three private firms will now set out more details before further discussions in spring 2014, the George Eliot NHS Trust said. The organisations are Care UK Clinical Services Limited, Circle Health Limited, Ramsay Health Care UK, South Warwickshire NHS Foundation Trust and University Hospitals Coventry & Warwickshire NHS Trust.... read more


Serco may face fines over Suffolk NHS contract (BBC News: 12 November 2013)

Serco may face fines over its community health service in Suffolk after NHS commissioners found it was failing to meet key targets. The multinational private company took on the £140m contract to run community health services in Suffolk last autumn. It has been issued with a "performance notice" and a review into potential safety issues has been launched. The company says there has been a period of transition but insists it is delivering a high level of care. Serco is one of the companies bidding for NHS contracts, worth £6bn, currently out to tender in England. According to unpublished figures seen by the BBC, Serco's community intervention teams are failing to meet urgent four-hour response targets - for nurses and therapists to reach patients at home. It was also failing to meet non-emergency 72-hour targets. The report, by clinical commissioners in Suffolk, also reveals delays in producing care plans for palliative patients and carrying out health assessments for children in care.... read more


Hospitals run by private provider the subjects of CQC concerns (The Independent: 21 October 2013)

Two hospitals run by Partnerships in Care, which in turn is owned by the private equity firm Cinven, have been the subject of recent reports conducted by the Care Quality Commission, which expressed concerns over patient safety, low staffing, and a lack of respect for basic dignity. The Dene, a medium-security psychiatric hospital in West Sussex, failed all seven categories of a recent inspection by the Care Quality Commission  and enforcement action was taken. Annesley House, a psychiatric hospital run by the company in Nottingham, failed four out of  five areas inspected, with growing numbers  of whistleblowers alleging that patients were treated in a “disrespectful” and “degrading” way.... read more


Tax Special Investigation: Firms running NHS care services avoiding millions in tax (The Independent: 21 October 2013)

Companies receiving lucrative government contracts to run care services looking after tens of thousands of vulnerable people are avoiding millions of pounds in tax through a legal loophole. (...) Several of the company’s secure hospitals for mental health patients have recently received damning inspection reports, which criticised poor patient safety, critically low staffing  and a lack of respect  for basic dignity.  The Dene, a medium-security psychiatric hospital in West Sussex, failed all seven categories of a recent inspection by the Care Quality Commission  and enforcement action was taken. Annesley House, a psychiatric hospital run by the company in Nottingham, failed four out of  five areas inspected, with growing numbers  of whistleblowers alleging that patients were treated in a “disrespectful” and “degrading” way.... read more


Private firm has NHS clinic contract terminated (The Daily Mail: 2 August 2013)

Ministers terminated the contract with Clinicenta to run the treatment centre at Lister Hospital in Stevenage after local GPs stopped referring patients to the unit. The CQC found the unit was not meeting minimum standards after an investigation into the deaths of three people. The unit is also said to have lost 8,500 outpatient medical files, resulting in six people suffering irreversible loss of sight. Yet the terms of the contract mean that the Department of Health must pay £53million to Clinicenta to end the deal. The NHS will resume providing services.... read more


Stevenage Surgicentre: Hospital licence to be suspended says MP (BBC News: 20 June 2013)

A privately-run NHS hospital has been told its licence is to be suspended after three patients died following routine surgery, an MP says. Stevenage Conservative MP Stephen McPartland said the Care Quality Commission (CQC) issued a suspension notice for the Surgicentre on 16 May. The CQC investigated three deaths at the Stevenage unit, in Hertfordshire. A spokesperson for the Surgicentre said services would continue as normal "for the foreseeable future".

NHS patients are referred to the Surgicentre at Stevenage. The Surgicentre provides routine surgery in areas such as ear, nose and throat, trauma, orthopaedics, gynaecology and ophthalmology.... read more


NHS stops referring patients to private hospital after damning report (The Guardian: 3 May 2013)

The NHS has said it will not refer patients to a private hospital following a scathing assessment of the chaotic and dangerous conditions that led it to suspend children's surgery two days previously. This is the first time the NHS has imposed such a block on local hospitals. The Mount Alvernia hospital in Surrey, run by BMI Healthcare, one of Britain's biggest private healthcare providers, agreed to suspend surgery earlier this week after the damning Care Quality Commission (CQC) report. Care failures cited by the report included a surgeon who operated without gloves in blood-stained shirt sleeves, and a child who was not seen by a paediatrician for seven hours despite their condition deteriorating.

An unannounced inspection in February, carried out after concerns were raised by whistleblowers, resulted in the hospital failing on every measure but one. It met an acceptable standard only on the management of medicines. The local NHS clinical commissioning group (CCG) said on Friday it had stopped referring patients there "for the time being".

BMI Healthcare apologised for the failures, which it called unacceptable. It said all the issues at Mount Alvernia had been put right since the inspection and that it had reviewed all of its other hospitals and found no similar problems elsewhere.... read more

Calls to close privately run NHS clinic after death (The Guardian: 5 January 2013)

The brother of a woman who died after routine treatment at an NHS surgical clinic run by Carillion, a building firm, has called for the centre to be closed after an investigation found that, at a crucial moment, the clinic did not have a ventilator available.

Anita Mansi, who was 86, died last summer from multiple organ failure two days after a knee operation at the controversial Surgicentre, an NHS service at the Lister Hospital, Hertfordshire run by Carillion, formerly part of Tarmac. She had previously been in good health. Hers was one of three deaths that prompted an independent investigation in December 2012 into the care of four patients, including one who survived treatment at the Surgicentre.... read more

‘It sounds like an upgrade. But being sent to a private clinic by the NHS can end in tears’ (The Daily Mail: 3 December 2012)

Mrs Celia Collett from Plymouth suffered serious burns in a surgical accident while undergoing a hip replacement as an NHS patient in a private hospital. She had been sent for the operation at the Haslar Hospital in Portsmouth, under a contract agreed between the NHS and Netcare, a South African health company. Following the surgery, not only did she have pain from the third-degree burns to her foot, but only a few weeks later her new hip became dislocated and had to be wrenched back into place causing her constant pain. The hospital assured her that the burn wound — caused by surgical equipment — was superficial and would heal in ten days. But in fact she had to have it dressed three times daily for three months until finally a surgeon recommended a skin graft. The NHS absolved itself of responsibility for the consequences of her surgery, forcing Mrs Collett to fight for help with the aid of a specialist lawyer. Six months after her original operation, she had further surgery, performed by an NHS surgeon at a private hospital paid for by Netcare.

Mrs Collett has subsequently been contacted by five other patients who had also received faulty hip operations around the same time as her, under the same NHS-private contract. Netcare blamed a single rogue surgeon who has since been excluded from operating.... read more


Patient deaths raise fears over clinic run by building firm (The Guardian: 28 October 2012)

An investigation has been launched into the deaths of two patients after routine surgery at an NHS surgical clinic run by Carillion, a building firm that has moved into offering "cost effective" healthcare. The local NHS has described the deaths as serious incidents and GPs have decided to adopt a policy of dissuading their patients from being treated by the private care provider. The Surgicentre, attached to the Lister hospital in Hertfordshire, is owned by Clinicenta, a wholly owned subsidiary of the building giant Carillion, once part of Tarmac.

Meanwhile, the Observer reported that according to minutes from a recent meeting of the local East and North Hertfordshire Clinical Commissioning Group reveal that there have been "21 serious incidents of both a clinical and patient information governance nature" since the clinic opened in September 2011.... read more

Patients 'lost sight' at NHS hospital private clinic (The Guardian: 31 August 2012)

Six people are feared to have suffered irreversible sight loss because of the failings of a privately run clinic at an NHS hospital. The surgical clinic, owned by Carillion, has only carried out NHS services at Lister hospital since September 2011, but has also been the subject of criticism from the Care Quality Commission regarding waiting times for a range of services. Now it has emerged that GPs in the area have been warned by their local representative body of allegations that permanent damage may have been inflicted on some patients with serious eye conditions because of a lack of follow-up care after treatment.... read more


Care UK fails to process x-ray records of 6,000 patients (The Guardian: 17 April 2012)

Leaked report into patient death exposes failings of private provider (Pulse: 26 May 2010)



More on quality: 






Trends in reported problems:

cost cutting

cuts in services


financial insecurity

Examples of reported problems (by provider)

BMI/Netcare - childrens surgery halted 

Care UK - patients discharged before they are treated

Carrillion - 6 patients feared sight loss

Harmoni (Care UK) - out-of-hours service alleged "unsafe"

Netcare -Celia Collet tells of her poor care

Serco - not enough staff and "fiddled" figures

         - NHS lab failings

PIP - breast implant scandal

Virgin - understaffing at Kings Health Centre





Share your examples about the impact of NHS changes - in a community d/base 


Recent reports:

Quarterly survey of NHS financial directors by The King's Fund - February 2013 report


‘Making it better? Assuring high-quality care in the NHS

NHS Confederation discussion paper on the quality of care in NHS following the Francis report - February 2013


Care Quality Commisson State of Care report 2011/12

Annual survey by the Care Quality Commission

“Overall CQC is finding that the increasing complexity of conditions and greater co-morbidities experienced by people are impacting on the ability of care providers to deliver person-centred care that meets individuals’ needs. It is also seeing increasing pressures on staff, both in terms of the skills required to care for people with more complex conditions and in terms of staff numbers.”

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