There was a 7% increase in private hospital admissions in the first three quarters of 2023 when compared to the same period in 2022, according to data released by the Private Healthcare Information Network (PHIN) today.
Admissions paid for through private medical insurance (PMI) stayed at near-record levels, were the joint second-highest ever recorded, and were higher than in Q3 2022.
While the number of private hospital admissions paid for by the patient, or their family (self-pay), was 32% above pre-pandemic levels, they did fall 8% to 66,000 over the third quarter of 2023 compared to the post-pandemic peaks of 72,000 per quarter.
On course for a record year
The total number of admissions was 9,000 (4%) above the same quarter in 2022. While the numbers have dropped each quarter in 2023, PHIN revealed the private sector is on track to have had more admissions than in any previous year on record.
Admission numbers rose highest in Northern Ireland by 42%, marking by far the biggest increase of any nation in the UK. Wales (5%), Scotland (5%), and England (4%) all grew at similar levels.
Insured admissions remain at record levels
According to the data, the number of admissions paid for with PMI remained at the second-highest level in PHIN records, with 11,000 more insured admissions than in the same period in 2022 (8% increase).
When comparing the data with Q3 2022, the number of admissions using PMI rose in every English region, except the South West where they remained the same. They also rose in Scotland (6%), Wales (+%), and Northern Ireland (2%).
While the biggest rise in England occurred in the North East (13%) and East Midlands (12%), the largest rises by volume were in London (4,560) and the South East (1,775).
Self-pay admissions down
Turning to self-pay, these admissions were down by 1,000 (-1.5%) in Q3 2023 compared to Q3 in 2022. While only a small decline, the data indicated self-pay admissions were at their lowest levels since before the pandemic.
Indeed, admissions financed by ‘self-pay’ fell in every English region. The biggest percentage fall in England came in the South West (-10%) and London (-9%). Those regions also had the largest fall by volume.
However, self-pay continued to grow in the devolved nations: Northern Ireland (159%), Scotland (4%), and Wales (7%).
Procedures
In terms of procedures, the biggest increases by volume in admissions in the Top 10 procedures were for ‘Diagnostic upper GI endoscopies’. These increased by 600 (6%).
The next biggest volume increase was in ‘Hip replacement (Primary) at 300 (4%).
The biggest decrease was in cataract surgery which was down 1,900 (-10%). ‘Therapeutics – Chemotherapy’ also had reduced admissions; it was down 1,500 (-8%). Patients require multiple admissions for chemotherapy and the number varies depending on their health and the type and stage of cancer.
New record private hospital admissions expected
Richard Wells, director of Healthcare Informatics, who manages PHIN’s data team, said: “Given the level of admissions in the first three quarters of the year (January-September), it would be very unexpected if hospital admissions in the private healthcare sector don’t hit record levels in 2023 when all the data is collected and analysed.
“However, the way people are paying for their treatment does seem to be changing again.
“After a rapid growth in self-pay following the pandemic, PMI has been firmly re-established as the primary method of payment for private healthcare and, indeed, is now more popular than before the pandemic.
“This will be down to several factors, including the increased availability of workplace-based insurance schemes and a better understanding of the costs and benefits of medical insurance.
Cosmetic surgery abroad
“Cosmetic surgery, which is predominantly paid for using self-pay, could be a factor in the reduction in admissions paid for that way. Procedures including breast enlargements, breast implants and rhinoplasty (nose jobs) were all down on the same quarter in 2022.”
Wells added that amid widespread reports of people traveling abroad for such surgeries, it was possible this was affecting the number of people choosing to self-pay for these treatments in the UK.
“We think it’s understandable that the lure of a ‘cheaper’ option abroad could be very attractive, especially if it’s combined with a bit of warmer weather, but – while many countries in Europe and beyond have excellent healthcare systems – we would caution people to ensure they do their research before making any decisions,” Wells continued.
“People should be aware that there are a variety of standards and regulations in different countries and that these may impact the treatment and aftercare they receive.
“We encourage people, even when traveling abroad, to use the information on the PHIN website as a standard template for questions when inquiring about medical care as we document the optimum information required.
“We would advise potential patients – whether thinking of traveling for a medical or cosmetic procedure – to check the qualifications and accreditations of the healthcare providers and facilities in the chosen country.
“It’s important to check that the medical care professionals are certified and the hospital or clinic adheres to international standards.”
Significant demand for private healthcare
David Furness, director of policy and delivery at the Independent Healthcare Providers Network (IHPN): “The latest data shows strong continued demand for private healthcare, with large numbers of patients choosing to use the private sector to access healthcare.
“Since the pandemic, we have seen a significant increase in the numbers of patients choosing private healthcare – paying for this either by their own means or through insurance.
“It’s notable to see the numbers of insurance-based admissions are still high, which insurers have also been reporting – with corporate insurance demand still strong.”
Furness maintained amid a lot of recent discussion about the cost of inactivity to the economy, it would be interesting to see whether the government takes further steps in tomorrow’s Spring Budget to support and encourage businesses to keep their workforce fit and well.
“Our most recent research showed that a quarter of businesses are already offering PMI to employees, and one in five are planning to introduce it within the next year, so businesses are being proactive in ensuring the wellbeing of their workforce,” Furness continued.
“We know that NHS waiting times are a significant factor in people’s decision to seek private healthcare, and we know that businesses are concerned too about the impact of these long delays on staff absence rates and productivity.”
Reflecting the deteriorating state of the NHS
Brett Hill, head of health and protection at Broadstone, said the figures reflected the deteriorating state of the NHS and the growing demand from employers to ensure they are protecting the health and wellbeing of their workforce.
“Since the pandemic, it has become increasingly difficult for people to access timely NHS healthcare that can treat debilitating issues and diagnose conditions at an early stage to avoid more complex conditions and treatment further down the line,” Hill continued.
“We are now seeing the impact of this materialise in the private healthcare market with private admission levels reaching record highs as people increasingly opt to go private rather than face the day-to-day pain of a persistent condition or the risk of more serious illnesses going untreated.
“The acceleration in private healthcare is largely being driven by a recognition from employers that they need to cover the NHS’ shortcomings urgently and put in place health services to help their staff get access to the care they need, when they need it.”
Hill warned unless employers can get to grips with the conditions that are driving record-high economic inactivity because of long-term ill-health, they risk seeing their productivity and retention levels suffer significantly.
“Meanwhile self-pay appears to have plateaued – albeit at higher than pre-pandemic levels – given the constraints around the number of people who can afford to fund their own treatment,” he added.
“Until the NHS can get on top of its vast waiting list, we expect to see these trends continue (or even accelerate further) and potentially drive a permanent change around how UK workers access the healthcare system moving forward.”
