The private healthcare sector is a useful way of dealing with NHS backlogs but may not be an “efficient” or “sustainable” way of managing wait times and highlights a lack of investment in the public service, according to the King’s Fund.
Instead the health think tank emphasised measures such as valuing and investing in people working in the NHS and having a clear, central vision and goal for waiting times.
While improvements in wait times in the early 2000s were achieved during a time of sustained economic growth, the think tank highlighted opportunities to reduce waiting times in the present day. These were by:
- addressing shortages of healthcare staff and physical resources urgently;
- working with integrated care systems in the spirit of prevention, collaboration, inclusion and community‑based models of care;
- and aligning a vision for the health services with a plan that offers collaboration between staff, patients and the public to hit drive down wait times.
Useful short-term measure
This subjects were part of the organisation’s report into strategies that were effective in cutting wait times across the NHS under the Blair/Brown Labour government between 1997 and 2008.
The report noted that the independent sector was potentially useful as a short-term measure for dealing with a backlog of care in the NHS.
However, it warned this use may not be the most efficient or sustainable way of managing waiting times in the long term in the context of a publicly funded health service.
And it emphasised that if it was necessary to rely on independent sector capacity to keep waiting times at a manageable level, this would suggest underinvestment in the capacity of that publicly funded health service.
Researchers also pointed out that independent sector treatment centres did not treat particularly high volumes of patients and so had a minimal impact on NHS waiting times in the early 2000s.
The increase in private sector activity came after 2008, resulting in a surplus of capacity that could be used to undertake a high volume of elective hip and knee procedures.
Speaking at an event presenting the report’s findings, King’s Fund chief executive Richard Murray told delegates that in the first decade of the century it had been thought that offering choice to reduce wait times would disproportionately benefit the most deprived who are solely reliant on the NHS.
But Murray added some treatments proved too expensive for even the middle class.
Murray explained: “If you look at the middle class you can pay privately to have a cataract operation but by the time you get to serious, heavy duty care, it’s beyond the ability of most middle class people to pay for it too.
“So there is an inequalities element in there, but just reducing wait times can’t be the only thing you do.”
Successful strategies
According to the report, researchers found that successful strategies to reduce wait times between 1997 and 2008 tended to be linked with a range of activities that simultaneously ensured sufficient supply of healthcare, managed demand and optimised the conditions within the healthcare system itself.
They were also underpinned by an idea of what the health service as a whole should look and feel like, and incorporated how waiting times are brought down as much as what activities might be used.
Experts told researchers the 18 week wait time target was hit due to:
- valuing and investing in people working in the NHS;
- a clear, central vision and goal for waiting and an ambition that those working within healthcare felt equipped to take on;
- cultivating relationships and leadership at all levels of the healthcare system;
- accountability, incentives and targeted support to encourage performance against waiting times targets and other measures of quality of care;
- and seizing the momentum of wider NHS reform.