Paying for an operation privately but performed in an NHS hospital - has anyone had any experience of this??

[BorntoDillyDally]

Quick background - FIL has been experiencing some health issues over the last few years. He had an exploratory procedure (via the NHS) in May. An issue was discovered. He is still yet to hear back from the department.

The issue worsened very much over the summer and resulted in a hospital stay so FIL decided he wanted it resolved and went down the private route. We had a consultation with a private consultant (who also works at our local NHS hospital) and was told he could perform the op privately, no issue. FIL has decided to go ahead with this. The operation is booked for the end of this month.

We assumed it would all go ahead at the local private hospital but have discovered that due to a number of potential complications (FIL being 85 and medically obese), the op will be performed at our local NHS hospital but still under the private hospital. It will cost him £25k.

We had the final consultation yesterday and had naturally assumed FIL would be transfered back to the private hospital after the op, when he was settled (the private hospital is just over a mile away from the NHS one) but have been told it is safer for him to spend his complete stay at the NHS hospital. The op will be about 5 hours long and if all goes well it should be a 2 day recovery stay.
Of course the safest place for him is the best place for him and if this is the NHS hospital then so be it.

In all honesty I didn't even know private paying patients were having operations within NHS settings but I suppose it all helps go towards the NHS purse?

Has anyone done this? How did it go?

Not necessarily. We have a private ward in both our acute hospitals in our county so private patients get better food and ensuite rooms as standard.

Yeah but the OP had already said that wasn’t an option.

And there are circumstances when PPs don’t get a private room ‘cos they are too high risk to be in one.

OP, I had an operation in a private hospital earlier this year (routine surgery) but they made it very clear that if there were any problems, I would be bundled unceremoniously into the back of an ambulance and taken to the nearest NHS hospital. Most private hospitals are simply not set up for any sort of emergency treatment, so although it may be irritating from your POV that your DF will be put on a ward after his operation, the NHS hospital is very much the safest place for him.

I have had a cosmetic procedure (day case, no overnight required) in an NHS hospital.

Basically the surgeon had a deal with the hospital where he rents the theatre in his lunch break/afternoon off.

It's no doubt better for him being in a fully equipped NHS hospital.
But I do have an issue with NHS facilities /operating theatres being used for private operations and moonlighting NHS surgeons using the NHS facilities for their private patients.
Of course I completely understand why patients do this and I wish your dad all the best OP and hope he has a speedy recovery.
But it just doesn't sit right with me. Same NHS surgeon same NHS hospital but pay 25k and you can go straight to top of waiting list and bump poorer patients down the list.
NHS operating theatres and beds should be fully utilised for NHS patients and not rented out to paying private patients.

He may be safer in the event of an extreme adverse event post surgery in the NHS ward - but what about basic nursing care, pain relief and even food and water?!

Will the consultant commit to regular visits after surgery and to ensuring that his instructions to nursing staff and pharmacy - in particular re pain relief - are carried out?!

Actually the OP didn't say that - she is assuming it, but it doesn't say anywhere in her posts that she is correct in that / has had it confirmed. As @TeenLifeMum said, all our local hospitals have at least one or two "private sections" with individual rooms or cubicles. One even has an entire building that is now private! AFAIAA only one hospital within the five counties around us has no private facilities.

News reports today of horrific events at another two NHS hospitals - one the unsolved sexual assault and murder of a female stroke patient on a ward in Blackpool and the other of a man left in constant pain despite doctor instructions in the Borders.

Actually the NHS benefits from over £700 million income (2023 figure) from renting out their facilities, which contributes to the treatment of NHS patients. If they didn't receive that income it wouldn't mean that more NHS patients would be treated - it would mean fewer NHS patients would be treated. And the surgeons are not moonlighting - they are fulfilling the employment contracts that they hold with the NHS, and have other employment as well, just as you or I could have two jobs.

I understand that the NHS is struggling to provide the level of care that it ought to do, but treating private patients is a net contributor to those facilities and there would be even less to go around if that money were removed.

When I was 23 I had braces on (teeth). The regular orthodontist couldn’t do what was needed as I had already had braces on (in my teens) and had multiple extractions, but my mouth was still cramped. He referred to to the consultant at the local hospital (maxiofacial consultant). I was told I could pay to skip the queue instead of wait for the referral, so I did, I could then choose to wait for an appointment on the nhs, wait time would be about a year or pay so I paid (I was a carer so not loaded and did extra shifts to pay for it, it was a couple of grand). I saw the same consultant in the same hospital ‘after hours’ when he basically rented the room, if I had an issue during the day he would always fit me in, between the nhs clients.

this was back in 2002.

Hope all goes okay

Having visited my local private hospital about a cosmetic operation recently, I can't say I was impressed!

would you prefer that the theatre was empty instead (because that's what would likely happen) and then likely wasting even more money (because even an empty theatre consumes resources with the air turnover/temperature control/fridges/heating cabinets etc). There just isn't always a full team to cover every theatre every day of the week (and increasingly medical staff at least are having their contracted number of sessions fixed at a lower number than in the past). The surgeon is allowed to do what they like on their days off from NHS practice - they can do private practice or be on the golf course or do an extra NHS list or maybe even see their families....whatever they like. Ditto for the rest of the theatre staff. There will be a pretty hefty transfer of cash from the private to the NHS which will support provision of NHS care to patients who otherwise may have had to wait longer. The deal for the resident doctors when I was young (which to be fair was about a thousand years ago) was that we had to support care of the private patients in the usual order of clinical priority because a chunk of the cash they attracted was used to support our training/facilities (saving the hospital from having to splash out so much on us). It really is more complex than you might imagine...

Absolutely. It would only be if icu/hdu were needed you wouldn’t get a private room.

The profit goes back into the nhs.

I've had a private procedure done in an NHS hospital - it went fine, the staff were very experienced, seen quickly, nice room etc.

The only negative was that this was through medical insurance and it was a palaver afterwards sorting out the billing, I got invoiced for it mistakenly because the insurer didn't normally deal with that hospital and it took a few calls to sort it all out.

@TeenLifeMum as someone who has had to manage expections around this professionally please take it from me there are many reasons why a private patient might not get their own room.

Yes, I'm sure they would like to have one but unless their agreement with the NHS hospital specifies that one will be provided to lead them to believe that it is a guarantee is setting them up for disappointment and some poor member of staff for a difficult conversation.

Different hospitals will have different policies. I can only speak about the two in my own trust.

Just a couple of thoughts.

I started in the NHS and then went to work at a private hospital. In the NHS we occasionally had private patients, mostly the money went in to the department's budget but sometimes I would do overtime and be paid by the NHS and again the money from the PP would go to the department.

The other thing. People up thread talking about how they would be taken by ambulance to the NHS hospital. What they have not said is that as a PP they would then be sent a bill from the NHS hospital because they are still PP.

The SORT score is 10% which the surgeon has rated as high risk.

The procedure is to remove a very enlarged prostate and to clear very large and multiple bladder stones which are causing recurring UTI's, the last one caused him to collapse and he was hospitalised for a week. The surgeon has said FIL will more than likely die within a year from sepsis if he does not have this op.

I really wanted him to see the NHS consultant who discovered the issue back in May just to find out if he was on the same page as the private consultant but FIL and DH are dead set on going down the private route so my hands are tied and I will just need to support them both I suppose.

I totally agree with you, as someone who has been sitting on an 18 month long NHS waiting list for my own surgery it does sting a little that this happens.

Tbh, we were taken aback during the initial consultation with this private surgeon, we were not expecting to be using NHS facilities at all and it still does not sit right with me. (although FIL safety is of course the main issue).

Ideally, I would have expected the surgeon to have stated the surgery was too high risk for the private setting and advised FIL to go back to the NHS consultant but there you go, £25k is a lot of money (for FIL and the surgeon!).

Again this is a concern of mine. The operation will be on a Saturday, the weekends always have less staff during weekends so that's a concern as well.

that SORT score is high - presumably they've explained to him what it means.
A few general thoughts that may be worth exploring.... if he hasn't already, he will likely benefit from seeing someone (probably an anaesthetist with an interest in perioperative medicine) who can go through the risks/benefits in a bit more detail and to see if anything can be optimised to improve that risk. Am not sure how routine these clinics are in the private, but they are routine in the NHS for high risk patients. There are some other scoring tools that can be used to predict how likely some other complications might be and help with planning post-op care. None of the risk predictors are perfect but I just wonder if it may be useful to help him frame his expectations about recovery. I would also ask some questions about where he'll be cared for post-op (does HDU know about him already/what would happen if they're planning to go there but there's not bed on the day...). If they're not planning an HDU bed I'd ask a) why and b) what critical care outreach provision they have at the weekend. Stones are usually managed pretty well in the NHS and it may still be worth referring back. Before parting with any cash I'd ask why, if he's recently had an episode of sepsis due to the stones, they decided not to proceed with planning surgery then....surgeons love operating and stones don't get better by themselves. If the reason they haven't planned the procedure in the NHS is because doing it is higher risk than doing nothing then that may be useful to know.
Sounds like he's a bit stuck between a rock and a hard place. Urologists are usually pretty good at thinking beyond their own organ system but perhaps may not have covered quite all of the things that could crop up and to make a properly informed decision about a) whether to proceed and b) where/how to proceed, he should know about all the benefits and risks. Very sensible not to be having it done in the private hospital!

Im glad all your relatives had their operations. Generally, I don’t think it’s right, when there are such long waits, for NHS staff to use NHS facilities to carry out private operations. Or even for the NHS to manage or undertake private work.

Thank you very much for the advice.

I will just add that FIL recent hospital stay was not due to sepsis, no one knows quite why he collapsed (his legs gave way in his bedroom, he fell and laid there for 3 days) they are assuming it is something to do with the UTI. The ward referred him back to the NHS urology department but we are still yet to hear from them. I tried calling but as I am not down as a next of kin they could not give me any info. DH has tried but due to the nature of his work he couldn't use a phone most days. I am concerned the NHS have deemed FIL too high a risk for surgery and this is why he has not heard anything but they have not contacted him following the cystoscope findings in May and the ward chase up.

He (and dh) had a consultation with the anaesthetist who works alongside the urologist, they are both happy to operate on fil despite the SORT score. They have basically sold it that he will more than likely die within a year from sepsis if he were to leave things which is a current regime of various antibiotics on a three week rota. The prostate will continue to grow (currently the size of a tennis ball) and completely block the bladder without surgery, according to the urologist.

We are due to have the pre-op appointment at the NHS hospital any day now so I will go with a full list of questions for them including what would happen if things did not go to plan and ask more about his after care.