Non Urgent Elective work in the private sector.

[Al1langdownthecleghole]

I've just picked this up from the Health Service Journal, not sure if the link will work but I know they are doing free access articles again for this wave if people sign up.

Seems senior medics are hospital leaders are seriously pissed off that some private non-urgent elective work is still happening, whilst NHS hospitals employing many of the same consultants are on their knees.

HSJ Private Elective Care

NHS England and senior clinical leaders in London are ‘profoundly uncomfortable’ that some routine elective care is continuing in private hospitals, while the NHS faces ‘unthinkable’ pressures from coronavirus.

In a joint letter to all the medical directors of the capital’s acute hospital trusts, regional leaders ask them “not to support” their staff who are performing non-urgent work in the private sector for the next month.

HSJ reported earlier this month, that NHS England London was attempting to get the private sector to provide more surgery for urgent cancer patients in London.

Where is Matt Hancock in this? Surely this needs more action than a letter?

That is shocking!!

I isn't it? So much for we're all in this together

I’d just assumed any medical staff working on elective procedure would be ‘lent’ for want of a better word to support the covid effort. At the least I’d hope they weren’t doing procedure that are elective as with most elective procedure there is a risk of a side effect or infections etc that might mean nhs resources taken up unnecessarily.

I think the govt could just requisition the hospitals if they wanted to and hire the nurses and support staff who are there already. But will they have the balls?

Sorry if this is controversial, but bear in mind non-urgent elective surgery covers a lot of things.

My DH had "non urgent elective surgery" two years ago. He had a back problem. Had been unable to get off the floor for months. Like 9-10 months. Literally he lay in the hall as it was closest to the bathroom. He had no quality of life. He couldn't do anything, not even shower, or sit up to eat. It took its toll on me too, as I became a full time carer. The kids were distressed. I felt like a single parent.

I fully agree that many many "elective" surgeries can be paused. But not all.

@concretejungle that’s a good point. I wasn’t thinking operations like that would come under ‘elective’.

It’s not that simple.
Simon Stephens wants as much elective work as possible to continue, not unreasonably. The independent sector already have huge contracts with CCGs to provide low risk elective surgery. It’s better to get those hips replaced, if at all possible.

Many of the consultants offering specialities in private sector aren’t much use on a critical care unit and wouldn’t have a clue about NIV settings. I’d not want a gynaecologist intubating me.
Anaesthesia is usually provided via a local consortium rather than direct employment. It’s a business, like any other.

Private hospitals, with very few exceptions, are not set up to manage very unwell patients at risk of sudden deterioration. Most just have one junior doctor on duty. They usually transfer out unwell patients using a 999 call. Not exactly useful at the moment.

Some independent hospitals are starting to offer beds for step down and rehabilitation but their skills are not with frail elderly medical patients, generally. Most current inpatients are either Covid19 patients, frail elderly, or a speciality with emergency admissions like stroke services and coronary care. They cannot be moved to independent sector.

I fully agree that many many "elective" surgeries can be paused. But not all

I agree, one of my operations was cosmetic and could have been paused completely, the other meant I couldn’t move my arm without excruciating pain

If they are doing it on the time they are contracted tomNHS, then that is very wrong.

If they are fulfilling their NHS hours (and survey after survey shows that, no matter how much people like to toss around the stereotype of fat cat consultant shafting the system, the consultants work well in excess of contacted hours) then nothing is changed.

Look at the many other threads here where MNers are advised, when their NHS elective procedures are cancelled again, to go private.

Who else is going to provide those private services?

I know. His other option was "wait and see". Consultant said 20% of cases resolve themselves in 3-5 years.

😱😱😱😱

3-5 year of my kids life. And my life. Not to mention his life.

Survey was "elective" as he had the option to "wait and see". Terrifying!

Why on Earth would they be doing it during time they are supposed to be working for the NHS?

That would be a sackable offence.

What’s happening is more like this - the private hospitals are doing elective NHS work Monday to Friday because the NHS hospitals can’t. This means that some NHS surgeons are ‘working in private hospitals’ during the week.

Private surgery is largely taking place at weekends, using theatres that are not otherwise being used, and staff that are having their weekend off work but choosing to work privately. It means that not quite so much private surgery is happening, so the type of surgery allowed to go ahead is based on clinical urgency.

I’m sorry some are so quick to jump to conclusions.

My MIL has just had a replacement knee. It was supposed to be done last year. She couldn't work.

It was done in the NHS in a private hospital.

One surgeon us doing 30 knee replacements a week at present for the NHS.

The hospital is currently 100% contracted to the NHS to do this work to try and reduce backlogs.

Elective surgery is not just for vanity or things that can wait. A lot of serious surgery is called elective.

Them going this is stopping further strain in the NHS by treating patients now and saving money in the longer term.

It is a way for the NHS to get surgeries done whilst the public sector hospitals treat Covid patients.

Sorry should have been could not walk.

Exactly. But people are just so determined to be outraged aren’t they? Even when they are so very ignorant to the facts.

I've just had my gallbladder out privately. It was 'elective' but symptoms were escalating, attacks were becoming more frequent and severe (worse than childbirth anyway) and my consultant was pretty adamant if I didn't have it removed I'd likely end up with a serious infection/pancreatitis, a week in (an NHS) hospital to sort the infection, and then probably an emergency NHS op to remove anyway. This all would also have affected my husband's ability to work and my children's happiness in the short term. How that would have been a better outcome for the NHS I don't know, seeing aside the benefits to me and my family and the removal of one more person from the queue once this shit show is over.

*setting

The only issue with elective surgery continuing at private hospitals is there is no ICU bed for the patient if a medical emergency happens and an ambulance is called. However I suspect private hospitals are minimising the risk of this by refusing to treat some patients.

You are correct!

I’m not sure if people have been able to access the article, but to be clear the concerns raised in the letter are about non-urgent elective procedures. It’s not suggesting emergency only and nor is the issue with NHS block contracts.

It is about the availability of senior medical staff who are prioritising private work over NHS work for money. And about the effort required to stop this.

I hadn’t realised the link was there. Just read it:

The focus on the staff - suggesting that hospitals should “ not to support their staff who are performing non-urgent work in the private sector for the next month.” Feels unfair.

I absolutely agree that anything that can safely be postponed without too much detriment to the individual should be and that any ‘spare resource’ from the private sector should be helping with the strain on the NHS. However I think the focus should be on the private clinic themselves not on making things more difficult for staff.

Its no wonder people feel uncomfortable about private clinics making money out of the difficult situation while the nhs is under such strain.

The system itself rather does invite this problem though doesn’t it? I mean the whole point of private health care is that people can access treatment they can’t get, or can’t get fast enough, on the nhs....otherwise there wouldn’t be private health care would there. I think maybe their needs to be changed in the system to ensure that at times of great need the health system as a while is used for the benefit of all, but I assume that would mean changes to law/contracts and lots of other complicated things I’m not knowledgable enough to understand.

Every experience people have mentioned on this thread so far seems reasonable to go ahead. My mum has had an operation cancelled that isn’t life or death but that is having a huge impact on her quality of life and my dads who is caring for her. I’d be happy if they could go ahead if it wasn’t for the risk involved that might mean she needs significant care.

@Al1langdownthecleghole

I’m not sure if people have been able to access the article, but to be clear the concerns raised in the letter are about non-urgent elective procedures. It’s not suggesting emergency only and nor is the issue with NHS block contracts.

It is about the availability of senior medical staff who are prioritising private work over NHS work for money. And about the effort required to stop this.

I accessed the link. It refers to operations classed as RCS category 3 or less urgent and goes on to mention that this includes some breast cancer and prostate cancer surgery.

The letter is just another example of people who think that Covid is the only medical thing going on.

The sooner people who can afford to pay for treatment get it, the less work and burden they are on the NHS, which is going to really struggle to catch up, many will die waiting.

I need a so called non urgent operation, i'm paying to go private because the alternative is going to be 18 months to 2 years waiting, in pain, loss of job and finally needing more surgery, with a far longer recovery - Operation now, 1 week. Operation in a 1 to 2 years 3 months plus the possibility it will become urgent, even life threatening.

Just because someone doesn't need surgery to save their life, doesn't mean they don't need the surgery. I think people should mind their own business.

Dd is supposed to be having surgery privately

It looks like all operations are about to be cancelled as the local NHS hospital is struggling

@puffinkoala

Just because someone doesn't need surgery to save their life, doesn't mean they don't need the surgery. I think people should mind their own business.

This. If an operation would improve someone's quality of life then why shouldn't they have it?