The government has proposed enabling private firms to take over NHS hospitals’ operational management, particularly those facilities that have long-term financial difficulties. This type of hospital is frequently referred to as ‘failing’, even if they are persistently avoiding medical negligence compensation cases and are achieving excellent standards of clinical care.
These financial struggles are being compounded by a drive to deliver efficiency savings worth £20 billion, as well as the requirement for all NHS hospitals to become part of foundation trusts before 2014.
As a result, the government suggests that efficiency could be improved by increasing the private sector’s role in the NHS and by increasing competition between hospitals, and therefore, there will be agreements that will see NHS hospitals’ management outsourced by private companies. An early pioneer of this approach is the company Circle, which began managing Hinchingbrooke Hospital in February 2012. Some people worry that these changes could lead to more medical negligence claims – the NHS Support Federation has suggested that private companies might threaten the efficiency and ethics of the UK’s public healthcare.
Clinical negligence claims – Circle and Hinchingbrooke Hospital
When Circle took over management at Hinchingbrooke Hospital, 1,200 of the hospital’s 1,700-strong workforce came to partnership sessions, and collaboratively, these individuals agreed that the hospital should pursue four different goals. In four years time, the hospital should aim to become the best in the fields of patient safety, staff engagement, patient experience and value for money. This would enable it to become one of the UK’s top ten district general hospitals, and the high standard of healthcare would reduce clinical negligence claims.
As a result, staff at Hinchingbrooke are aiming to stamp out infections and medical errors, while simultaneously achieving the region’s lowest rates of post-operative blood clots, pressure sores, preventable falls. When life-threatening events occur, workers want to see decisive action take place that will prevent these events from reoccurring. Any ‘hotspots’ in which medical negligence claims or other adverse effects occur regularly will be dealt with and nurses will spend more time with patients and less time completing paperwork.
However, when Circle first took over Hinchingbrooke, there were concerns that standards would slip. MP for Labour Valerie Vaz said she could not understand how Circle will be able to maintain proper healthcare standards while simultaneously maximising profit, arguing that the only way the company can turn a profit is by cutting costs. This might involve fewer staff, shorter recovery times or other reductions in services, which she argued will compromise the care of patients. Clinical negligence compensation cases could be therefore more common.
The Guardian also revealed that Circle itself had expressed some concerns about patient care, with a document it sent to the government revealing that it intends to expand the extent of its NHS business. The file added that this growth will strain Circle’s resources, which could affect the company’s ability to provide patients with a “consistent” service.
However, these doom-laden predictions do not appear to have yet come true. In its 6-month report, Circle revealed that Hinchingbrooke had gone from being one of The Guardian’s lowest-rated hospitals to 5th in the Midlands and East hospital rankings, which contain 46 hospitals. It also came number 1 in the 46-hospital poll of friends and family-recommendations, as well as number 1 among 46 hospitals in terms of A&E department targets.
This is despite the fact that the NHS Support Federation expressed concerns that Circle would be unable to successfully manage the A&E department and other complex services.
Circle claims its ethos is to work on behalf of patients and to make healthcare services better value, simpler and more effective by re-engineering its delivery. When operating day-surgery facilities in Burton and Nottingham, it managed to achieve patient satisfaction rates of 99% and productivity improvements of more than 20%.
The firm’s former chief executive Ali Parsha explained that Circle works by unleashing the talent of NHS professionals with devolved decision-making processes and clinical leadership, rather than implementing top-down plans. Staff and clinician control is a more sustainable way of resolving the financial problems of smaller district general hospitals than shutting the facilities down is, he added.
Has Circle’s management of Hinchingbrooke Hospital caused medical negligence claims?
While it is too early to tell how effective Circle’s management of the hospital has been, early signs point towards the facility actually improving, with clinical negligence claims therefore less likely to occur. However, arguments about private companies in the NHS will be sure to continue for many years and it would be difficult for anyone to make any definite comments on whether or not this government strategy will make medical negligence solicitors busier. Hopefully, as Circle claims to have done, all private companies that become involved in hospitals will realise patient care is more important than private profit.