World leading hospital at funding risk
The Royal National Orthopaedic Hospital, more widely known as “Stanmore” where it is based, has announced fears of a 25% drop in income due to changes in treatment tariffs paid by the NHS.
Stanmore is considered one of the finest orthopaedic hospitals in the world, with 20% of the UK’s Orthopaedic Surgeons receiving their training there. It provides leading surgery and specialist rehabilitation to patients who have suffered serious orthopaedic injuries, often in road traffic and other accidents, which is not available in many other more general hospitals.
Clarke Willmott’s serious injury lawyers represent clients involved in serious accidents who have been treated at Stanmore, and value the quality of service provided there.
The problem now facing the hospital is the change to the amount of money the NHS will pay hospitals for providing orthopaedic treatment, which is lower than other NHS services and less than the actual cost of providing the treatment. For hospitals that offer multiple services, such as general hospitals this is less of a problem, as the fees paid for other services exceed the cost to the hospital, and the surplus covers the shortfall in the orthopaedic income. Stanmore exclusively provides orthopaedic services and therefore does not have access to better paid services to bridge the gap.
The hospital estimates that it will lose around 16% of its NHS tariff income this year, amounting to £8million. If it cannot source alternative funding, services will likely have to be withdrawn and fewer patients will have the benefit of receiving treatment at the centre of excellence.
It seems that the decision to restrict payments under the orthopaedic tariff is down to the increase in patients receiving NHS funded orthopaedic treatment at private facilities. Outsourcing is now routine practice within the NHS and by having a low tariff it can ensure that the costs of outsourcing treatment is cost effective. But this policy has little regard for facilities that rely solely on NHS income.
Dr Victor Chua, Healthcare Analyst is worried that the deficit may be even worse than predicted by Stanmore and has said:
“If this happens, RNOH as an independent trust is probably finished. They would have to merge with another Trust, probably Imperial”.
“For the NHS this is the lesser of two evils … it will be saving money on the NHS activity it contracts to the private sector … in general the NHS has managed to achieve a price cut and overall not caused too many problems for the NHS contractor”.
Monitor, the body responsible for the financial regulation of the NHS has said that the proposed tariffs are not final and could in fact rise. It also added that changes to payments across the NHS are required “to incentivise the best practice … to make sure that NHS funding goes as far as it can for patients”.
The sad reality is that best practice appears to mean the cheapest possible treatment to the NHS. Best practice should mean investing in leading hospitals and clinicians. The NHS should be investing more into it’s centres of excellence, which will not only improve the quality of care offered by the service but could have the effect of easing the burden on general hospitals, allowing them to get on with more general and emergency medicine. Centres of excellence attract patients from across the regions, but this means they need more money to meet demand, and the reality is that the opposite is occurring. Earlier this month, we blogged about the challenges facing the Royal Devon & Exeter Hospital in battling its cancer waiting times – read our blog here. The hospital says the fact it has the best technology in the region has meant it is now being expected to treat increasing numbers of patients, without a corresponding increase in resources.
What this is ultimately going to mean is that victims of serious accidents will not receive the same level of orthopaedic treatment at Stanmore that many currently enjoy. This in turn will reduce their prospects of returning to their pre-accident levels of ability and may affect their return to work and their health later in life. The cost of this will have to be picked up by the insurance companies of those who caused the accident, leading to an increase in our own insurance premiums, or other areas of the NHS and public spending such as welfare and social services.
If you have been involved in an accident in which you suffered serious orthopaedic or other injuries, please contact a member of our specialist serious injury team on 0800 316 8892 for advice.