Private Healthcare Information Network
Understanding competition and choice in the NHS
Prepared by Matt James, Chief Executive
for Nuffield Trust/ IFS
20 May 2013

What is PHIN?
A new not-for-profit organization
which collects data
from independent hospitals
to publish comparative information,
helping patients, policyholders and GPs
to make better-informed choices
and hence to raise standards.
• Established 2012, launched April 2013
• Not-for-profit, funded by subscriptions
King Edward
VII's Hospital
Sister Agnes

Our website launched on 30 April, and will feel
familiar to anybody who has used Choices
• Search by: Location, Procedure & Age
• Information returned
– Contacts
– Regulated categories of activity
– Volume of activity
– Length of stay

Initial information is modest, but much more will be
added over coming months

PHIN’s remit is independent hospitals, covering both
NHS-funded and privately-funded care
NHS Funding
NHS Provision
“The NHS”
NHS Funding
Independent Provision
“The Independent Sector”
NHS “patient choice” at ISTCs
and private hospitals
Private Funding
NHS Provision
“NHS Private Patient Units”
Private Funding
Independent Provision
“Private Hospitals”
NB: draft data

Around 1 million patients were admitted into
independent hospitals in 2012
• PHIN’s data for 2012:
– Privately funded: c650,000
– NHS-funded: c350,000
• 183 hospitals included at
present
• Website covers independent
providers only at this point
• Could provide information by
practice/ CCG if requested
NB: draft data

Three main points of response to IFS Report
1. High growth cannot continue
2. Quality matters at least as much as volume
3. Hips an Knees are a key focus, but not representative
– Independent providers conduct:
• c19% of Primary Hip and Knee replacements, but
• c5% of all elective procedures

Get it while it’s hot: growth of independent NHS elective
care will slow dramatically
• ISTCs -
– No more being built
– All are at or near capacity
• Choice in private hospitals
– c157 available hospitals
– Only c16 remain eligible
– Marginal capacity remains
• Purpose-built hospitals
– Investment now too risky
0
200
400
600
800
1000
1200
NHS Purchased independent-
provided acute care (£m)
Other
G-Sup
Diagnostic
ISTCs
Local & Choice
Source: Laing & Buisson Private Acute Medical Care UK Market Report 2012


 




Quality in the independent sector holds up well
Independent Hospitals Specialist Orthopaedic Hospitals NHS Hospitals
Source: Hospital Episode Statistics (HES) / PROMs, The NHS Information Centre for health and social care.
IncreasingHealthGain Hip replacement – PROMS health gain
14
15
16
17
18
19
20
21
22
23
24
GREATWESTERNHOSPITALS…
NORFOLKANDNORWICH…
UNIVERSITYHOSPITALSOF…
THEROYAL…
SPIREHULLANDEASTRIDING…
THEHORDERCENTRE-ST…
EMERSONSGREENNHS…
SPIRENORWICHHOSPITAL
COUNTESSOFCHESTER…
WORCESTERSHIREACUTE…
MIDCHESHIREHOSPITALS…
IMPERIALCOLLEGE…
CALDERDALEAND…
SPIREPORTSMOUTHHOSPITAL
DUCHYHOSPITAL
HAMPSHIREHOSPITALSNHS…
BMI-THEALEXANDRA…
SPIRELIVERPOOLHOSPITAL
BMI-BATHCLINIC
AIREDALENHSFOUNDATION…
SPIRECHESHIREHOSPITAL
YEOVILDISTRICTHOSPITAL…
BMI-GORINGHALLHOSPITAL
ABBEYGISBURNEPARK…
PORTSMOUTHHOSPITALS…
MIDESSEXHOSPITAL…
PENINSULANHSTREATMENT…
NORTHUMBRIAHEALTHCARE…
ROYALSURREYCOUNTY…
CAMBRIDGEUNIVERSITY…
SHEPTONMALLETNHS…
SURREYANDSUSSEX…
CLAREMONTHOSPITAL
CHELSEAANDWESTMINSTER…
BARLBOROUGHNHS…
NUFFIELDHEALTH,DERBY…
TRAFFORDHEALTHCARENHS…
EASTCHESHIRENHSTRUST
BMI-THESANDRINGHAM…
BMI-THEDROITWICHSPA…
SPIREMURRAYFIELDHOSPITAL
SPIRELEEDSHOSPITAL
ROYALDEVONANDEXETER…
SPRINGFIELDHOSPITAL
IPSWICHHOSPITALNHSTRUST
SPIREWASHINGTONHOSPITAL
NUFFIELDHEALTH,NORTH…
BMI-THORNBURYHOSPITAL
MOUNTSTUARTHOSPITAL
DORSETCOUNTYHOSPITAL…
AdjustedOxfordHipScoreHealthGain
* Hospitals treating at least 50 patients during the selected period
Primary hip replacement:
Top 50 hospitals* ranked by mean adjusted Oxford Hip Health Gain Score
(NHS funded care, Apr '11–Mar '12)

• Independent healthcare is much broader than hospitals (and the
NHS is broader still)
– Mental health
– Primary care and Out of Hours
– Prison health
– Home healthcare
– Nursing homes
– etc
It is important to remember that hospitals are just one
part of the picture

NHS Partners Network membership shows the
breadth of services offered