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Concerns continue to be raised about emergency care in private hospitals

Posted: 12/04/2024

In 2020, an inquiry (known as the Paterson Inquiry) into the conduct of Ian Paterson, a consultant breast surgeon who worked out of the Spire Group’s hospitals, found that he had subjected more than 1,000 patients to unnecessary and damaging operations over a 14-year period.

Since the Paterson Inquiry, the Department of Health and Social Care has confirmed that there are stronger mechanisms in place to protect the safety of patients who receive healthcare in the independent/private sector.

Waiting lists for NHS care are at a near all-time high, with more than 7.58 million people waiting for a procedure or appointment. As a consequence, in an attempt to clear the backlog and enable patients to receive more timely treatment, the NHS pays for some patients’ care to be transferred into a private hospital setting. Since 2021, Spire Healthcare has treated more than half a million NHS patients.

However, a recent review has raised concerns that this may be subjecting NHS patients to increased risk of harm. The review found that many private hospitals under the Spire Healthcare Group (which runs 39 private hospitals across the UK) do not have facilities to manage and treat patients who require essential emergency care and intervention. This is in stark contrast to NHS hospitals which in most cases do have emergency care facilities and intensive care units.

Ultimately, these findings mean that many private hospitals are reliant upon ambulance transfers of their patients to local NHS hospitals when the need for emergency treatment arises.

The review has highlighted that some patients who require emergency care have experienced long delays in being transferred to an NHS hospital which, in some instances, has led to serious consequences, including fatalities.

In the past two years, Spire has received three prevention of future death (PFD) reports (these, in effect, identify circumstances that create a risk that other deaths will occur unless action is taken to prevent the continuation of such circumstances). In one case in Norwich, the coroner issued a warning about Spire’s continued reliance on ambulance transfers to NHS hospitals, after three patients had died following long delays.

This issue is compounded by many patients being unaware that, by agreeing to their treatment being transferred into a private hospital, there may be insufficient intensive care facilities should the need arise. This is potentially a major issue when an NHS hospital seeks to obtain a patient’s consent for care in a private setting.

Other concerns in relation to healthcare in private hospitals relate to a number of cases involving delays in diagnosing serious medical complications following routine operations, for example, sepsis. This is a complex condition that requires emergency management to avoid escalation and, if not treated swiftly and properly, can result in devastating consequences.

This issue can more often arise in private hospital settings when a patient is retained in hospital after hours, and left in the hands of a resident doctor (sometimes known as the RMO), who may not have the specialist skills required to assess a patient’s post-operative condition and, either, provide appropriate treatment, or know when specialist, emergency input is required. For example, the report found that at Spire Leeds Hospital, a woman had developed sepsis after a routine hernia operation. The hospital was late in identifying the complication because the RMO, who visited the patient twice during the night, failed to appreciate that the deterioration in her condition necessitated an escalation to specialist emergency care.

Reportedly, some resident doctors are contracted to work up to 168 hours a week, which gives rise to obvious concerns around patient safety, when patients’ after hours, post-operative care is left to an over-worked junior doctor who does not have the specialist skills to manage complex post-operative complications. 

Arran Macleod, senior associate in the clinical negligence team at Penningtons Manches Cooper, comments: “There are, of course, risks and complications associated with any surgery and poor outcomes can occur even with good quality care. However, the issues identified within private hospital settings are not, in our experience, new. We have been concerned by these issues for some time, as illustrated in a number of recent cases.

“Many patients are unaware that private hospitals do not have adequate emergency care facilities and do not have an appropriate level of doctors working out-of-hour shifts. If patients are being asked to transfer their care away from an NHS hospital, these deficiencies should be made clear to them as part of the consenting process.”

Penningtons Manches Cooper has a specialist team dealing with clinical negligence claims. We provide an initial consultation on a no obligation basis to individuals who have concerns about their care and outcome. Please contact the team on 0800 328 9545, email, or complete our online assessment form.

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