Progression towards “Meltdown” is going well. Faster and faster as more hamster doctors on their wheels break down or escape. Even Orthopaedics at Stanmore under threat. A Two or three tier system seems inevitable now…. either by default (Private “selective” or State “Universal”) or by design (Wales). That is now the choice for politicians..
Fears grow that hospitals will run out of money and care standards will deteriorate unless chancellor injects more cash
Royal National Orthopaedic hospital says it could face 25% drop in income, with other hospitals fearing impact on patient care
Specialist NHS orthopaedic hospitals in England fear huge drops in funding because of changes to the payments they receive for treating patients.
The Royal National Orthopaedic hospital (RNOH) in Stanmore, north London, has warned that it will lose £15.2m in income during 2016-17 under draft proposals, more than a quarter of what it received last year for inpatients on the tariffs then in force.
The changes would also mean an 11% fall in the hospital’s overall turnover, leading its financial experts to warn of an impending deficit at the flagship hospital, where one in five of the UK’s orthopaedic surgeons are trained.
The Robert Jones and Agnes Hunt Orthopaedic hospital (RJAH) in Oswestry, Shropshire, has calculated it will lose £8m, or 16% of its expected tariff-related income this year. The hospital’s entire budget last year was £94m.
Although the Royal Orthopaedic hospital in Birmingham has not published any estimates on how the changes will affect its operations, it is concerned by the impact they could have on patient care.
The hospitals are among the big losers from the proposed new system, because many trusts with a broader mix of patients can balance significant reductions in payments for orthopaedics by increasing numbers of patients whose treatment attracts higher fees.
Private hospitals that perform many planned hip and knee operations for the NHS will also see their state-funded income fall.
NHS hospitals specialising in women’s health will be among those to benefit.
Monitor, the NHS financial regulator, insists the proposed tariffs are not intended to be final prices, saying they may rise by as much as 30%.
The changes across all NHS payments are said to be necessary “to incentivise best practice (and) efficient and accessible delivery of care to make sure that NHS funding goes as far as it can for patients”.
John Grinnell, the acting chief executive at the RJAH, said: “Monitor’s own impact assessment indicates that RJAH and other standalone orthopaedic hospitals stand to suffer the greatest impact of the tariff proposals.
“Whilst this is clearly of concern, we continue to work with Monitor and NHS England with a view to finding a long-term and sustainable solution to the funding of orthopaedic care.”
Dr Victor Chua of healthcare analysts Mansfield Advisers said the figures at RNOH exceeded even his forecasts. “If this happens, RNOH as an independent trust is probably finished. They would have to merge with another trust, probably Imperial. But these orthopaedic hospitals have been centres of excellence for 50 years,” he said.
“They have a long proud history of independence and innovation. They have great training programmes, attracting fellowship doctors from all over the world.
“For the NHS, this is the lesser of two evils. It needs to save money. It will be saving money on the NHS activity it contracts to the private sector, mainly for hip and knee surgery. But for the private hospitals it will be incremental revenue and it will be very hard for them to give it up.”
Chua added: “In general the NHS has managed to achieve a price cut and overall not caused too many problems for NHS contractors.”