Doctors have concerns about quality in ISTCs, BMA survey find
19 July 2007
On the day the Healthcare Commission publishes its report on Independent Sector Treatment Centres (ISTCs), the BMA issues results from its own survey revealing senior doctors’ concerns about the ISTC programme.
More than half (62%) of clinical directors working in NHS trusts in England are concerned about the quality of care provided by ISTCs, according to a survey of senior doctors leading clinical departments.
Over half (61%) of clinical directors are aware of patients who have developed complications following treatment in an ISTC, requiring an emergency admission to an NHS hospital. Only one in ten report that the relevant medical records are always supplied by the ISTC when follow-up or after care is required, and a quarter say they are never made available. Fewer than one in six report that they are always able to discuss the operation with the clinicians involved in the ISTC, and around two-thirds report that this is never the case.
Commenting on the BMA and Healthcare Commission’s findings, Dr Jonathan Fielden, chairman of the BMA’s consultants’ committee says: “The BMA’s research reveals that there are significant differences between treatment centres run by the NHS and those provided by the independent sector. Their continued lack of integration with local NHS services is leaving some patients at risk and is fragmenting their care.
“The independent sector will normally only carry out more straight-forward procedures, leaving complex and more costly cases to the NHS. This significantly destabilises local health services with long term financial implications, risks to patient care, and threatens the future of medical training.”
The BMA is dismayed to hear that there are still problems with data collection. Lack of data was raised by both the BMA and the Health Select Committee many months ago.
Dr Fielden adds: “The BMA agrees with the Healthcare Commission that we need more robust data to assess health outcomes, and a comparable clinical governance system put in place to ensure the highest standards of care are being provided. We are disappointed that the Commission feels it can reassure patients about quality when it acknowledges that data collection is inadequate. Although important, cleanliness, choice of provider and nursing levels are not adequate indicators of quality. Patients must be able to make choices about their treatment based on the clinical outcomes of operations.
“In many localities, the need for an ISTC to provide extra capacity has been poorly assessed and contracts, paid for regardless of activity, are under-utilised. This is a shameful waste of NHS money and any further expansion in the ISTC programme must be seriously questioned. There is now an urgent need for the public accounts committee to review whether the programme provides value for money.”
View the BMA survey
View the Healthcare Commission report