Independent (Private) Hospitals
Independent sector hospitals in Scotland are represented by the Independent Healthcare Provider Network (Scotland). Within this network, there are seven acute hospitals in Aberdeen, Ayr, Edinburgh, Glasgow and Stirling. The independent hospitals are fully supportive of the aims and objectives of the Scottish Arthroplasty Project (SAP) and have a representative on the steering committee. At present however the hospitals are prevented from submitting data directly to the Scottish Arthroplasty Project (SAP) and this is somewhat restrictive in enabling the hospitals to contribute fully to the workings of the project.
Activity undertaken in independent sector hospitals on behalf of Health Boards is fully recorded in SAP and this data is coded within Health Boards for inclusion in the report. However, the data for patients funded privately either through medical insurance or through self-funding is omitted as the methodology which would allow it to be included is not currently in place. The steering committee continue to explore ways of enabling the inclusion of this data.
Given the increasing activity in the independent sector and in the absence of a methodology for formal inclusion in the register, data is gathered separately by the independent hospitals for inclusion in the report. At present, the data gathered in the independent sector is limited to hip and knee arthroplasty procedures; these procedures making up the vast majority of arthroplasty activity in the independent sector. In future the sector will submit data for the SAP report which will also include ankle and elbow replacement activity.
Arthroplasty activity continues to increase in independent hospitals and in 2018 there were a total of 1,218 and 884 primary hip and knee procedures performed, in comparison with 1,142 and 861 respectively in 2017. Of this activity, those procedures funded privately by the individual patient either through medical insurance or self-funding continues to increase at 84% of the total number undertaken for 2018 compared to 75% in 2017. The remaining activity is funded through Health Board waiting list initiatives.
To provide assurance, all complication rates for activity is tracked through the individual hospital’s clinical governance mechanisms, and is not available within individual surgeon’s data in SAP. This data continues to demonstrate low complication rates across Scotland in the independent sector. Low volume activity consultants are also reviewed within the independent sector, although it is noted that it may be the case that the surgeon’s activity in the sector is low compared to their activity overall.
Moving forward, the independent sector remains fully committed to SAP and will continue to seek ways of working more closely with the project to both increase and improve the data available, ideally through direct access to the register to enter data at source.
K Hay, Steering Committee Member
For more data please see our online report.
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