Private sector refutes claims of unsafe staffing levels
Independent healthcare providers have hit back at a new report that suggests patients operated on in private hospitals may be at risk from factors including unsafe staffing.
The report, published by the Centre for Health and Public Interest, raises a number of concerns about patient safety in private hospitals including lack of facilities, equipment and specialist staff – flagging up the fact many do not have intensive care beds or resuscitation teams.
Not only are many NHS patients now undergoing operations in private settings, but the NHS acts as a “safety net” for them when things go wrong, with more than 2,600 emergency admissions from the private sector in 2012-13, warn the report’s authors, who also highlight a lack of performance data.
“When patients choose to have an operation in a private hospital they may be unaware of the difference in terms of risk between a big NHS hospital with surgical teams and intensive care beds and a private hospital with neither,” said report co-author Brian Toft, professor of patient safety at Coventry University.
However, the Association of Independent Healthcare Organisations (AIHO) reacted angrily to the think-tank’s findings, arguing that the report presented an “out of date” picture of private healthcare.
The report – which claims to be the first to bring together what is known about patient safety in private hospitals in England – includes concerns about nurse staffing levels and training.
“Care Quality Commission reports into private hospitals have found cases where nursing staff fail to keep their training up to date, including training in resuscitation,” stated the report.
“In private hospitals where concerns have emerged, staffing levels have sometimes been below what CQC inspectors consider adequate with a relatively high reliance on agency staff being not uncommon,” it added.
Another risk highlighted by the report is the fact many private hospitals only supply theatre nursing staff, while different surgeons and anaesthetists come and go.
“Modern safe practice emphasises the importance of teamwork but in private hospitals a team culture can in which all theatre staff feel equally part of the team, can be hard to build,” said the report, which also questions whether private hospitals employ enough specialist staff, such specialist nurses.
“We found the [private] sector frequently had higher ratios of nursing staff than the NHS”
But Sally Taber, a nurse and director of the Independent Healthcare Advisory Services, which is part of AIHO, described the report as “unfair” and said many of the issues raised had already been addressed.
While the CQC may have previously identified staffing problems in a few hospitals, she said recent investigations into staffing levels showed overall many private hospitals had better nursing staff ratios than NHS organisations.
“I was on the National Institute for Health and Care Excellence staffing group and did spend a lot of time checking ratios,” she told Nursing Times. “We found the sector frequently had higher ratios of nursing staff than the NHS.
“If staff weren’t keeping up to date with resuscitation, or there were unsafe staffing levels and an over-reliance on agency nurses, then the CQC would pick up on that,” she said. “You cannot tar the entire independent sector with a few bad apples – that’s really important for patients’ reassurance.”
Ms Taber also said it was unfair to demand all private hospitals, which mainly do low-risk, elective surgery, to have intensive care beds and staff.
“This is total ignorance,” she claimed. “The NHS is trying to ensure their specialised work is in hospitals that have got all the back-up, and that is exactly the same as the independent sector.
“We couldn’t have critical care Level 3 beds in every small, independent hospital because they are for the low dependency, elective surgery and not for major surgery,” she said. “In fact it would put the country’s resources for critical care nurses at risk because there just wouldn’t be enough.”
However, Ms Taber acknowledged the independent sector needed to publish more data, and had recently set up the Private Healthcare Information Network in order to do so.
The body is currently working with the NHS to ensure that happened, and that private hospitals could also feed into the National Reporting and Learning System.