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Gold, incentives and meh

Care at ISTCs 'comparable to NHS hospitals'

The first ever academic study of the quality of care provided by independent sector treatment centres has concluded it is comparable to that available at NHS services.

It comes after doctors told the Commons health select committee of their concerns over serious complications in those treated in the centres.

An audit conducted by the Healthcare Commission last year was unable to come to a conclusion because of a lack of data.

But the new research, which examined data on 769 patients treated at in six ISTCs and 1,895 treated in 20 NHS hospitals, found care was no worse in the private sector, but no better either. The study was conducted in England using data from 2006/7.

Study leader Professor Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine, said the results had to be adjusted for the fact that patients seen in ISTCs were healthier, less likely to have co-morbidity and with less severe primary conditions.

‘Most of the concern about quality of care has been based on specific examples, where something has gone wrong – often disastrously wrong. The issue is how typical is that, because of course things also go wrong with NHS providers'

The results showed no significant differences between ISTCs and NHS providers in terms of patient-reported complications or the amount of benefit people received from surgery for knee and hip operations, cataracts, hernia repair or varicose vein surgery.

‘This is very much a pilot study but it's the only data available and it suggests there are not grounds to be too concerned about the quality of care in ISTCs,' Professor Black said. His team is now planning a much wider evaluation of all the ISTCs in England providing hip and knee surgery.

But Dr Robert Morley, executive secretary of Birmingham LMC, was unconvinced by the findings, published online by BMC Health Services Research.

‘I don't think we can draw any conclusions at the moment,' he said. ‘We know that the Government is opening up NHS provision to a multitude of providers and there may be cases where capacity is needed but the jury is still out on whether fragmenting care is the right way to improve standards and quality.'

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