Row over £2m health treatment bill

Health bosses are at loggerheads over charges after a £2m overspend at a private hospital.

Monday, 11th April 2016, 5:30 am
Spire's Fylde Coast Hospital Image: Google

An extra 160 patients treated at Spire Fylde Coast Hospital cost the taxpayer £2m last year.

Health bosses have demanded answers, while the validity of the costs – which works out at £12,500 per patient – has been questioned by one Fylde coast GP.

The 33 per cent hike in costs, compared to a 2.6 per cent rise in patient numbers, has been partly blamed for Blackpool’s Clinical Commissioning Group (CCG) ending the year with a £500,000 surplus – instead of a projected £2.5m.

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Blackpool Victoria Hospital

An audit has now been carried out although the results have yet to come back.

Spire, in St Walburga’s Road, claims the CCG under-estimated how busy the hospital was going to be.

But in a joint statement, the Blackpool, and Fylde and Wyre CCGs said the sum ‘greatly exceeds what we predicted and agreed with Spire and is a greater increase than from any other hospital’.

A spokesman said: “In light of this significant increase in costs, we asked Spire to formally explain the reasons for this and instructed external auditors to undertake work on our behalf to explore these further.

Blackpool Victoria Hospital

“This audit was completed in February and we are awaiting the final report from this.”

Members of Blackpool CCG’s governing board also admitted their concern at a recent meeting.

They were asked by Dr Leanne Rudnick, a GP at St Paul’s Medical Centre in North Shore, if there “were any concerns about the validity of the charges”.

Chief finance officer Gary Raphael said that “for the time being we had to accept them, pending the outcome” of the audit, which was originally due to be carried out in January but delayed, it is understood. And David Bonson, chief operating officer, said the CCG “does not know why there is such an increase,” documents showed.

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“It was recognised that the costs were higher at Spire than at other providers,” they added.

A meeting has been held between staff from both CCGs and senior management at Spire, while concerns are also believed to have been raised with NHS England.

“A full and frank discussion had been held, particularly around coding, charging and the speed at which patients were now being seen,” documents said. Spire, one of 38 private hospitals run by Spire Healthcare UK, offers a range of services including scans and x-rays, surgery, including plastic, cosmetic and obesity, and physiotherapy.

Patients are given the choice of being referred there by their GP instead of Blackpool Victoria Hospital.

Picture: PA

Spire’s director of commercial contracting, Martin Rennison, said: “Spire Healthcare regularly reviews its activities and costs as the healthcare market fluctuates over time.

“It is not unusual for a CCG to carry out audits with healthcare providers to understand the factors leading to change in activity flows.

“We are currently working with Blackpool CCG while this audit is underway, and we look forward to a successful collaboration with them going forward.

“We believe the spike in costs is most likely due to a combination of increased referral flows from GPs under choice via the NHS e-Referral Service and fluctuations in underlying case mix.

“Due to the construct of National Tariff, relatively small case mix variation can drive disproportionate movement in activity value.

“This situation is also somewhat magnified by an indicative activity plan that underestimated the likely in-year activity.

Blackpool Victoria Hospital

“We are confident that the activities we are undertaking with the commissioner to review contract performance will provide the required understanding.”

Two years ago, The Gazette revealed how Spire was benefiting to the tune of £1 million a year from Northern Irish patients being flown to the resort for surgery.

They were being put up in top hotels, including the Hilton and De Vere, and cared for by the hospital, all at the expense of the NHS.

Hospital director Liz Cousins said at the time: “It’s worth £1m to the hospital per year, it’s substantial, especially with regards to the contributions patients make while they are here.

“It’s bringing money into the community. These patients are staying here and contributing.

“We provide the support and logistics, safe and good accommodation, and the fact it’s in Blackpool is a bonus.

“People love Blackpool.

“It has the added attraction of things to do while they are here.

“But it’s not a holiday, it’s surgery. We’ve got to make sure it’s absolutely safe for them.”

Spire has also previously complained patients were not being offered a choice of hospitals for routine surgery, or being given enough information about the different hospitals available. Health watchdog Monitor upheld the complaint last March but dismissed claims commissioners were directing patients away from Spire towards a nearby foundation trust.

The regulator said both CCGs submitted plans to improve the choice offered to patients, and said they also committed to helping GPs give them more information about the different services available.

At the time of the complaint, Mrs Cousins said: “We noticed a considerable decrease in the number of NHS patients being referred to our hospital since the new CCGs were formed.”

But chief clinical officer Dr Amanda Doyle hit back: “There is not a shred of evidence to substantiate Spire’s supposition that we have told GPs to direct patients to any particular provider and I, personally, deeply resent the accusation that either Blackpool CCG or its constituent GPs have acted in any way other than in the best interests of our patients.”

Blackpool Victoria Hospital
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Picture: PA