Treatment centres

Independent sector treatment centres (ISTCs) are private-sector owned treatment centres contracted within the English National Health Service to treat NHS patients free at the point of use. They are sometimes referred to as 'surgicentres' or ‘specialist hospitals’. ISTCs are often co-located with NHS hospitals. They perform common elective (i.e. non-emergency) surgery and diagnostic procedures and tests. Typically they undertake 'bulk' surgery such as hip replacements, cataract operations or MRI scans rather than more complex operations such as neurosurgery.

The NHS Plan 2000 originally conceived of opening eight treatment centres by 2005, but by August 2005 at least 25 had been opened, with more being planned. 46 NHS treatment centres opened between 2003 and 2009, treating approximately 300,000 patients a year with high rate of patient satisfaction (>94%).

Wave I ISTCs worked on pre-arranged central government bulk contracts nominally at or below the national tariff [2] on which NHS hospitals can charge commissioning NHS Primary Care Trusts. These contracts included a profit margin. Additional costs associated with the programme, up to a ceiling of 25% over and above the NHS Equivalent Cost, were paid for by central Government. Treatments were paid for in advance by central government whether or not the numbers paid for were taken up and regardless of success rates. The rationale was that the waiting times for patients are cut by separating routine elective surgery and tests from emergency work.

Referral rates varied across the country, with some ISTCs performing as much 115% of their contracted volumes but with the average referral rate around 85%. Pressure was put on local GPs to refer patients to the centres, rather than to NHS hospitals, because the Primary Care Trusts had to pay for activity whether or not it was used. According to the NHS Partners Network, which represents private providers working within the health service, GP referral rates were rising in 2009 as patients report positive experiences back to their GPs.

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