Evidence Submitted by Capio Healthcare
UK (WP 26)
OVERVIEW
— Capio Healthcare UK is the fourth
largest provider of independent healthcare services. Capio has
a contract with the NHS to establish nine independent sector treatment
centres (ISTCs) across England, from Cornwall to Northumberland.
— The ISTC programme was introduced
to create immediate capacity to reduce waiting times. Additionality
rules were included in the first wave of ISTC contracts in order
to bring additional doctors to work in the NHS. Capio has already
recruited 150 clinical staff as part of the wave one ISTC programme.
— Additionality rules should now be
relaxed to allow free movement of staff between providers, as
is allowed in any other area of work.
— Capio is planning to make use of
extended staff roles to introduce innovation to the ISTC programme.
This involves adding additional responsibilities to existing staff
roles and making them more adaptable.
— Capio is about to begin junior doctor
training at its York ISTC. Capio would welcome the opportunity
to train doctors and nurses in its other facilities
— Capio second a number of clinicians
from NHS trusts. Capio would recommend the increased use of secondment
arrangements in order to aid training and increase skills in the
workforce.
1. INTRODUCTION
1.1 Capio is a progressive company with
a commitment to fair employment and has five board members who
are trade union representatives. We provide healthcare in Sweden,
Norway, Denmark, France, Finland, Spain and the UK. Across Europe,
90% of the patients Capio treats are publicly funded. Capio Healthcare
UK is the fourth largest provider of independent healthcare services.
Prior to the ISTC programme, Capio had 21 acute units throughout
England, plus six mental health units (providing adult, child
and adolescent services), two neurological units and a dedicated
eye clinic. All Capio units continue to treat NHS patients under
national and local arrangements.
1.2 Capio shares the values of the NHS,
and wants a long term partnership. The company believes its contribution
to treating NHS patients is helping to grow a publicly funded
health service.
1.3 Capio has a contract with the NHS to
establish nine ISTCs across England, from Cornwall to Northumberland.
Six of the centres are newly constructed; two are on existing
NHS estates and four are new builds in innovative locations, chosen
to fit with the requirements of the local Healthcare Community
and to improve patient access as pragmatically as possible. Of
the remaining three Capio ISTCs: one is a facility within an existing
NHS hospital, and two are within existing Capio hospitals. Approximately
95,000 NHS patients will be cared for at our centres over the
five year contract (until 31 March 2010). The value of the contract
is £300 million. A previous Capio contract (G Supp) to treat
13,600 patients (worth £23.9 million) has been successfully
completed.
1.4 Capio welcomes this inquiry by the Health
Select Committee. Please note that our answers are focused on
those areas where we feel we have the most to contribute.
2. MEETING FUTURE
DEMAND
Increasing Capacity
Additionality
2.1 The ISTC programme was introduced to
create immediate capacity to reduce waiting times. In the longer
term, the Government also constructed it to create sufficient
capacity to enable choice and competition between providers.
2.2 Additionality rules were included in
the first wave of ISTC contracts in order to bring additional
clinical staff to work in the NHS. Capio has already recruited
150 clinical staff as part of the wave one ISTC programme. This
will increase further as all Capio ISTCs across the country become
live, adding capacity to the UK health economy.
2.3 We believe that the additionality rules
should now be relaxed to allow free movement of staff between
providers, as is the case in other areas of work. The NHS and
private providers will continue to be attractive and competitive
employers to foreign clinical staff and Capio will continue to
search both at home and abroad for the best employees.
2.4 There are very few consultants who work
purely in the independent sector, and additionality rules have
forced Capio to deny employment to a number of UK clinicians who
have wanted to treat NHS patients in ISTCs. Rigid separation of
the NHS and ISTC workforces makes it more difficult to share and
spread best practice and innovation. Patients would benefit from
the movement of staff between the NHS and ISTCs.
2.5 One area in which we feel the NHS could
learn a great deal from the independent sector treatment centres
is the ability to deliver safe, high volume elective surgery.
Delivering surgery in this manner demonstrates an effective patient
and clinician management process, in addition to specific surgical
skills, and could transform the clinical productivity currently
achieved in the NHS.
Changing Roles And Improving Skills
Extended Roles
2.6 Capio is planning to make use of extended
staff roles to introduce innovation to the ISTC programme. This
involves adding additional responsibilities to existing staff
roles and making them more adaptable. Not only will these new
staffing roles benefit patients and add to the efficient running
of Capio's centres but they will also provide staff with the opportunity
to develop new skills. Two examples of these new roles are being
developed for nursing staff:
(a) Medical Care Practitioner, a role in
which a suitably trained nurse will take on many of the clinical
aspects of the doctor's patient contact, including assessment
and management of the patient's condition, medication, care and
after care. A Medical Care Practitioner will contribute particularly
in Admissions/Out-patients and on the In-patient unit.
(b) Anaesthetic or Surgical Practitioner,
a role in which a suitably trained nurse will be able to take
on direct anaesthetic work under the overall guidance of an anaesthetist
or will be able to undertake minor surgery and act as first assistant
to the surgeon.
Training schemes are available for such roles
and we are organising a scheme to provide us with places via the
University of Hertfordshire. Nurses undertaking this training
will spend half their time in the treatment centre and half on
the study programme.
Training
2.7 Capio already facilitates the training
of NHS nurses and physiotherapists in some of its hospitals. Capio
would like to increase its role in the training of clinical staff
to help meet the country's workforce demand. Utilisation of the
excellent clinical facilities in ISTCs to facilitate the training
of junior doctors, in particular, would also improve the quality
of the skills acquired, and expose young doctors and nurses to
innovative clinical and patient management processes. Again the
benefits to the NHS and patient care would be very significant.
2.8 Capio is about to begin junior doctor
training at its York ISTC. We welcome this development and the
Department of Health's move to include training in the second
wave of the ISTC programme.
Secondment
2.9 A small number of staff (mainly surgeons
and anaesthetists) provide services in some of Capio's ISTCs via
a structured secondment arrangement with the local trust (for
example in Capio's York ISTC). Capio is happy to partner with
PCTs wherever this is the preferred model for delivery. Movement
of staff in this way allows for sharing, and therefore the spread,
of knowledge and best practice. It also provides NHS staff with
the opportunity to work in new or different ways and aids professional
development. Capio is keen to ensure that those who are seconded
to the ISTC team are rewarded with career enhancement and development.
Capio would recommend the increased use of secondment arrangements
in order to aid training and increase skills in the workforce.
3. SUMMARY
3.1 Capio would like to emphasise its desire
to work with NHS colleagues locally and nationally as appropriate
to develop the approaches listed above as well as the use of joint
appointments and "reverse secondments" (from Capio to
NHS Trusts) to develop the staff and the skills available in the
health economy.
Capio Healthcare UK
15 March 2006
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