With almost eight million people in need of treatment, many are looking for quicker options in solving more routine conditions.
Using information from PHIN, Jenny Tucker wrote this piece for The Telegraph, published on October 16, 2023. The article is reproduced here with the permission of the syndication team at The Telegraph and can be read in PDF format.
Your knees are playing up, your eyesight is dwindling and every time you eat rich food, you're doubled over in pain. It's little surprise that your GP thinks you might need more specialist treatment, but the harsh truth is that NHS waiting lists for operations are rocketing.
The latest NHS figures have soared to a record 7.75 million, with nearly 400,000 of those patients hanging on for more than a year. Plus, recent NHS statistics show there is a two-and-a-half-year delay in crucial diagnostic ultrasound tests, and CT and MRI scans. Zoe Chivers, director of services and influencing at Versus Arthritis, says: "We hear from people every day who tell us that paying for hip and knee replacement surgery is their only hope, which can cost up to £16,000 without private medical insurance," she says. "It's completely unacceptable that people feel forced to choose between long waits on the NHS or financial instability to access help."
The backlog caused by the pandemic is largely to blame, and strikes by doctors and consultants are only adding to the problem. It's no wonder the number of self-paying in-patient and day-case private admissions are at an all-time high (227,000). Patients using private medicine insurance has also significantly increased - WA health insurance says its insurer claims volumes are up 20 per cent this year. And visiting a private GP for an £80 consultation is becoming so popular, demand is outweighing supply. At AXA Health, Fergus Craig, commercial director, states: "Our virtual GP service, Doctor at Hand, was dealing with 17,000 appointments per month pre-pandemic. Now it's in excess of 55,000 per month."
With a new Covid strain adding to the load, and health experts warning we are heading for a "troubled winter" what are the private options? The Private Healthcare Information Network (PHIN) is a respected independent organisation that helps people make a more informed decision about whether to go private, and if they do, who to choose (consultant and hospital). Here is a breakdown of the most common private procedures by number of admissions according to data from PHIN during January to March 2023.
Cataract surgery
Cataracts are a typical result of ageing. They occur when the proteins in the lens in your eye clump together to create a cloudiness (the cataract). Surgery replaces this cloudy lens with an artificial one.
Since Covid, there has been an 84 per cent increase in waiting times at NHS hospitals for this relatively simple operation.
In 2021, the NHS waiting list was an average of nine months, but according to an Optical Express article in 2021, some patients in Northern Ireland were waiting up to four years. Dr John Buchan, a consultant ophthalmologist working at Leeds Teaching Hospital says: "Patients waiting many months for surgery are being exposed to increased risks of the negative consequences of the poor vision they are experiencing, like falls, fractures and road traffic accidents, as well as the psychological impacts like social isolation and deteriorating cognitive function."
How to find an expert
According to PHIN, nearly 19,000 cataract surgeries were carried out privately in the three months to March 2023.
While PHIN will not provide specific recommendations to patients, they do help individuals make informed choices for all procedures based on factors like location and facilities, admission numbers, length of stay and patient feedback.
PHIN also publishes guides to help patients ask the right sort of questions when researching their treatment plan. You can use their non-biased, non-commercial website to find a specialist for all procedures in your area.
Aftercare and recovery
It's a same-day procedure that takes about 10 to 20 minutes for each eye. You will be given anti-inflammatory and antibiotic eye drops and an eye shield to wear at night for a week. You should be able to drive within 48 hours.
Expect to pay
Anything from £2,500-£3,200 per eye, depending where you live.
Chemotherapy
Cancer can be a very serious illness and time is often crucial. While the NHS will prioritise urgent cases (according to NHS performance data, 80.5 per cent were seen by a specialist within two weeks of an urgent referral), nearly 17,000 patients still opted to go down the private route for chemotherapy (anti-cancer chemicals or drugs) treatment. But it's an expensive choice; a single round costs up to £30,000.
How to find an expert
Your GP will refer you. The Royal Marsden, with centres in London and Surrey, is one of the leading cancer hospitals in the world and treats more than 60,000 NHS and private patients every year. Its award-winning private division has been rated Outstanding by the Care Quality Commission (CQC).
Aftercare and recovery
Chemotherapy is a debilitating experience with patients citing extreme fatigue, nausea, loss of appetite and dehydration. You will need support and rest to manage well.
Expect to pay
A significant amount. The plus side is that private patients may be given access to new drugs and treatments, as well as clinical trials. It's important to remember that any treatment that hasn't completed all clinical trials will not be recommended by the National Institute for Health and Care Excellence, which was set up to provide assessment of pioneering medicines and guidance for practitioners.
Diagnostic GP endoscopy
With waiting lists of nearly 390,000 in England for general gastroenterology treatments, just over 11,000 patients turned to private care for an exploratory endoscopy using an endoscope (a thin, flexible tube with a camera). This tube is passed through the mouth to check the windpipe, stomach and small intestine for digestive problems related to either acid reflux, ulcers, celiac disease, blockages or cancer. Carried out under mild sedation, it is a slightly uncomfortable but low-risk and quick (around 30 minutes) procedure.
How to find an expert
The Independent Healthcare Providers Network (IHPN) is the membership network for independent healthcare providers. It plays a leading role in bringing together all types of providers, and supporting them to deliver greater care to patients. David Hare, the chief executive, says: "Like any service, it's good to shop around, so check out the websites of your local providers, plus PHIN is an excellent source of information. The CQC also issues reports that can be used to find and compare services, though with more than 90 per cent of independent sector hospitals being rated Good or Outstanding by the CQC, you can have a high degree of confidence in your treatment."
Aftercare and recovery
You may experience a sore throat and some grogginess from the sedation afterwards, but generally you can return home within the hour.
Expect to pay
Around £1,500.
Diagnostic colonoscopy
The aim of a diagnostic colonoscopy is to find out if there is any irritated tissue, polyps or cancer, going on in the large intestine (colon) and rectum. Sometimes, patients will opt to have this as a precautionary procedure if there is a family history of bowel cancer. Just over 9,000 people went private for this treatment according to PHIN's latest figures. Colin Elton, a consultant and colorectal general surgeon specialising in colorectal surgery at the Wellington and Barnet hospitals in north London, says: "It is important that patients see consultants who are experienced; this is down to the number of years performing the surgical procedures, the total number of procedures and their results. Patients should also have a good rapport with their consultant; it all helps build a trusting relationship."
How to find an expert
A good starting point for any treatment is your GP who will be able to give referral advice. Unfortunately, since the pandemic, GPs are stretched to breaking point. The 2021 British Social Attitudes Survey revealed that not being able to see a GP quickly was the public's most common reason for dissatisfaction with the NHS. Kevin McMullan, health and travel director at Saga Insurance says: "We have seen an increase in people turning to private healthcare as an alternative or supplement to the NHS. Overall, we are particularly noticing more people than ever using our Saga GP telephone service as the pandemic prompted a wider acceptance of remote GP access."
Aftercare and recovery
Intravenous sedation to make you sleepy, or gas and air, is administered, so you may need someone to help you get home safely afterwards. Because carbon dioxide gas is blown into your colon to allow easier assessment with the colonoscope camera, you can feel bloated and slightly uncomfortable post-procedure. Recovery time from the sedation is about an hour but you will need rest from driving or work for 24 hours.
Expect to pay
£1,800-£2,400.
Hip replacement
Waiting lists for hip replacements are long. Even though the NHS guidelines say patients should wait no longer than 18 weeks from GP referral to treatment for all medical conditions, the Royal College of Surgeons of England says patients hoping for a hip replacement have some of the longest wait times; more than a year in some cases. Consequently, PHIN states just over 8,000 went down the private route.
How to find an expert
It's worth considering travelling to a different part of the UK to reap a better financial outcome. Opting for a different location could save you thousands. According to PHIN, hip operations in Liverpool cost between £11,993 and £15,075, while, in somewhere like Cambridge, they can reach £16,210.
Some patients choose to travel abroad for their ops to places like Spain, Hungary and Lithuania. The Office for National Statistics estimated that 248,000 UK residents went abroad for treatment in 2019 compared with 120,000 in 2015. In Kaunas, the capital of Lithuania, UK patients pay about £6,000 for hip-replacement packages (flights, check-ups, hospital room, physio) with a waiting list of just a few weeks. David Hare of IHPN adds a sobering thought: "We have heard some horrifying stories recently about the harm patients have suffered in other countries. Almost without exception in the UK, providers are highly trained, regulated, and rated." The NHS recommends ensuring your overseas clinic or hospital is regulated, and to consider the language barriers you may encounter, the care abroad terms of your insurance cover and any follow-up treatment you may need back in the UK.
Aftercare and recovery
You will probably stay in hospital for up to five days, but your specialist will be keen to get you moving very soon after the operation. It is a major procedure and so will be painful for a while. You will be given a programme of physiotherapy to build strength and movement.
Expect to pay
Anything from £9,500 to £16,000.
Knee arthroscopy (keyhole surgery)
You may have a general or local anaesthetic, then small incisions around the knee area are made so a telescopic camera can be inserted to assess the problem (usually damage to the cartilage and ligaments). If treatment is needed to repair or remove the damage, it can be done at the same time.
How to find an expert
Private operations on nearly 6,000 patients were carried out in the first quarter of 2023. When researching your hospital, find out if they offer the chance to spread the total cost across a period of time. If you are self-funding, this may influence your decision on where to get treatment.
Aftercare and recovery
You may not be able to put weight on your leg for up to a week so crutches, a knee brace or a walking frame might be needed. A programme of physiotherapy will support your recovery.
Expect to pay
About £4,500 to £7,000 for both knees.
Knee replacement
This is a replacement of your damaged knee parts, or entire knee, with metal and plastic alternatives to create an artificial joint. This can last up to 10 to 15 years. Waiting figures in England for general trauma and orthopaedics surgery are some of the highest in the NHS. In March of this year, more than 800,000 people were hoping for a slot. Just over 5,000 private patients went in for this particular procedure.
How to find an expert
Versus Arthritis says that 830,000 people are currently waiting for trauma and orthopaedic treatment, such as hip and knee replacement, in England alone. Always remember to check the surgeon's ratings as well as the hospital's when researching your private care. These patient feedback scores appear on the hospital and consultant profiles on PHIN's website.
Aftercare and recovery
It can take several months to get over a knee replacement. You can start walking very quickly with the help of crutches or a frame, and physio will be necessary.
Expect to pay
Average cost ranges from £10,000 to £16,000 per knee.
Therapeutic colonoscopy
This is a similar procedure to a diagnostic colonoscopy but goes one step further by treating any problems, like lesions, ulceration, polyps and repair of a perforation. Nearly 4,000 people opted to have this treatment privately.
How to find an expert
A good starting point is your own GP for any treatment. They will be able to provide a referral to a private specialist. If you have a private insurer, they will offer recommendations, but they are limited to the particular practitioners assigned to their database. Private hospitals often stipulate a packaged price, which includes everything you might need but if not, you could be charged separately for everything from the consultant to medication and meals. If you are a self-paying patient, get clarity on your fees up front, and if you are using medical insurance, know exactly what is covered by your premium.
Aftercare and recovery
You may feel bloated and pass wind. There could be some blood in your initial bowel movements so it's sensible to monitor these for a few days. Eat healthily and rest.
Expect to pay
Around £2,200.
Hernia repair
Unless your hernia is at risk of strangulation (when the blood supply to the hernia is cut off) which is a medical emergency, hernia operations tend to have long waiting lists on the NHS. PHIN says 3,700 procedures have been carried out privately from January to March 2023. An inguinal hernia is the most common type and appears as a lump in your groin. Keyhole surgery is sometimes an option.
How to find an expert
When researching consultants, it's important to consider their experience. If a surgeon is at the top of their game and has carried out thousands of procedures they will be very skilled. But this expertise is likely to be reflected in their cost. It's a balance.
Aftercare and recovery
Rest is key as it can take up to three weeks to feel completely comfortable. A healthy diet is important to avoid constipation and no strenuous activities for up to six weeks.
Expect to pay
Between £2,500 and £4,000.
