May 2017 Issue 91
www.independent-practitioner-today.co.uk
INDEPENDENT PRACTITIONER TODAY
IT makes you smart
The business journal for doctors in private practice
In this issue
Breathing life into a dead art An amusing look at doctors’ obituaries in the last taster of Medicine’s Strangest Tales P30
Keep taxman sweet
Accountant Susan Hutter gives useful pointers on staying the right side of the taxman P39
£12.50
Starting a new series on using technology to support your private practice n Turn to page 14
I’m under investigation
What are you to do if a private hospital wants to investigate your practice or suspend practising privileges? P42
Overseas work dilemma By Robin Stride Independent practitioners are being cautious about chasing more overseas business following a fall in the number of acute patients coming to central London from abroad. New figures for the area show the self-pay market dipped 15% between 2014-15 – a drop in value from £261m to £222m. According to a detailed state-ofthe-market report by analysts Laing-Buisson, the fall in international self-pay dragged down a general growing trend in UK self-pay. Embassy patients held up overall, rising 1% from £320m to £323m and were helped by an improved NHS PPU performance, although many independents suffered declines. The UK private medical insurance contribution rose 11% from £782m to £870m, representing 61% of the funding. Report author Ted Townsend told Independent Practitioner Today: ‘While it is hard to tell if the downturn in overseas patients is a hiccup or a new longer-term trend, it would appear that many practitioners are becoming wary of overcommitting time and energy to this historically lucrative market.’ He said a drop in the oil price hit the amount of money available to overseas patients, while new competition plus a desire to keep In association with
patients at home had affected overseas revenues in London ‘and apparently continues to do so’. The issue for many private practice businesses was how much time and effort they should now invest in overseas patients if the trend was going away from them. His report for LaingBuisson says NHS PPUs overall have a higher dependence on embassy earnings than the independent sector, suggesting there is still demand out there. They are thought to have suffered less of a down-turn in 2015 than private hospitals. But against this, various Gulf countries appear to be cutting the number of patients sent abroad, said Mr Townsend. London faces growing competition from other centres, particularly in Germany and the US for the more complex patients and India, South Korea and Thailand for the less complex. His report states: ‘In general, 2015 seems to have marked a point where both sides re-assessed the existing patient flows, and possibly some hospitals have started to become a little bit more cautious in over-investing in overseas/embassy patients as a source of revenue growth.’ The private acute medical care market in central London grew to an estimated value of £1.43bn during 2015, the report says. This is equivalent to around 35% of the national market for
private patient revenues in independent hospitals and PPUs in the UK. But while this represents overall growth of over 4% compared to 2014 and an improvement on the 2.6% growth seen in 2014, this is still down on the ten-year average growth of 7.8%. The report says private hospitals appear to be getting better at marketing to prospective self-pay patients, introducing packaged prices and targeting individual patients effectively as consumers, rather than relying on private consultants to bring them the work. But it adds: ‘However, not all hospitals, nor consultants, feel able to take the risk that a patient may need to come back for unanticipated further treatment, particularly for the complex patients that central London hospitals tend to cater for. This has affected the types of treatments available, broadly limiting them to the less complex end of the spectrum.’ On consultants’ groups, the report says forming a partnership or company with more than four to six clinicians seems to be difficult in central London, particularly if their private practice is still only part-time. Simply sharing the proportion of their fees spent on admin/staff/ offices with other clinicians is not enough to build up any capital in a business to be used for invest-
ment and few specialties appear to have key diagnostic or treatment procedures that can be done outside hospital. Hospitals’ existing investment in equipment means that it can be difficult for groups of clinicians to establish a critical mass sufficient to be able to offer its own end-toend patient services. LaingBuisson’s Private Acute Medical Care in Central London. Available at www.laingbuisson.com
Pipework makes an artistic impression in a new cancer centre funded by HCA Healthcare. n See full story on page 8