The below Parliamentary question was asked by Roger Godsiff on 2016-01-21.
To ask the Secretary of State for Health, whether NHS bodies which carry out surgery to repair work performed by outsourcing companies are able to claim back the costs of carrying out that work.
George Freeman
Whether or not National Health Service bodies are able to claim back the costs depends on a number of circumstances. For instance:
– A clinical commissioning group (CCG) may have placed a contract for elective surgery with an independent sector provider. A patient treated in this provider’s hospital may experience complications and require further treatment, which has to be arranged under the CCG’s separate contract with the local NHS trust or foundation trust (FT) (perhaps because it has the facilities to carry out more specialist treatment); or
– An NHS trust or FT may sub-contract surgical procedures to an independent sector provider. Again, a patient treated at the sub-contractor’s hospital may experience complications and require further treatment, which has to be carried out by the NHS Trust or FT (again, because it has the facilities to carry out more specialist treatment).
The terms of such subcontracts are not nationally prescribed, but it would be usual for such a sub-contract to require the sub-contractor to indemnify the NHS provider for the cost it incurs as a result of negligent or inadequate treatment on the part of the sub-contractor.
However, it is important to be clear that complications after surgery are not necessarily associated with negligence. It is normal for patients experiencing complications to be referred to the hospital which can provide the best care. In these circumstances, each NHS provider will normally be paid by the relevant NHS commissioner for the specific service it has provided to the patient.
In the first example, the NHS trust or FT will be paid in full by its local CCG for the further treatment it has provided, at the normal national prices laid down in the National Tariff Payment System. Normally, the CCG would also have paid for the initial treatment provided by the independent sector provider, but if there is evidence of breach of contract or negligence, the CCG would be entitled to be indemnified for the additional costs of further treatment.
In the second example, the NHS provider is responsible to the commissioner both for the treatment it has carried out itself and under sub-contract by the independent sector provider. It will therefore be paid by its CCG at National Tariff prices for all the operations that have been undertaken at both hospitals – though, again, this would be subject to the potential for the CCG to withhold payment to in a clear case of negligence or breach of contractual requirements. Payment between the NHS provider and its sub-contractor would be a matter for those parties to agree locally between themselves, as a part of their sub-contract.