NHS triggers ‘de-escalation’ clause to allow private providers to restart work

The private sector will remain block-booked under commission from NHS England. However, the national commissioner has triggered the “de-escalation notice” in the contract. 

This means that local NHS commissioners and providers can open negotiations with private firms about how they might help reduce the exploding NHS elective waiting list. It also gives the private sector permission to begin to restart work funded by indviduals or insurers.

NHS England block booked almost all the sector’s facilities and staff at the end of March in readiness for a surge in covid-19 patients. Most of the booked capacity was not needed, although many staff transferred to work in NHS hospitals.

David Hare, chief executive of the Independent Healthcare Providers Network, said: “We’re still in the contract, so today’s signal by NHS England doesn’t end the block-booked phase.

“It’s just we’re in a different phase of the arrangement…. where it’s permissible to do non-urgent routine work where the local NHS system agrees that that’s appropriate.”

Sir Simon Stevens wrote to chief executives at the end of last month to say plans should start for a cautious return to NHS elective work. HSJ understands that NHS trusts have been told to explain to the centre how they might best use private providers to achieve this goal. This intelligence will inform how and if NHSE might renegotiate the contract. 

Many hospitals began winding down their non-urgent electives in March before a nationwide instruction on 17 April to suspend all such work.

An NHS England spokeswoman said: “Faced with an unprecedented global health pandemic, private hospitals were rightly used by the NHS to deal with any extra demand.

“Their focus can now switch to delivering other services including elective surgery and cancer treatments - ensuring people can get the treatment they need.”