Do Independent Sector Treatment Centres (ISTC) Impact on Specialist Registrar Training in Primary Hip and Knee Arthroplasty?

Clamp, Jonathan A.; Baiju, Dean; Copas, David; Hutchinson, James; Rowles, J. M.

doi:10.1308/003588408x301073

Cited by 13 publications

(10 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are already studies suggesting that, in some cases, training in Independent Sector Treatment Centres (ISTCs) is inadequate. 19 Postgraduate training is still struggling to adjust to the challenges posed by the European Working Time Directive (including within military practice 20 ) and further threats from pseudoprivatisation could derail current efforts to maintain effective junior doctor teaching.…”

Section: Passing On the Baton: Potential Knock-on Effects On Trainingmentioning

confidence: 99%

Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

Maruthappu¹,

Sugand²,

Nagendran³

et al. 2010

Br J Gen Pract

View full text Add to dashboard Cite

Section: Passing On the Baton: Potential Knock-on Effects On Trainingmentioning

confidence: 99%

Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

Maruthappu¹,

Sugand²,

Nagendran³

et al. 2010

Br J Gen Pract

View full text Add to dashboard Cite

“…Training suffered as consultants concentrated on service provision. 3 Training in both outpatient clinics and operating theatres was affected.…”

Section: Ann R Coll Surg Englmentioning

confidence: 99%

Outpatient Experience at ST3 Grade Orthopaedic Trainees: A Cause for Concern

et al. 2010

View full text Add to dashboard Cite

show abstract

“…An NHS study by Clamp et al showed a 19% reduction in the number of total hip and knee procedures performed by junior doctors in an NHS hospital in Derby following the opening of a local ISTC. 20 In addition to the tariff, the independent sector treatment centres receive a considerable subsidy in the form of a premium for the first five years. The NHS is contractually obliged to buy back £187 million of independent centre facilities at the end of the contracts if the providers do not wish to continue operating.…”

Section: Journal Of the Royal Society Of Medicinementioning

confidence: 99%

Independent sector treatment centres: the first independent evaluation, a Scottish case study

Pollock

Kirkwood

2009

J R Soc Med

View full text Add to dashboard Cite

SummaryObjectives The £5 billion English Independent Sector Treatment Centre (ISTC) programme remains unevaluated because of a lack of published contract data and poor quality data returns. Scotland has a three-year pilot ISTC, the Scottish RegionalTreatment Centre (SRTC), the contract for which is now in the public domain.This study aims to conduct an independent evaluation of the performance of the SRTC during the first year of operation.Design A retrospective analysis of the SRTC comparing activity as reported by hospital episode statistics returned to ISD Scotland with: volume and cost data in the SRTC contract; a 10-month audit carried out by management consultants Price Waterhouse Coopers (PWC); and an internal NHSTayside performance report.Setting All day-case and inpatient activity at the SRTC from 1 December 2006 to 31 January 2008. Main outcome measures Activity and cost.Results The annual contract was based on patient referrals to the SRTC and not actual treatments.The contract was awarded on the basis of 2624 referrals a year, total value of £5,667,464. According to ISD data, the SRTC performed 831 procedures (32% of annual contract) in the first 13 months worth £1,035,603 (18%). PWC's figures report 2200 referrals (84%) to the SRTC at a cost of 2,642,000 (47%) in the first 10 months.Conclusions Basing the SRTC contract on payments for referrals rather than actual treatment represents a major departure from normal standards of reporting and commissioning and may have resulted in over-payment for referrals for patients who did not receive treatment of up to £3 million in the first 10 months.The PWC report falls well below the standards one would expect of an independent evaluation and we were unable to validate PWC's analysis and the claim of value for money. If wave-one ISTCs in England perform similarly to the SRTC then as much as £927 million may have been paid for patients who did not receive treatment. We recommend a moratorium on all ISTC contracts until the contracts have been published and properly evaluated with respect to work paid for and actual work carried out and quality of care.

show abstract

Do Independent Sector Treatment Centres (ISTC) Impact on Specialist Registrar Training in Primary Hip and Knee Arthroplasty?

Abstract: ISTCs may adversely affect SpR training in primary joint arthroplasty.

Cited by 13 publications

References 1 publication

Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

Outpatient Experience at ST3 Grade Orthopaedic Trainees: A Cause for Concern

Independent sector treatment centres: the first independent evaluation, a Scottish case study

Contact Info

Product

Resources

About