The changing role of Independent Sector Treatment Centres – a
clinician’s view
By Mr Cyril Marek, Consultant Orthopaedic Surgeon.
When the independent sector was first invited to tender for new
NHS facilities in 2005, the concept caused controversy, as new
ideas often do. However the raison d'être of Independent Sector
Treatment Centres (ISTCs) was fairly straightforward - to provide
additional capacity, and to help reduce waiting times for NHS
patients.
A few years into their contracts, ISTCs are certainly living up
to these expectations. ISTCs’ waiting times can be as little as two
weeks and, while they in no way claim to be the sole explanation,
will have contributed to the achievement of 18 week targets.
But ISTCs contribute to today’s NHS much more than this. As a
Consultant working at the ‘coal face’ of the NHS in two busy ISTCs,
I have seen these centres battle through opposition to become a
true part of the healthcare landscape, providing benefits both to
patients and to the wider NHS.
More and more ISTCs offer junior doctors’ training, expanding
the diversity of experiences available to the specialists of the
future. Trainees at our sister facility, Clifton Park ISTC in York,
have been benefiting from such training for three years. As well as
learning from seconded NHS Consultants in a completely different
setting, the trainees are involved in 30 to 40 per cent more cases
than they were at the local district hospital, providing invaluable
hands-on experience.
Student nurses, Physiotherapists and Radiographers also benefit
from increasing ISTC training opportunities. As well as technical
skills, such partnerships promote shared learning between the
independent sector and the NHS, whose services are becoming
increasingly integrated.
Knowledge sharing by ISTCs also stretches to primary health
practitioners, with facilities holding education evenings for GPs
and other community practitioners. Such activities, with topics
ranging from sports injuries to arthritis management, also
facilitate shared learning, as well as better relationships between
local experts. ISTC Consultants have also contributed to national
healthcare issues, ranging from NICE guidance, to Joint Advisory
Groups.
As many ISTCs were commissioned as new-build facilities, this
presented the opportunity to use the very best options for hospital
design. The two ISTCs in which I practice both use a
state-of-the-art circular layout which minimises the risk of
infections - patients undergoing surgery follow a continuous path
through the building, never doubling back on themselves. These
facilities have never reported an incidence of hospital-acquired
MRSA.
ISTCs have also been pioneers of day surgical procedures, again
being able to capitalise on their beginnings as new-build
facilities. The move of certain procedures from inpatient to day
case surgery was viewed with suspicion by some at first, but is
increasingly being accepted as preferable both for patient care and
for the NHS budget. I hope a similar analogy can be applied to
ISTCs in the very near future.
Mr Cyril Marek is a Consultant Orthopaedic Surgeon at
Blakelands NHS Treatment Centre, in Milton Keynes, and Horton NHS
Treatment Centre, in Banbury. For more information Blakelands
NHS Treatment Centre.