Great Ormond Street Hospital for Children NHS Trust today announced
proposals to manage its international and private patient division (IPP)
through a separate charity.
The proposals were agreed at the Board meeting Sept 26th, but are subject to a 12 week period of public consultation, starting today. (October 1st)
All those interested in receiving a copy of the consultation document should email email@example.com or call 020 7239 3123. More information is on the website www.gosh.nhs.uk/world
Chief Executive Dr Jane Collins said
need to find a legal, open, fair, and sound solution to our
international patient issue. We want to become a Foundation Trust,
independent within the NHS. However, the ‘private patient cap’ would
require us to limit our international income, from an estimated £25 m
this year to only £17 m, an £8m shortfall. At a time of financial
pressure, this would have a significant effect on our financial
stability, particularly in future years.”
“Most of our
international work involves working with foreign governments, to pay for
children who cannot get the treatment they need at home.”
international income we receive allows us to treat more NHS patients
than would otherwise be the case. Limiting international income
actually reduces our capacity to treat sick children on the NHS.”
“In fact we believe we can expand our international work, further benefiting the NHS work. But the cap would prevent this.”
solution we propose is, we believe, fair to staff and guarantees that
international patients can be treated to our standard of excellence; it
also ensures we can grow our international work, benefiting the NHS
“We want to hear people’s views.”
Key elements of the proposals are:
A legally independent charity will manage the International and Private Patient division
propose around 30 staff – admin, finance and business support staff and
a small number of senior management – will transfer to employment by
the new charity.
These staff will be protected by TUPE (the transfer of undertakings regulations).
charity will buy its clinical services from the NHS Trust. Therefore,
the clinical staff on the wards will remain employees of the NHS Trust,
with NHS terms and conditions.
A series of agreements will cover
use of the buildings, the services supplied from cleaning to operating
theatres and so forth. These agreements will need to satisfy the broad
regulatory and legal requirements for fair terms.
The charity will make a surplus which it will donate to the work of the NHS Trust
new body can seek funding (bank loans, etc) without competing for
resources within the NHS Trust, it will be free to operate in the market
for international services, and it should be able to grow.
allows more business freedom , potentially generating more income to
support the NHS services in the Trust. The new body will also continue
to support broader social obligations such as staff training and
The Trust is seeking the views of staff and its stakeholders through a 12 week consultation.
Key elements of the IPP service
IPP is 10 per cent of our patient admissions but 16 per cent of our income
main business is helping children judged by foreign governments to
require care at a world centre of excellence. 77 per cent of these
patients are sponsored by foreign governments and healthcare systems to
receive care not available at home. 15 per cent are overseas patients
paying for themselves or through private insurance and 9 per cent UK
patients choosing to pay.
For 06/07 we identified 19 separate
countries of origin, based on the location of the agencies paying for
treatment. In 06/07, we had 2018 in-patient and day case admissions,
and 12,499 out-patient attendances. The Middle East and the Greek
speaking world are key customers.
Key arguments for becoming a Foundation Trust
The Trust wishes to remain independent in order to keep its focus
on the needs of children. The Trust contends that children’s services
have a lower priority in mixed Trusts.
Foundation Trust status
keeps us within the NHS but allows for quicker decision making and a
measure of greater financial freedom. The Trust welcomes the user
involvement aspects of Foundation Trust status and has recruited nearly
3000 members, 70 per cent of whom are patients over ten, or parents.
Trust needs to demonstrate a viable business plan. The requirement to
cut and then hold low our international income has a significant effect
on our financial planning.
We face financial pressures through
changes to the regime for research funding and the payment by results
system, which covers many of the patients we treat. We are working
closely with the Strategic Health Authority and the Department of Health
on these issues. A sound solution on IPP income removes a further area
Key facts about Great Ormond Street Hospital for Children
Great Ormond Street Hospital for Children is (with its partners)
-the largest centre for research into childhood illness outside the United States (1)
-the largest trainer of paediatric staff in the UK (2)
-the hospital with the widest range of children’s specialists in the UK
largest UK centre for children with cardiac, renal, or neurological
problems; and with UCLH, the largest centre for children with cancer in
1 – with UCL Institute of Child Health
2 - with UCL Institute of Child Health and London South Bank University among others
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