TY - JOUR T1 - Outsourcing care to the private sector: some reassuring evidence on patient outcomes JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 486 LP - 488 DO - 10.1136/bmjqs-2021-014349 VL - 31 IS - 7 AU - Alex Bottle AU - John Browne Y1 - 2022/07/01 UR - http://qualitysafety.bmj.com/content/31/7/486.abstract N2 - Many countries have a mixed healthcare economy, with a private sector (either for profit or non-profit) making up a varying proportion of capacity, depending on the financing model. The outsourcing of routine elective care to the private sector by the National Health Service (NHS) in England has become well established over the last two decades. Introduced in 2003 to cut waiting times for high-volume surgical and diagnostic procedures, a range of privately owned healthcare providers were contracted to provide services that are free at the point of access to NHS patients. The scale of capacity boost is modest, accounting for less than 10% of all elective procedures carried out using public funding. However, the absolute amount of healthcare purchased by English NHS Trusts from independent providers continues to grow steadily, although from a low baseline.1 The use of private facilities to boost public sector capacity in England, where government-funded healthcare through the NHS is available to all citizens regardless of their income or employment status, has long been politically controversial. Fears have been expressed that current policy will lead to a form of privatisation, where private providers are contracted to run select NHS facilities, or that outsourcing grows to the point where the financial viability of some NHS providers is undermined.2 There are also concerns around the impact of an enlarged private sector on workforce supply for the NHS and around the value for money of contracts agreed with the private sector.3 Finally, there are concerns about the extent to which streaming low-risk patients away from NHS facilities may affect training opportunities for junior NHS clinicians.4 The role of the private sector remains a part of the ever-present debate about the optimal organisation of the NHS. A further … ER -