Two surgeons in an operating theatre

Surgical care of NHS patients in independent hospitals

HSIB legacy content

HSIB legacy content

This investigation was carried out by the Healthcare Safety Investigation Branch (HSIB). Find out more about HSIB legacy.

Investigation summary

We launched an investigation to support the delivery of safe care to NHS-funded patients undergoing surgery within independent (private) hospitals.

There has been a history of collaboration between the NHS and independent hospitals when delivering care to patients.

This has included NHS patients undergoing care for certain conditions in independent hospitals. Recently, COVID-19 has placed increased pressure on the NHS. This has resulted in independent hospitals providing more care for NHS patients including urgent NHS elective surgical care and delivery of cancer pathways.

Our investigation considered the safe provision of surgical care, with reference to a specific incident, and how decisions are made around which patients are cared for in independent hospitals.

The reference event involved a man with a diagnosis of bowel cancer. He was booked to undergo laparoscopic (keyhole) surgery to remove part of his bowel in an NHS hospital. He subsequently underwent open surgery in an independent hospital as a result of COVID-19.

Following surgery, the patient made slow progress and on day eight following surgery he started to deteriorate rapidly. He was transferred to the local NHS hospital for investigation and further surgery. He died later the same day as a result of sepsis following a complication of his recent surgery.

The investigation explored:

  • safety issues associated with the establishment of surgical services in independent hospitals to support the NHS and in particular the specialist services that are in place to deliver patient care
  • the assessment of patients prior to surgery to identify their risk and suitability for an operation and where it was to be undertaken; this included identification of patients with frail physical states.
Investigation report