Board assurance regarding the profitability of private patients

The request was successful.

Dear Moorfields Eye Hospital NHS Foundation Trust,

I am making a freedom of information request to all NHS Foundation Trusts and Trusts with a significant level of income from private patients. I request that the authority answer each of the following questions.
1. Have the authority implemented service line management, as a tool for measuring the financial performance of each clinical (and possibly other) service within the organisation?
2. Do the authority measure the profitability of private patient services provided by the authority?
3. Which of the following costs are included in measurements of net profitability of private patients?
a. Costs of staff directly involved in private patients
b. Prostheses, devices and drugs used by private patients
c. An allocation for clinical facilities and staff which are not used exclusively for private patients, including:
i. operating theatres/ theatre staff;
ii. diagnostic imaging equipment and staff
iii. Pathology laboratory equipment and staff
iv. Pharmacy equipment and staff
v. Therapy equipment and staff
vi. Critical care, intensive care, and high dependency units
d. An allocation for overhead costs and staff who provide services to private patients, including:
i. Information technology equipment and staff
ii. Human resources staff
iii. Finance staff
iv. Estates and facilities management staff
e. An allocation of costs for the space occupied by private patient services
4. Do the authority measure the net profitability of each payer group, specifically, do the authority measure the net profitability of private patients funded by the following payers:
a. International patients
b. Self-funded patients
c. BUPA insured patients
d. AXA/ PPP insured patients
e. Aviva insured patients
f. Vitality insured patients
g. Other privately insured patients
h. Any other groups (please specify)
5. Do the board of the authority recognise that an NHS organisation should never subsidise private care with public money, and that to do so would be a breach of core NHS principles?
6. Which of the following best describes how the board interpret their responsibility to ensure that private care should never be subsidised with public money:
a. Private care should overall make a gross contribution before the allocation of costs in groups 3d. and 3e. above
b. Private care should overall make a net profit after the allocation of all costs in 3. Above
c. Each payer group (as defined in 4 above) should make a net profit after the allocation of costs defined in 3 above.
d. Each patient/ procedure should make a profit after the allocation of costs (sometimes referred to as patient level information costing systems or PLICS)
e. Other – please describe
7. If they are not considered commercially confidential, please provide an analysis of the profitability of the authority’s private patient activity for the years end March 2018, March 2019 and March 2020.

Yours faithfully,

David Woods

Foi (MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST), Moorfields Eye Hospital NHS Foundation Trust

Dear Martin,

Thank you for your request for information which was received on 11th May 2020, and has been logged under ref FOI/20/0019 .Please quote this reference in any future correspondence.

Your request will be dealt with under the terms of the Freedom of Information Act 2000, and as per the terms of the Act, we expect to have responded to you no later than 20 working days after the date your request was received or, where applicable, further clarification is provided.

Yours sincerely,

Information Governance Officer (IG)
Moorfields Eye Hospital NHS Foundation Trust
Kemp House | 152 – 160 City Road | London | EC1V 2NX
020 7253 3411
[email address]

show quoted sections

Foi (MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST), Moorfields Eye Hospital NHS Foundation Trust

Dear David,

Thank you for your Freedom of Information request which was received within the Trust.

In accordance with S.1 (1) (a) of the Freedom of Information Act 2000 (FOIA), I can confirm that we do hold the information relevant to your request.

Please find our responses to your request below.

Your request and Our response

I am making a freedom of information request to all NHS Foundation Trusts and Trusts with a significant level of income from private patients. I request that the authority answer each of the following questions.

1. Have the authority implemented service line management, as a tool for measuring the financial performance of each clinical (and possibly other) service within the organisation?

SLM is in an early implementation stage in the organisation.

2. Do the authority measure the profitability of private patient services provided by the authority?

Yes.

3. Which of the following costs are included in measurements of net profitability of private patients?
a. Costs of staff directly involved in private patients
b. Prostheses, devices and drugs used by private patients
c. An allocation for clinical facilities and staff which are not used exclusively for private patients, including:
i. operating theatres/ theatre staff;
ii. diagnostic imaging equipment and staff
iii. Pathology laboratory equipment and staff
iv. Pharmacy equipment and staff
v. Therapy equipment and staff
vi. Critical care, intensive care, and high dependency units -

All of the above are included in the assessment of net profitability.

d. An allocation for overhead costs and staff who provide services to private patients, including:
i. Information technology equipment and staff
ii. Human resources staff
iii. Finance staff
iv. Estates and facilities management staff
e. An allocation of costs for the space occupied by private patient services

A corporate allocation is undertaken for all of the relevant headings in this section.

4. Do the authority measure the net profitability of each payer group, specifically, do the authority measure the net profitability of private patients funded by the following payers:
a. International patients
b. Self-funded patients
c. BUPA insured patients
d. AXA/ PPP insured patients
e. Aviva insured patients
f. Vitality insured patients
g. Other privately insured patients
h. Any other groups (please specify)

Profitability by individual payer is not measured

5. Do the board of the authority recognise that an NHS organisation should never subsidise private care with public money, and that to do so would be a breach of core NHS principles?

Yes

6. Which of the following best describes how the board interpret their responsibility to ensure that private care should never be subsidised with public money:

Private care is treated as a business segment in its own right with a specific purpose to support the NHS and as such the key metric is the overall contribution. This is disclosed within the Trusts Annual Accounts under the segmental reporting section.

a. Private care should overall make a gross contribution before the allocation of costs in groups 3d. and 3e.
above

b. Private care should overall make a net profit after the allocation of all costs in 3.

As above

c. Each payer group (as defined in 4 above) should make a net profit after the allocation of costs defined in 3

As above.

d. Each patient/ procedure should make a profit after the allocation of costs (sometimes referred to as patient level information costing systems or PLICS)

e. Other – please describe

7. If they are not considered commercially confidential, please provide an analysis of the profitability of the authority’s private patient activity for the years end March 2018, March 2019 and March 2020.

This now completes or response to your request for information.

The Trust has a formal internal review and complaints process which is managed by the Head of Information Governance. Should you have any concerns with our response, or how we have dealt with your request, you can request for an internal review. You can formally request for an internal review, these should be submitted within three months of the date of receipt of the response to your original letter, and should be addressed to:
Head of Information Governance,
Moorfields Eye Hospital NHS Foundation Trust,
162 City Road,
London,
EC1V 2PD

or by emailing [Moorfields Eye Hospital NHS Foundation Trust request email] This option is available to you for up to three calendar months from the date your response was issued.

If you are not satisfied with the Trust’s review under the Freedom of Information Act 2000 you may apply directly to the Information Commissioner’s Office (ICO) for a review of your appeal decision. The ICO can be contacted at: ICO, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF www.ico.org.uk

Yours sincerely,

Information Governance Officer (IG)
Moorfields Eye Hospital NHS Foundation Trust Kemp House | 152 – 160 City Road | London | EC1V 2NX
020 7253 3411

show quoted sections