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Healthcare intelligence LaingBuisson

PRIVATE ACUTE HEALTHCARE MARKETLatest Trends & Forecastsa LaingBuisson presentationOctober 2019

LaingBuissonHealthcare intelligence

• Background• Number of consultants• Trends in episode setting

• Forecasts• By payor groups nationally• By Central London/rest of UK

Healthcare intelligence LaingBuissonLaingBuissonHealthcare intelligence

Agenda

• Select Committee on Health July 2000• 24,000, of which 16,000 work privately

• National Audit Office Feb 2013• 38,197 FTE, of which 15,754 work privately

• Of which 5,071 work >5 hours per week privately ( 32% of private)

• BMJ March 2017 quoting Ray Stanbridge• 25,000 of which 5,000 (20%) doing 80% of private work

• LaingBuisson 2019 est.• 20% of consultants do 80% of the work• 80% of consultants see <patient per week privately

Healthcare intelligence LaingBuissonLaingBuissonHealthcare intelligence

How many consultants work privately?And how many are busy privately?


Number of Hospital Invoices by Episode Setting

Note: All data is nominal


77% 77% 78% 78% 79% 79% 79% 80% 80%

16% 15% 15% 15% 15% 15% 15% 15% 15%8% 7% 7% 7% 6% 6% 6% 5% 5%

0%10%20%30%40%50%60%70%80%90%

100%

2010 2011 2012 2013 2014 2015 2016 2017 2018

Outpatient Daycase InpatientSource: Healthcode


Value of Hospital Invoices by Episode Setting



30% 31% 32% 33% 35% 36% 36% 37% 38%

26% 26% 26% 27% 27% 27% 28% 28% 29%

44% 43% 42% 40% 38% 37% 36% 34% 33%

0%10%20%30%40%50%60%70%80%90%

100%

2010 2011 2012 2013 2014 2015 2016 2017 2018



Average value of Hospital Invoices by Episode Setting



AGR 5.1%

AGR 6.5%

AGR 12.0%

£0

£1,000

£2,000

£3,000

£4,000

£5,000

£6,000

£7,000

2010 2011 2012 2013 2014 2015 2016 2017 2018

£



PMI-funded Independent Hospital Revenue Growth

1.4% 1.7% 2.5%0.9% 1.7% 1.1% 0.9%

-0.8% -0.2% 0.3% 0.2% 0.1% 0.0%

-5%

0%

5%

10%

15%

20%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)



Last 3 years -0.0% p.a.


PMI-funded Independent Hospital Revenue Growth Forecast



1.9%

1.8%

1.9%

0.8%1.0%

1.0%

-0.5% -0.3% -0.2%

0.2% 0.1% 0.0%

£2,150

£2,200

£2,250

£2,300

£2,350

£2,400

£2,450

£2,500

£2,550

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns

LB Forecast Oct 2016 £m LB Forecast Oct 2017 £m LB Forecast Oct 2018 £mLB Forecast Oct 2019 £m Actual

0.3%


NHS funded Independent Hospital Revenue Growth



10.5% 10.5% 11.0%10.1% 10.2%

7.6%

5.3%

0.6%-1.0%

4.0%3.0% 2.5% 2.5%

-3%

-1%

1%

3%

5%

7%

9%

11%

13%

15%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)

Last 3 years 1.6% p.a.


NHS funded Independent Hospital Revenue Growth Forecast



7.5%8.0%

9.0%

6.0%7.0%

7.0%

1.0% 2.0% 3.0%3.0% 2.5% 2.5%

£0

£500

£1,000

£1,500

£2,000

£2,500

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns


4.0%


Self-Pay Funded Revenue Growth

8.8%7.1%

5.1% 5.7%

9.6% 9.5% 9.8% 8.7%7.1%

4.5% 4.5% 5.0% 5.0%

0%

5%

10%

15%

20%

25%

30%

35%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)



Last 3 years 8.6% p.a.


Self-Pay Funded Revenue Growth Forecasts



7.5%7.5% 6.0%

11.0%10.0%

9.0%

7.0%6.0% 5.0%

4.5% 5.0%5.0%

£0

£200

£400

£600

£800

£1,000

£1,200

£1,400

£1,600

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns


4.5%


International Private Funding Revenue Growth

16.5% 13.8%

26.1% 24.7%

10.9%

-4.4%

-12.2%

-30.9%

-13.8%

0.0% 3.0% 3.5% 4.0%

-35%

-25%

-15%

-5%

5%

15%

25%

35%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)



Last 3 years -19.4% p.a.


International Private Funding Revenue Growth Forecasts



7.0%7.5%

7.5%

1.0% 2.0% 3.0%

-10.0% -5.0% -2.5%

3.0% 3.5% 4.0%

£0

£50

£100

£150

£200

£250

£300

£350

£400

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns

LB Forecast Oct 2016 £m LB Forecast Oct 2017 £m LB Forecast Oct 2018 £m

LB Forecast Oct 2019 £m Actual

0.0%


Summary - Private Acute Market Revenue Growth



Includes PPUs

5.1% 5.3%6.0%

5.3% 5.8%4.3%

3.2%

0.5% 1.1%

2.6% 2.4% 2.4% 2.4%3.6% 3.7%4.4%

3.7% 4.3%3.0% 2.4% 0.5%

2.0%

2.0% 2.2% 2.3%2.4%

-1%

1%

3%

5%

7%

9%

11%

13%

15%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Total national Of which PPO only

Last 3 years; Total market 1.6% p.a. PPO only 1.6% p.a.


Central London Private Acute Market Growth Forecasts

9.3%7.1%

9.3%

9.1%

5.1%3.3%

1.4%

-7.0%

-0.6%1.5%

2.0%2.5% 3.0%

5.1%

15.4%

10.8% 7.9% 8.0% 7.7%6.0%

9.3%7.0% 7.0% 7.0% 7.0% 7.0%

-10%

-5%

0%

5%

10%

15%

20%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)

Independent NHS PPUs

Last 3 years: Independent only -2.1% p.a. PPU only +7.4%p.a




Central London Private Acute Market Growth Forecasts



3.8%5.4% 3.7%

2.0% 3.0%4.0%

2.0% 2.5% 2.0%

2.0% 2.5% 3.0%

£0

£200

£400

£600

£800

£1,000

£1,200

£1,400

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns



Central London PPUs Market Growth Forecasts



2016 8.0%

2017 5.0%

2018 and 2019 7.0%

£0

£100

£200

£300

£400

£500

£600

2016 2017 2018 2019 2020 2021 2022

£ m

illio

ns



Out of Central London Private Acute Market Growth Forecasts



1.8% 2.1%2.5%

1.5%

3.8%

2.4% 2.6%

1.6% 1.6% 1.4%

10.5% 10.5% 11.0%10.1% 10.2%

7.6%

5.3%

0.6%

3.0% 2.5% 2.5%

-2%

0%

2%

4%

6%

8%

10%

12%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Nom

inal

Gro

wth

(%)

Independent PPO Only £million NHS £million

Last 3 years Total market 2.4% p.a.NHS only 1.6% p.a.

2018£m

2019%p.a.

2020% p.a.

2021%p.a.

2022%p.a.

National

PMI £2,305 0.3% 0.2% 0.1% 0.0%

NHS £1,628 4.0% 3.0% 2.5% 2.5%

Self-pay £1,105 4.5% 4.5% 5.0% 5.0%

International (exc PPU) £137 0.0% 3.0% 3.5% 4.0%

Regions

Central London Independent £950 1.5% 2.0% 2.5% 3.0%

Out of London Independent PPO £2,600 1.5% 1.6% 1.6% 1.4%

SUMMARY


Private Acute Healthcare Market Report


By Philip Blackburn6th edition due October 2019

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