Member Article

How do you run a successful hospital?

Responsibility for lives is not something on the tick sheet for all directors and managers. Bdaily recently spoke to Silvie Adams, the registered manager of Washington Spire Hospital, to find out more about the healthcare market and how you run a successful hospital.

Silvie is responsible for both the financial and clinical performance of the hospital, although the latter is delegated to a head of clinical services. She runs one of the 37 Spire hospitals nationwide, each with their own manager who reports into a chief operating officer based in London.

More than half of Spire Washington patients are insured by private health insurance companies, or pay individually for treatment, and the rest are NHS patients.

“My day involves dealing with consultants primarily (we have 150 of them), and all consultants work differently so there’s a variety of things we engage on, from individual patients and paperwork to new procedures and equipment,” says Silvie.

The hospital operates with a significant degree of autonomy, and Silvie explains that Spire’s model is based on the premise that individual hospital managers know the local market best: “Within a broad framework, we determine the hospital’s strategy based on the need in the area for private and NHS care. We cover the whole North East, that is as far as Northumberland down to Teesside and would generally market our services within this catchment.

“Any geographical area has its own specific health care needs and the health statistics of the North East are influenced by the historic mining community, poor diet, and other socio-economic conditions. It’s also particularly characterised by the amount of people with private medical insurance. The reason we cover such a wide area is because there are fewer people in the North East with private health insurance than in other parts of the country.

“If you were to look at one of our hospitals in the South, the catchment area is considerably smaller because the proportion of the population with private medical insurance is much higher.”

The big question is how do services differ for private and NHS patients?

Silvie explains: “Everybody gets the same level of clinical care. We constantly monitor our standards and benchmark ourselves against other private and NHS providers to make sure that our clinical standards for all patients are excellent.

“Where the proposition differs slightly for NHS patients is in what we call the ‘hotel services’ - that is the choice of food and so on. Whilst there is still a choice of excellent food, it is not the à la carte menu in the same way it is for private customers.

“We are contractually obliged to see NHS patients within an 18 week period from referral but we always aim to beat this. As such our average time to see NHS patients is around 6 weeks, sometimes much quicker if there is an urgent clinical need. Private patients are generally seen within a few days.

“What NHS patients don’t realise is that they can ask their GP whether they can come directly to us, which is a possibility if it’s deemed appropriate.”

Silvie explains that the privately insured market has changed considerably over recent years. Companies who might have given private medical insurance, not only to their employees, but also their employees’ families, have cut back significantly. Now it may be just senior staff who enjoy such benefits.

While the corporate market has declined, those who pay for private medical insurance themselves are seen to be shopping around, and smaller insurers are becoming increasingly popular among patients.

“For some it is a cost saving measure, in other instances it is where companies have introduced what are known as ‘baskets’ of benefits. This is where staff choose which benefits make up their package,” says Silvie.

“I think often young people are less inclined to choose health insurance as it’s not something they see as immediately useful. Of course, if employees have private medical insurance, chances are they will be seen quicker and their companies get them back to work sooner.”

Spire want to encourage the use of private medical insurance, and one way to instigate this is through GPs.

Often GPs are unaware that patients have private cover and send them straight on to NHS providers. Prompting GPs to ask patients if they have private insurance can, as Silvie points out, save NHS resources: “If you contrast the set-up to what happens in Australia for instance, there’s a big difference. There, patients are asked if they have private medical insurance as soon as they come through the public hospital doors. If the answer is yes, the patient is then told to go to a private hospital so that public resources are not used up by people who are privately insured.

“We don’t look upon it like that in this country at all. A lot of how this might change will be dependent on government policy. Although it’s unlikely under a Labour government, one day they might have to look at introducing tax breaks for people taking private medical insurance, to make it more attractive and take the strain off the NHS.”

Customer service is a big focus for Spire Washington Hospital in the coming year. Silvie is keen to build the hospital’s hospitality services, and wants to continue to foster “caring friendliness” to complement the efficiency.

It’s a less measurable component of the hospital’s services but one that is key to their word-of-mouth success.

Silvie says: “I’m actually looking to bring in someone who has worked as a telephone coach in call centres. They will work with the clinical teams who may not necessarily have that call-handling knowledge and customer service skills, both of which are key to the patient’s experience.”

Elsewhere, the hospital is on constant path to ensure new technologies and innovations are delivered to patients. An erectile dysfunction clinic, digital mammogram capabilities and the latest ultrasound technology are among the latest provisions that keep the hospital at the forefront of care.

Silvie concludes: “One of the biggest parts of my job is using information from experts, and the detailed input from consultants and clinicians to make informed judgements and decisions. It’s a team effort here and much of our success comes from using the knowledge of the excellent people around me.”

This was posted in Bdaily's Members' News section by Tom Keighley .