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April 29, 2026BMJ0 citations

Private care soars at some hospital trusts despite huge NHS backlogs

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LDLawerence Dunhill

Key Points

  • To analyze growth in private patient activities at NHS trusts amidst increasing public patient backlogs.
  • Analyzed activity data of the 20 NHS trusts with highest income from private patients.
  • Identified trusts with higher growth in private care compared to NHS activity from 2019-20 to 2024-25.
  • Private activity data sourced from the Private Healthcare Information Network.
  • Some NHS trusts increased private patient cases significantly while NHS activity lagged.
  • Concerns raised regarding prioritization of private patients over publicly funded patients.
  • Great Ormond Street Hospital had the largest increase in private care among analyzed trusts.

Abstract

Hospital trusts are under huge financial pressure, but are efforts to boost their income from private patients coming at a cost? Lawrence Dunhill reports Growth in numbers of private patient cases at some NHS hospitals has accelerated since the covid pandemic, despite backlogs of publicly funded patients. Analysis by The BMJ has identified several hospital trusts that grew their private elective care work by a significantly higher margin than their NHS activity over the past five years. One think tank raised concerns that hospitals may be choosing to prioritise private patients ahead of NHS cases, as trusts seek to bring in additional revenue to meet stringent financial targets. Last month Healthwatch England warned of an increasing “two tier” health system after a report from the watchdog described a surge in patients seeking private care.1 Among the 20 trusts with the most private activity, Great Ormond Street Hospital for Children (GOSH) had the largest increase over the past five years, The BMJ ’s analysis found (see box 1 for methods). Box 1 ### How The BMJ ’s analysis was done The BMJ examined activity data at the 20 NHS trusts with the largest incomes from private patients and identified seven (see second chart) that grew activity at their private patient unit by a higher margin than their NHS activity between 2019-20 and 2024-25 (first chart). Private activity data were accessed through the Private Healthcare Information Network (PHIN),2 which publishes finished consultant episodes for inpatient and day cases. NHS trusts are legally required to submit detailed and accurate data to PHIN. Where trusts submitted incomplete data, such as Oxford University Hospital in 2019-20, a projected annual figure was calculated from completed submissions in that year. Great Ormond Street Hospital said its published private activity data were incorrect but provided … RETURN TO TEXT

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Lawerence Dunhill (2026) studied this question.

synapsesocial.com/papers/69f154c0879cb923c4944f65https://doi.org/10.1136/bmj.s793
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