How staffing issues are impacting both public and private healthcare

6 October 2023

Jon Burke (Chief Medical Officer) and Sarah Taylor (Head of Specialist and Practitioner Relations) at AXA Health discuss how the challenges faced by the NHS mean that healthcare issues are not solely limited to the nation’s health service.

Growing demand for health services post-pandemic

Firstly, it is driving huge demand for access to private health services.

Following the pandemic people are understandably more anxious about medical issues, mental health conditions are more prevalent and there is increasing awareness that the NHS may not always be able to support the health of employees as quickly as they might want or expect.

This demand for private health services goes beyond just traditional insured admissions.

It has also led to a significant increase in people looking to pay for certain treatment which can be seen through the uplift in volumes of self-pay, particularly from people who may have saved up during the pandemic.

Because the NHS is facing unprecedented demand, many companies, and individuals, who have private medical insurance policies are increasingly looking to cover healthcare that traditionally was not included in insurance policies, such as access to cancer screening or fertility benefits, due to concerns about their ability to access these services through the public health system.

Social media is also having a growing impact on demand for private services.

Documentaries and well-publicised instances of health conditions among celebrities are driving more patients to ask for specific diagnoses and treatments and they are more demanding, even less trusting, of their assessments. In addition, advancing medical technologies are also leading to more demand for treatment.

Supply struggling to meet demand

Within the private sector, the pandemic has also had a significant impact on supply chains.

Doctors are more in demand than ever before. This can be seen both through their increasing power at the negotiating table during industrial action and through measures in the Budget on removing the Lifetime Allowance to encourage more doctors to remain in work and encourage others back into the workforce.

There is also increasing pressure on waiting lists within the private sector which is adding pressure on supply further impacted by the government drive to utilise private capacity.

These pressures have driven suppliers to carefully examine the most efficient and effective way to deliver services, and a significant part of this is offering remote and digital options where appropriate.

There is also greater pressure on gatekeeping and primary health services as people are more health anxious. Increased use of digital GP services means that the treatments that traditionally would have been delivered in a primary care setting are often being referred onwards for further tests. In turn this leads to another source of pressure on supply around diagnostics and specialist consultations.

The private sector has always relied on clinicians being willing to work long hours, providing services to both NHS and private patients during their working week.

Since the pandemic, however, there has been a far greater emphasis on work/life balance for many of these medical professionals. It means, in reality, that there are fewer doctors available, which in turn places further pressure on costs. Specific hotspots have emerged in certain specialisms such as anaesthetists, neurology and dermatology.

For example, due to the government’s focus on trying to get waiting lists down, specialists were encouraged to work weekends on an NHS list. This increases pressure on supply and consequently on fees. This is an issue faced by the whole medical insurance industry as there is an absolute need to ensure appropriate coverage and access whilst balancing any required premium increases to ensure policies remain good value for money.

Unfortunately, there is little prospect of these pressures subsiding in the foreseeable future.