London Calling

HCA Healthcare’s healthcare network in the United Kingdom provides quality care and cutting-edge research

“We have hospitals in the United Kingdom?”

That’s the response of many HCA Healthcare employees when they’re told about their counterparts across the Atlantic. They’re even more surprised when they find that the British hospitals, clinics and research facilities are well-known centers of cutting-edge care, and also play a role partnering with England’s National Health Service (NHS).

“Several hospitals were bought by HCA Healthcare in the 1990s, and then everything consolidated into what is now the International Division in 2000,” says Rebecca Pullen, corporate affairs director. “There are six main hospital facilities, and then additional primary-care facilities, laboratory facilities and a number of partnerships with leading NHS facilities. We also have some outpatient diagnostic centers and a branch of the Sarah Cannon Research Institute.”

Healthcare in the UK is significantly different than in the United States. In England, the NHS was established in 1948 and provides care for every citizen, covering everything from primary care physician visits to prescriptions, emergency care and surgeries. Specialist services, consultations and other care also fall under its umbrella.

“It’s all free when you access it – there’s no charge for anything from primary care, to dentistry, to prescriptions – and it’s any kind of healthcare you could possibly want,” Pullen says. “But the downside is that often you have to wait for access, which can in some cases be a long time.”

A role for private insurance and facilities

When the NHS came about, many people thought private insurance and care might wither away. Instead, in part because of the waits that sometimes occur around popular procedures and also because of the benefits of private care such as seeing a particular physician at a time convenient to the patient, they have continued to operate alongside — and often in tandem with — the NHS. That’s where HCA Healthcare comes in.

“People have always been willing to pay for access to a particular doctor they wanted to see at a time that works for them, or have services more quickly,” Pullen says. “As the NHS matured and the pressures on it became greater, the waiting list got longer. HCA Healthcare saw an opportunity to deliver world class care to the 10 to 12 percent of the population that has private medical insurance or are willing to make out-of-pocket payments. Before HCA Healthcare came to the UK, you couldn’t really access complex care in the private sector.”

When HCA Healthcare entered the UK market, primarily in and around London and Manchester, it invested in complex care such as cancer treatment, neurosurgery and cardiac care. Those service lines were fairly limited in the private sector at the time, and many patients and physicians immediately sought HCA Healthcare out.

“Ninety percent of our doctors work in the NHS, mostly in the big teaching hospitals of London and Manchester, but also do private sector work,” Pullen explains. “In fact, we have the privilege of working with some of the UK’s most pre-eminent doctors. Many of them will spend a half day a week, for example, in private practice, and so they work with our facilities then.”

Another difference from the United States is that the private sector in the UK doesn’t deliver emergency care, so HCA Healthcare in the UK doesn’t have any ERs. Patients who have additional private insurance or are willing to pay out-of-pocket make their way to HCA Healthcare hospitals and facilities when they see their regular physician. Because of the limited number of people with supplemental coverage, HCA Healthcare’s facilities in England only have about 150 beds on average. And while they do not provide emergency care at all, leaving that to the NHS hospitals, they set themselves apart in other areas.

“We’re the only hospital group in the United Kingdom with intensive care in all our hospitals,“ Pullen says. “And then we are the only private facilities providing very complex care such as liver transplants. We also are very advanced in the more complex cardiac care and cancer services as well.”

Partnering with the NHS

HCA Healthcare has been able to connect with the NHS and academic institutions through its research facilities and Sarah Cannon expertise to share information, and also to provide some services to the national organization.

“We run a number of private-patient units in partnership with the NHS,” Pullen explains. “Some NHS hospitals have private-care areas. We deliver the care, and then a share of the revenue received by us is returned to them and invested in the overall system. We also invest in cutting-edge equipment with the NHS. In fact, on a number of occasions, HCA Healthcare has been the first to introduce innovative new technologies and processes to the UK.”

For example, HCA Healthcare works with University College Hospital in London to operate its private bone marrow transplant service.

“We provide in-demand services, and some very complex care, at all our facilities,” Pullen says. “The treatment we offer attracts patients from all over the world. About one in five of our patients travels from overseas to the UK to access the care we deliver. HCA Healthcare has really made its mark in the UK and beyond.”