Death of NHS-funded private patient at Spire Hospital raises safety concerns

A woman died when a national private healthcare provider failed to transfer her to NHS intensive care quickly enough after she became critically ill, the BBC has revealed.

The death of Mrs Khan from east London was one of several deaths following surgery at Spire Healthcare, examined by BBC Panorama.

Spire Healthcare, one of the biggest UK private hospital chains, runs 39 private hospitals across the UK but has received three Prevention of Future Deaths (PFD) reports from coroners in the past two years.

PFDs are issued when someone has died, and action needs to be taken to reduce the risk of further deaths in similar circumstances.

In one case in Norwich, the coroner issued a warning about Spire's continuing reliance on ambulance transfers to NHS hospitals in the event of emergencies, after three patients died following long waits.

In England alone, there are more than six million people on NHS waiting lists. In some cases, the NHS will pay for patients to be treated in private hospitals to help reduce the backlog. 

Since 2021, Spire Healthcare has treated more than half a million NHS patients. Last year its profits rose by more than 30% to £126m.

While most NHS hospitals have intensive care units, most private hospitals do not, and BBC Panorama has found evidence that some patients treated at Spire hospitals were unaware there were no intensive care facilities. 

Senior safety investigator at the Health Services Safety Investigations Body, Dr Nick Woodier, said that "there is a risk to patient safety", particularly where the NHS does not understand the capabilities of a particular private hospital. 

Following Panorama's questions to Spire, the company has now updated its hospital websites, informing patients they may need to be transferred to the NHS for intensive care.

Spire Healthcare says it communicates with patients about its facilities "in various ways including information on our website, admission letters and patient leaflets which are regularly updated as appropriate."

When ambulance staff eventually arrived to take Nafisa Khan to an NHS hospital, her daughter Sabrina says Spire Healthcare's east London hospital had so few staff on duty that the cleaners let them in. 

After having been referred to Spire, Mrs Khan underwent a routine gallbladder operation in September 2021. She had been told it would be quicker for the NHS to pay for the procedure to be done privately.

The morning after her surgery, Mrs Khan deteriorated, and her condition became critical. Spire has five hospitals with critical care units, but Spire East London does not have one. 

Sabrina Khan said Spire Healthcare staff "should have known something was wrong" with her mother, Nafisa and that the ambulance to take her to an NHS hospital did not arrive until about 22:00 that night.

The BBC also obtained testimony from doctors contracted by the company to work up to 168 hours a week, who say long hours could put patients at risk. Mrs Khan died shortly after being taken into NHS intensive care. 

Spire Healthcare has apologised for failings in Nafisa Khan's care.

Sabrina Khan added: "Why did they wait that whole Saturday while she was deteriorating, while she was vomiting, to transfer her to the NHS hospital?"

Spire Healthcare has admitted it failed to fully appreciate the seriousness of Mrs Khan's deteriorating condition and has apologised. It said she should have been transferred earlier to an NHS hospital for critical care.                 

In 2023, Spire Healthcare was warned about another death as part of a coroner's PFD after a woman developed sepsis at Spire Hospital, Leeds, after a routine hernia operation.

The hospital was late in identifying the complications and the woman died. The coroner concluded her death had been avoidable and highlighted the role of the on-call doctor, known as the resident medical officer (RMO).

The coroner in that case said: "The RMO was called twice during the night but failed to appreciate that the deterioration in her condition necessitated an escalation to the surgeon or anaesthetist."

RMOs provide 24-hour cover at private hospitals and in some, including Spire, are contracted to work up to 168 hours a week.