Table of Contents
Executive Summary
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- Market size
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- Figure 1: UK Expenditure on Private Acute Healthcare, 2013-17, (£ Million)
- Figure 2: The UK PMI Market, 2013-2017, by Number of Policyholders and People Covered, (000)
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- Figure 3: Estimated Weekly Spend on PMI Premiums, by Region, 2015-17, (Average Weekly Spend in £)
- Market factors
- Continued pressures on the NHS provide opportunities, but private providers must proceed with caution when acquiring patients
- Slow progress in Brexit talks means uncertainty remains over future impact on healthcare spending and recruitment
- Third IPT rise in two years adds barrier to PMI growth
- Consumer
- Forecast
- 3% growth per year expected to 2022
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- Figure 4: Forecast UK Expenditure on Private Acute Healthcare, 2018-2022, (£ Million at 2017 prices)
- Growth will be driven by uptake in corporate PMI but will remain sluggish
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- Figure 5: UK Market Forecast for Private Medical Insurance Subscription Income, 2018-2022, (£ Million at constant prices)
- What we think
Key Insights
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- Are private providers gaining patients from the NHS due to increased waiting times at NHS hospitals?
- Can improvements to information regarding treatment help improve the number of patients using private healthcare?
- Can data and technology help hospitals adjust to changing patient needs?
Introduction
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- Definitions
- Methodology
- Abbreviations
- Market positioning
- Healthcare Environment
UK Economy
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- Key points
- Overview
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- Figure 6: UK GDP, 2007-2017, (% Quarterly Growth and GDP in £ Billion)
- Figure 7: UK Output, by Industry, 2008-2017, (Index 2013 = 100)
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- Figure 7: Quarters after GDP Peak, 1979, 1990 and 2008, (Number of Quarters and GDP as % of Pre-Downturn Peak)
- Inflation
- Interest rates
- House prices
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- Figure 8: UK House Price changes, 2007-2018, (12 month % change)
- Consumer spending
- Manufacturing
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- Figure 9: UK Manufacturing, 2014-18, (Index, 2013 = 100)
- Business investment
- Imports
- Exports
Market Factors
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- Key points
- Continued pressures on the NHS provide opportunities, but private providers must proceed with caution when acquiring patients
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- Figure 10: Total Departmental Expenditure Limits, in Real Terms, 2013/14-2017/18, (£ Million, % of Total DEL and % Change in NHS DEL)
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- Figure 11: Total Departmental Expenditure Limits, in Real Terms, 2013/14-2017/18, (£ Million and % of Total DEL)
- Slow progress on Brexit talks means uncertainty remains over future impact on healthcare spending and recruitment
- Business rate rise has had less of an impact on private providers
- Outsourcing to private sector has been boosted by regulation updates
- Fall in disposable income in 2017 adds to the downward impact of PMI premium growth
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- Figure 12: GDP per Head at Current Market Prices and Real Household Disposable Income per Head, Q4 2013 - Q4 2017, (£)
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- Figure 13: GDP per Head at Current Market Prices and Real Household Disposable Income per Head, Q4 2013 - Q4 2017, (£)
- Record low unemployment rate should at least maintain corporate PMI demand
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- Figure 14: Total UK Unemployment Rate Among People Aged 16+, Q1 2013 - Q4 2017, (%)
Independent Hospital and Clinics
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- Key points
Market Size
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- Key points
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- Figure 15: UK Expenditure on Private Acute Healthcare, 2013-17, (£ Million)
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- Figure 16: UK Expenditure on Private Acute Healthcare, 2013-17, (£ Million)
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- Figure 17: Analysis of the Development of Private Acute Hospitals in the UK, 2013-2017, (Number of Hospitals)
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- Figure 18: Analysis of the Development of the Number of Beds in Private Acute Hospitals in the UK, 2013-17, (Number of Beds)
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- Figure 19: Development of the Number of Beds in Private Acute Hospitals in the UK, 2013-17, (Number of Beds)
Market Segmentation
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- Key points
- Expenditure
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- Figure 20: Segmentation of Private Healthcare Expenditure, by Type, 2013-2017, (£ Million)
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- Figure 21: Segmentation of Private Healthcare Expenditure, by Type of Service, 2013-2017, (£ Million)
- PMI remains largest source of revenue, but share is declining
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- Figure 22: Funding Source Segmentation for Acute Hospitals and Clinics, by Source, 2016 and 2017, (£ Million and % Share)
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- Figure 23: Funding Source Segmentation for Acute Hospitals and Clinics, by Source, 2017, (% of Total Value)
- Growth in ‘self-pay’ users showing no signs of slowing
- Regional analysis
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- Figure 24: Regional Analysis of UK Independent Acute Hospitals, 2017/18, (Number of Hospitals and Beds)
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- Figure 25: Regional Analysis of UK Independent Acute Hospitals, 2017/18, (% of Hospitals and % of Beds)
Market Share
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- Key points
- Hospital and Bed Share
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- Figure 26: Major Private Acute Hospital Operators, 2017/2018, (Number of Hospitals, Beds and Average Number of Beds)
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- Figure 27: Major Private Acute Hospital Operators, 2017/18, (Number of Hospitals and Beds)
- NHS foundation trusts report stagnating private patient income, but continuing financial pressures could lead to growth
- CQC inspections show that overall standards of care in independent hospitals are at a good level
- Malpractice case leads to calls for greater transparency
Company Profiles – Private Healthcare Industry
BMI Healthcare
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- Recent company news
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- Figure 28: Financial Analysis of BMI Healthcare, 2012-16, (£ 000)
- Company strategy
Care UK
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- Recent company news
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- Figure 29: Financial Analysis of Care UK, 2013-17, (£ Million)
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- Figure 30: Revenue Breakdown of Care UK, by Division, 2015-17, (£ Million)
- Company strategy
HCA International
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- Recent company news
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- Figure 31: Financial Analysis of HCA International, 2012-2016, (£ 000)
- Company strategy
Roodlane Medical
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- Figure 32: Financial Analysis of Roodlane Medical, 2012-2016, (£ 000)
- Company strategy
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Nuffield Health
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- Recent company news
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- Figure 33: Financial Analysis of Nuffield Health, 2012-16, (£ 000)
- Company strategy
Ramsay Health Care UK Operations
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- Figure 34: Financial Analysis of Ramsay Health Care UK Operations, 2013-17, (£ 000)
- Company strategy
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Spire Healthcare
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- Figure 35: Financial Analysis of Spire Healthcare Group, 2013-17, (£ Million)
- Company strategy
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St Martins Healthcare
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- Figure 36: Financial Analysis of St Martins Healthcare, 2012-2016, (£ 000)
- Company strategy
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Independent Hospitals and Clinics Forecast
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- Key points
- Lead up to Brexit could pose several challenges
- 3% growth per year expected to 2022
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- Figure 37: Forecast UK Expenditure on Private Acute Healthcare, 2018-2022, (£ Million at 2017 prices)
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- Figure 38: Forecast UK Expenditure on Private Acute Healthcare, 2018-2022, (£ Million at 2017 prices)
- Release of data on patient outcomes will improve transparency and may increase trust among patients considering using private healthcare
Private Medical Insurance
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- Key points
- PMI Ownership and Availability
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- Figure 39: Ownership of PMI and related health products, August 2017, (% of Respondents)
Market Trends
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- Key points
- Medical inflation rates continue to put pressure on uptake levels
- Increasing waiting times for NHS treatments provide opportunities
Market Size
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- Key points
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- Figure 40: Annual Average PMI Premium, by Purchaser Type, 2007-17, (£)
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- Figure 41: Average Annual PMI premium, by Purchaser Type, 2007-17, (£)
- Premium and Subscription Growth
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- Figure 42: The UK Market for Private Medical Insurance, 2013-17, (£ Million)
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- Figure 43: Claim Amounts Incurred as a Proportion of Gross Earned Premiums, 2013-17, (£ Million and % Gross Margin)
- Figure 44: PMI Gross Earned Premiums, Claims Paid and Gross Margin, 2013-2017, (£ Million and % Gross Margin)
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- Figure 45: The UK PMI Market, 2013-2017, by Number of Policyholders and People Covered, (000)
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- Figure 46: The UK PMI Market, 2013-2017, by Number of Policyholders and People Covered, (000)
- Market development
- Private practice register helps streamline insurers’ recognition processes
Market Segmentation
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- Key points
- Corporate and Group PMI
- Individual PMI
- Overall PMI Market
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- Figure 47: Segmentation of Private Medical Insurance, by Policyholder Type, 2013-17, (000 Subscribers and £ Million)
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- Figure 48: Segmentation of Private Medical Insurance Subscribers, 2013-2017, by Policyholder Type, (000 Subscribers)
- Figure 49: Segmentation of Private Medical Insurance Value, 2013-2017, by Policyholder Type, (£ Million)
- Regional Analysis
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- Figure 50: Estimated Regional PMI Penetration and Weekly Spend on Private Medical Insurance Premiums, (% of Households in 2015-2017 and Average Weekly Spend on PMI Premiums in 2012-14 and 2015-17)
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- Figure 51: Estimated Regional PMI Penetration, 2015-17, (% of Households)
- Figure 52: Estimated Weekly Spend on PMI Premiums, by Region, 2015-17, (Average Weekly Spend in £)
- Household Expenditure by Age Group
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- Figure 53: Average Weekly Household Expenditure on Medical Insurance Premiums, by Age Group, 2013-17, (£)
Industry Development
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- Key points
- Improvements made to industry sourcing system that will aid PMI advisers
- Recent industry acquisitions
- Market share
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- Figure 54: Estimated Market Share in the UK PMI Market, by Company, 2017, (% of Total Subscription Revenue)
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- Figure 55: Private Medical Insurance Market Share, by Company, 2017, (% of Total Subscription Revenue)
Company Profiles – Private Medical Insurance Industry
Aviva Healthcare UK
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- Figure 56: Financial Analysis of Aviva Plc, 2012-16, (£ Million)
- Company strategy
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AXA PPP Healthcare
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- Figure 57: Financial Analysis of AXA PPP Healthcare, 2012-16, (£ Million)
- Company strategy
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Bupa
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- Figure 58: Financial Analysis of Bupa, 2013-17, (£ Million)
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- Figure 59: Divisional Analysis of Bupa, 2013-17, (£ Million)
- Company strategy
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VitalityHealth (formerly PruHealth)
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- Figure 60: Financial Analysis of VitalityHealth (formerly PruHealth), 2013-17, (£000)
- Company strategy
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Western Provident Association
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- Figure 61: Financial Analysis of Western Provident Association, 2012-16, (£ 000)
- Company strategy
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PMI Forecast
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- Key points
- Growth will be driven by uptake in corporate PMI but will remain sluggish
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- Figure 62: UK Market Forecast for Private Medical Insurance Subscription Income, 2018-2022, (£ Million at constant prices)
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- Figure 63: UK Market Forecast for Private Medical Insurance Subscription Income, 2018-2022, (£ Million at constant prices)
- Figure 64: UK Market Forecast for Private Medical Insurance, by Number of policyholders, 2018-2022, (000s of Subscribers)
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- Figure 65: UK Market Forecast for Private Medical Insurance, 2018-2022, by Number of Policy Holders, (000s of Subscribers)
- The growing popularity of the self-pay market could further dampen PMI growth
- Demographic trends are likely to drive PMI product design
The Consumer – Last Private Healthcare Visit
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- Key points
- Nearly three-quarters of consumers have never used a private healthcare service
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- Figure 66: Private Healthcare Use, by Time Passed Since Last Visit, April 2018, (% of Respondents)
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- Figure 67: Private Healthcare Use, by Time Passed Since Last Visit, April 2018, (% of Respondents)
- Under-44s most likely to have used private healthcare in the last year
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- Figure 68: Private Healthcare Use, by Time Passed Since Last Visit and by Age and Gender, April 2018, (% of Respondents)
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- Figure 69: Private Healthcare Use by Males, by Time Passed Since Last Visit and by Age, April 2018, (% of Respondents)
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- Figure 70: Private Healthcare Use by Females, by Time Passed Since Last Visit and by Age, April 2018, (% of Respondents)
- Young people most likely to consider private healthcare in the future
The Consumer – Method of Payment
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- Key points
- PMI cover via employer pays for most healthcare but self-pay on the rise
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- Figure 71: Private Healthcare Payment Method, April 2018, (% of Respondents)
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- Figure 72: Private Healthcare Payment Method, April 2018, (% of Respondents)
- A third of women self-fund treatment
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- Figure 73: Private Healthcare Payment Method, by Gender, April 2018, (% of Respondents)
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- Figure 74: Private Healthcare Payment Method, by Gender, April 2018, (% of Respondents)
- Self-payment and employer-provider PMI used in most recent private use
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- Figure 75: Private Healthcare Use, by Time of Last Visit and by Payment Method, April 2018, (% of Respondents)
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- Figure 76: Private Healthcare Use, by Time Passed Since Last Visit and by Payment Method, April 2018, (% of Respondents)
The Consumer – Health Insurance Provider
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- Key points
- Bupa represents close to 30% of health insurance coverage
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- Figure 77: Private Healthcare Insurance Provider, April 2018, (% of Respondents)
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- Figure 78: Private Healthcare Insurance Provider, April 2018, (% of Respondents)
The Consumer – Choice Factors
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- Key points
- Treatment cost determines choice of healthcare provider
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- Figure 79: Private Healthcare Choice Factors, by Rank of Importance, April 2018, (% of Respondents)
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- Figure 80: Private Healthcare Choice Factors, by Rank of Importance, April 2018, (% of Respondents)
Further Sources and Contacts
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- Trade Associations
- Association of British Insurers (ABI)
- Association of Independent Healthcare Organisations (AIHO)
- Association of Medical Insurers and Intermediaries (AMII)
- British Healthcare Trades Association (BHTA)
- Federation of Independent Practitioner Organisations (FIPO)
- The Independent Doctors Federation (IDF)
- London Consultants’ Association (LCA)
- The Private Healthcare Information Network (PHIN)
- Trade Magazines
- COVER
- Health Business
- Health Insurance & Protection
- Health Service Journal
- Hospital Times
- The View
- Trade Exhibitions
- Health and Care Innovation Expo 2018
- Healthcare Efficiency Through Technology (HETT)/Commissioning in Healthcare (CIH)/Procurement in Healthcare (PIH)/Cyber Security in Healthcare (CSIH) Expo
- Hospital Innovations
- Safety & Health Expo
- The Private Healthcare Summit
- The Procurement Event for Health
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