Highlights from LaingBuisson’s Private Healthcare Self-Pay UK market report (sixth edition), sponsored by GoPrivate.com

  • The self-pay market has continued to grow, but the pace of growth has slowed from double-digit increases that were seen immediately after the pandemic, according to the most recent LaingBuisson market analysis
  • Recent growth has been driven by demand for private GPs, diagnostics and outpatient consulting, whilst growth across elective procedures has steadied. This suggests a potential shift in consumer behaviour towards a willingness to pay for diagnosis and reflects the continuing challenges of individuals being able to access NHS services at all levels
  • Growth is expected to continue, but sector stakeholders have begun to temper their expectations down from immediate post-pandemic estimates. In our annual survey, 60% of respondents to LaingBuisson’s survey of sector stakeholders estimating that it would grow a minimum of 5% over the next three years, whilst 30% felt it would remain static
  • Self-pay demand is growing across England – with high growth experienced in Scotland, the North East, Wales and the South-West. Growth in these areas may suggest demand pushed by challenges accessing public-pay NHS services rather than more traditional consumer-driven preferences for private healthcare services
  • London and the South East remain the highest regional areas of self-pay activity – with the highest density of providers offering self-pay services and a market that can attract a high-income domestic base as well as appealing to high-wealth medical tourists from abroad
  • Overall, LaingBuisson estimates that the self-pay market has grown at 10.4% CAGR – between 2013 and 2022

The self-pay market has grown over the last year, according to the latest research by healthcare intelligence specialists, LaingBuisson. Growth is modest but, according to those in the sector, sustainable.

Against a backdrop of continued pressure on NHS waiting lists, it appears that increasing numbers of people are considering private self-pay services. According to GoPrivate.com, enquiry levels have boomed among regions of the UK that traditionally did not have strong self-pay demand. PHIN data reinforces this view with self-pay admissions in Northern Ireland alone increasing 144% in 2023.

The growth of regional interest suggests that demand growth for self-pay may be linked to challenges in accessing NHS services. The growth of ophthalmology clinic networks that may offer a mix of NHS and self-pay outside of traditional locations in London and the South point to how private providers are looking to capitalise on both pressure on the NHS to outsource capacity to the private sector, as well as capturing demand for those individuals looking at waiting lists that could stretch out over a year for lower priority treatments and who are willing to assess alternative self-pay options.

Demand is reported to be driven by diagnostic and private GP activity. This may reflect a desire for certainty for individuals struggling to access their local GP or facing lengthy diagnostic waiting lists. Self-pay volumes for elective and general surgical procedures have continued to grow but a much slower rate, suggesting that individuals maybe using the private sector to gain a clinical opinion and potentially returning to the NHS to seek public-funded treatment.

Whilst analysing prices of self-pay and cosmetic procedures, LaingBuisson has noted a continuation towards the drive towards providers instituting increasingly regionalised or harmonised their pricing structure across the UK. However, for many smaller providers, local pricing still underpins their approach, with localism a large factor for consumers. There is little evidence of a ‘race to the bottom’ in price competitiveness, analysis of average pricing of the highest volume self-pay and cosmetic surgery procedures shows that average prices have shifted upwards, but below overall Inflation.

The market does appear to be stabilising since the initial post-pandemic rush to treatment, and this is reflected in our annual survey of sector stakeholders. Whilst confidence remains about a growing market, only 30% felt it would grow more than 10% over the next three years, whilst an equal number felt it would remain static. The remaining 40% estimated growth of between 0 – 10%. For the first time since the pandemic, the wider economic horizon and consumer uncertainty was cited as a reason for dampening growth demands.

This growing concern over affordability can also be noted in modest price rises across many popular surgical areas. With cataract surgeries and knee replacements both increasing in price by less than 4% – far below background inflation.

Author of this year’s report, Liz Heath said:

“The concept of paying to secure rapid access to diagnosis and treatment now appears well-embedded among the general population. A large part of this is clearly connected to NHS waiting lists and waiting times for treatment, which have not improved. We are also seeing the younger generation much less wedded to the idea of loyalty to the NHS and choosing to pay for rapid access and convenience. Even in older generations, a ‘mix and match’ approach to NHS and privately funded care now seems increasingly normalised.

 “Greater promotion of private healthcare options, particularly self-pay, is leading to a greater awareness of choices for patients. The increased transparency and clarity around the costs of private healthcare is making decisions around affordability easier for many.

 “Whilst NHS private patient revenues continue to recover post-Covid, they are still not at levels seen in 2019. For many patients, the idea of accessing private healthcare whilst supporting the NHS is a positive one, but in terms of self-pay, many NHS Trusts have still not been able to develop their service offerings in a way that competes with the independent sector.

 “Future prospects for the self-pay market look encouraging. Even if growth has slowed, volumes of self-pay activity are still ahead of 2019 and appear to be steady. This, coupled with an increase in revenues per case for a number of providers, bodes well for the short and medium term.”