Independent sector treatment centres (ISTCs) provide elective care, not emergency care.
ISTCs have procedures in place to respond to complications, including arrangements with a local national health service trust in case of an unforeseen emergency.
As part of performance monitoring of ISTCs there is a key performance indicator included in the contracts, which sets out the performance criteria on the transfer activity of patients. This activity is reviewed by the primary care trust (PCT) Commissioner at a Joint Service Review between the provider, commissioner and key stakeholders, undertaken quarterly to assess the performance of ISTCs.
PCTs commission and contract with NHS hospital trusts to provide emergency care services according to local needs. They are responsible for monitoring the performance of those trusts. The Department has set a national standard that patients should not wait more than four hours in accident and emergency departments from arrival to admission, transfer or discharge. National annual performance against the standard was 98.1 per cent. in 2008-09 and national performance in quarter 1 of 2009-10 was 98.6 per cent. 98 per cent. achievement against the standard is regarded as a success. The 2 per cent. margin allows some patients to remain longer in accident and emergency where there is a clinical need to do so.