NHS trusts with record waiting lists are promoting “quick and easy” private healthcare services at their own hospitals, offering patients the chance to jump year-long queues, the Observer can reveal. Hospitals are offering hip replacements from £10,000, cataract surgery for £2,200 and hernia repairs for £2,500. MRI scans are offered for between £300 and £400. This comes as figures show a record 7.21 million people are waiting for NHS treatment in England, with routine breaches of the maximum waiting time of 18 weeks for non-urgent referrals. Health experts warn of the risk of creating a “two-tier” health service. An Observer investigation has found: East Sussex healthcare NHS trust has thousands of patients waiting for diagnostic tests but offers “fast access” to scans through its private division. Great Western hospitals NHS trust in Wiltshire is warning patients that services are “extremely busy”, while its private division promotes self-pay treatment for those who “don’t want to wait for an NHS referral”. James Paget university hospitals NHS trust in Norfolk is advertising private services on its NHS website, stating: “We provide highly experienced consultant-led services … without the waiting list.” The premium treatments are being offered through private patient units owned and operated by NHS trusts and typically located on hospital premises. Procedures are often carried out by the same staff who would eventually treat patients if they stayed on the NHS waiting list. Under a code of conduct, private services cannot impact on NHS patient care, and profits go back into the health service. At Sussex Premier Health, part of East Sussex healthcare NHS trust, MRI scans are carried out within 48 hours for £379, according to a recent Instagram promotion. The trust has more than 7,800 patients waiting for diagnostic tests. Great Western hospitals NHS trust in Wiltshire offers private healthcare through a 20-bed unit, the Shalbourne suite. The private patient website says: “We believe quality healthcare should be readily accessible.” A woman whose elderly mother was treated by the trust in October claims she was told she could bypass long waiting lists if she paid. “My 86-year-old mum will have to wait two years on the NHS or can see the same surgeon in the same hospital and be treated in two weeks for £1,200. How is this right?” she wrote on Twitter. A teacher from the north-east who asked not to be named said she borrowed £350 for an MRI scan. “At the appointment, there were posters on the walls stating times for the return of results: three days for private, three weeks for NHS.” The scan revealed she had a swollen cyst on her knee which required treatment. Another trust, Hampshire hospitals NHS trust, is promoting services through its private Candover clinic. More than 53,500 patients were waiting for non-urgent elective treatment at the trust in October. Meanwhile, Kingston Private Health, the private unit at Kingston hospital NHS trust in south-west London, offers “rapid access” with “no long waiting lists”. Treatments include hip replacements for £10,100. Patients are cared for by “experienced NHS nursing staff”, the website says. The Royal Free London NHS foundation trust writes on the website for its private division of a “quick and easy way to get immediate access to the healthcare you need”. Under the Health and Social Care Act 2012, NHS hospital trusts were permitted to generate up to 49% of their income from private patients. By 2015/16, nearly £600m a year was being generated by the NHS treating private patients. The pandemic and record waiting lists led to a review of private services by some trusts. King’s College hospital NHS trust in south London stood down inpatient and outpatient private services during the pandemic to allow the inpatient beds to be used for NHS patients. The inpatient service has yet to reopen. Newcastle hospitals NHS trust, where waiting times are among the longest in England, says that its private patient facilities are “currently being used for NHS services”. David Rowland, director of the Centre for Health and the Public Interest, said while it was “potentially justifiable” for trusts to offer private services when the NHS was not under strain, it was “ethically very dubious” during a crisis. Advocates of private patient units say they can help boost revenues for trusts, but some experts say the benefits are unclear and argue that if private divisions lose money, they may drain NHS resources. Hampshire hospitals NHS trust said: “NHS care always comes first. Any income that is generated through our commercial activity is fully reinvested into the NHS.” Great Western hospital NHS trust said it had not operated a full private patient unit since before Covid and that where it does offer private treatment, “it’s out of hours, and where there is capacity in empty outpatient clinics”, with NHS patients always receiving “priority care”. Kingston hospital NHS trust said it scaled back private activity in winter and used the space to relieve pressure on the NHS. “Of our 417 adult beds, we currently have only 2 patients in private beds,” a spokesperson said. The Royal Free said it had cut waiting lists in the last two years. “All profits generated by our private patients unit is reinvested in the trust. It is wholly separate from our NHS capacity and does not impact on care to NHS patients.” The Department of Health and Social Care said: “NHS hospitals have always been able to generate small amounts of additional income by treating private patients, which can then be used to improve the services that NHS patients receive.”