Campaigning is generally concentrated on hospital services. Large parts of the hospital estate which were previously designated as long-stay geriatric wards were closed in the 1980s and 90s. Such patients were moved to residential care or nursing homes, which are almost entirely privately provided. Previously homes were provided by local authorities but the funding regime was engineered in such a way as to make that unsustainable. Some is regarded as social care, which is means-tested. Continuing healthcare, though paid for by the NHS, is largely privately provided. NHS trusts spot purchasing from private providers, largely to meet NHS targets rose from £645 million in 2013-14 to £1.3 billion in 2018-19. In May 2018 private providers carried out 43,145 NHS day case electives and 7,720 overnight elective procedures. In May 2021 it was 40,700 day cases and 6,715 overnight electives. NHS commissioning expenditure from non-NHS organisations in England increased by 27% to more than £18 billion in 2020-21 under the pressure of the COVID-19 pandemic in England. This includes services provided by social enterprises and charities, as well as private corporations.
