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In 2018/19 almost three quarters of NHS contract awards were to non-NHS organisations

An analysis of contract awards published from April 2018 to end of March 2019 found that 74% were awarded to non-NHS organisations, which includes private companies, charities and not-for-profit organisations. The overall value of published contract awards was just over £4.9 billion and 65% of this amount went to non-NHS organisations.

Overall there was a slight fall in the total value of awards, down 7% on the 2017/18 figure of £5.3 billion. However, at £3.2 billion the value of awards to non-NHS organisations is up 3.3% on the 2017/18 figure (£3.1 billion). These figures show that the private sector is still very active when it comes to bidding for NHS contracts and they continue to be very successful.

An analysis of the awards given to the not-for-profit sector – charities and community interest companies – found that in 2018/19 the value fell by 13.6% to £761.6 million (2017/18 = £881.4 million). Many not-for-profit organisations are very locally based, but there are a few that work across England. In 2018/19 the charity Change, Grow, Live (CGL) was particularly successful at gaining contracts for substance misuse (drug and alcohol) addiction services across England, with eight contract awards.

The data for the awards is obtained from the Government’s ContractsFinder service and the European Commission’s TED system. As these two systems do not publish all awards for various reasons, including low value awards that do not need to be published and in our experience CCGs and other bodies often don’t bother publishing, the value and number of the awards is probably an underestimate across the board of both NHS awards and non-NHS awards.

In the 2018/19 awards data there were ten awards valued at over £100 million, with the highest being a framework contract valued at £600 million for the provision of patient discharge services across England, which was awarded to a large number of organisations, both NHS and non-NHS. Three large (over £100 million) contracts awarded to single non-NHS organisations, were to Virgin Care (see below), BrisDoc Healthcare services Ltd and Devon Doctors Ltd.

BrisDoc Healthcare Services Ltd was awarded a contract to provide Integrated Urgent Care (IUC) services in the Bristol, south Gloucestershire and north Somerset area worth £125 million over 10 years and Devon Doctors, a not for profit organisation, was awarded a five-year £152 million contract for urgent integrated care services in Somerset.

In December 2018, NHS England awarded a framework contract covering the South East worth £199 million to numerous private dental surgeries for carrying our NHS-funded orthodontic procedures. Identical framework contracts have also been awarded in other areas, but of lesser value.

The data shows that the leading companies, such as Care UK and Virgin Care, continue to be awarded substantial contracts.

There were four contract awards listing Care UK in 2018/19. All the awards are valued at less than £100 million, but together they add up to £156.4 million over a period of five years. There are three contracts for integrated urgent care services and one for offender healthcare. 

The integrated care services are in Surrey worth £46.1 million for five years, Suffolk and Essex worth £61.5 million for five years, and in Southampton Care UK was awarded a contract for an urgent care treatment centre worth £23.2 million for an initial period of 5 Years.  The fourth contract worth £25.6 million was awarded by NHS England and covers full health care services to HMP Isle of Wight for five years.


Virgin Care, one of the leading companies in community care, was awarded one large contract worth £107.9 million in the period 2018/19 and part of another contract in partnership with an NHS trust. Together the awards add up to £108.2 million. The major contract for Virgin Care was the Public Health 0-19 Healthy Child Programme (0-19 HCP) across Lancashire awarded by Lancashire County Council. This is worth £107.9 million over five years. This is the second award of this contract. Virgin Care was originally awarded the contract in 2017, but this award was successfully challenged in court  by Lancashire Care Foundation Trust and Blackpool Teaching Hospitals FT, joint bidders for the contract. As a result the evaluation process had to be carried out again. Virgin Care was once again awarded the contract by the council in November 2018. A full overview of Virgin’s activity in the NHS can be found here.

Two service areas have stood out in 2018/19 as having a high amount of private sector success in contract awards – diagnostics and GP services.

Private companies were dominant in the diagnostics market in 2018/19 when contract awards are analysed. There were 37 contracts awarded in diagnostics in 2018/19, only two of which went to an NHS provider and four to a combination of NHS/non-NHS provider. The remainder went to private companies, with the two dominant ones being InHealth and Everlight Radiology. 

InHealth has been the most successful company in the diagnostics arena in 2018/19, with nine contract awards for the company and two with the company sharing the award with several other companies. All together the company was listed on almost 30% of awards and the value was £30.2 million or 13.8% of total value. A full overview of the company can be found here.

InHealth’s highest value contract award was for a seven year community gastroenterology service for NHS Ipswich and East Suffolk Clinical Commissioning Group and East Suffolk and North Essex NHS Foundation Trust. This is valued at just over £14.8 million.

In terms of number of awards, Everlight Radiology was also very successful in 2018/19 with six awards, however each contract is fairly small and the total value was just under £11.6 million. Everlight Radiology’s business is specialised in the area of remote diagnostics. The company is sent scans and its team assess and diagnose. The company is often called upon to do short-term contracts with hospital trusts to reduce backlogs of scans due to a shortage of radiologists and consultants in the NHS. Due to the remote technology used, Everlight’s employees can be based anywhere in the world, with many in Australia working over the UK night.

The other service with a notable number of contracts going to non-NHS organisations, is GP services. In terms of type of service, the largest proportion of awards in 2018/19 were made for GP services (73), with just over half of these being for contracts to provide extended/enhanced access (50.7%). 

Non-NHS providers (including not-for-profit organisations) were awarded just over 71% of the contracts or 62.4% in terms of value.

Prominent companies include GTD Healthcare and Modality Partnership.

GTD Healthcare, a not-for-profit company, also known as GoToDoc, won three contract awards for GP services in 2018/19 in the Manchester area with a total value of just over £34 million.

Modality Partnership is known as a GP super-partnership, where numerous GP practices around England have come together to form one single partnership. The organisation has a central management team based in Birmingham. Modality won contracts for two GP services, worth £24.2 million and a share in a contract for diagnostics.

Awards to non-NHS organisations have continued since April 2019, including two massive contracts to two not-for-profit companies: a contract worth over £1 billion to Sirona Care and Health for adult community health services in the Bristol, North Somerset and South Gloucestershire area over 10 years and a contract worth over £240 million to Spectrum Community Health for provision of healthcare in prisons in North East England. Virgin Care has also been awarded a share of an £85 million contract in Surrey and North East Hampshire for integrated community services.


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