InHealth provides diagnostics and imaging services to the NHS, private hospitals and clinics, including MRI, CT, X-Ray, DXA, nuclear medicine, mammography, ultrasound, interventional cardiology, audiology, ENT, endoscopy and physiological measurement. It operates in both acute care and primary care. The company is also involved with pain management services. The company reports that it provides services to more than 2 million patients per year (both NHS and private).
The company employs around 1,700 people, including clinical specialists and patient referral teams. Its services are provided from over 350 locations in the UK and Ireland and they work with a significant majority of NHS Trusts in the UK covering over 200 hospitals and over 80 community health clinics. In 2017, tests, scans, procedures or interventions were carried out to over 2 million patients according to their Director's report on Companies House.
InHealth divides its business as 'Community' and 'Hospital'. In the community sector, the company has contracts with a large number of CCGs for direct access diagnostics following GP referral. The company has also been part of AQP (any qualified provider) contracts.
In the area of hospital trusts, InHealth has both mobile and fixed sites available. InHealth has a mobile fleet of over 55 fully mobile diagnostic scanners and a number of semi-permanent facilities. InHealth notes that this fleet can be mobilised quickly to fulfill or enhance existing diagnostic services and can be used for very short-term contracts.
In April 2017, InHealth reported the appointment of Geoff Searle to manage Integrated Services for the company signalling the company's strategy to improve its delivery of integrated services, i.e., building more multi-service locations.
InHealth’s business strategy has included acquiring existing diagnostic companies such as Preventicum and Vista Diagnostics. Some subsidiaries of the InHealth Group include, Molecular Imaging Solutions Ltd, Euroclinics UK Ltd, Preventicum UK Ltd, e-Locum Services Ltd, Vista Diagnostics Ltd, and Prima Diagnostics.
Recent company acquisitions are Radiographer Reporting in January 2016, Pain Management Solutions in June 2016, and in September 2016, 76% of Health Intelligence. The acquisition on Pain Management Solutions will enhance InHealth's services in a community setting. In January 2017 InHealth took over Care UK's Manchester CATS service.
InHealth also shows a great deal of interest in "bringing care closer to home" in its strategy; it refers to "challenging the status quo" and disagreeing with clinicians in the acute sector in order to support more integrated community care.
The most recent accounts for InHealth Ltd are for the financial year ending September 2018, according to Companies House. The company reported revenue of £113.2 million, up from £108.6 million in 2017. The company's profit jumped to £17.8 million in 2018, from just over £2.8 million in 2017.
InHealth is a private company owned by The Damask Trust, the trustees of which are Ivan Bradbury and the Embleton Trust Corporation Ltd. (2018 Accounts via Companies House July 2019)
InHealth has a great many contracts with clinical commissioning groups and hospital groups and is also listed on several framework contracts. A framework contract involves a list of providers that have been approved to carry out the services covered by the contract. The amount of work each provider carries out is not fixed. This section focuses on the company’s most recent awards and lists only a fraction of the company’s total contracts.
In March 2019, InHealth was chosen as the preferred provider to be awarded a contract for PET-CT scanning in the Thames Valley area, including Oxford. The decision to award the contract to InHealth caused controversy (see below). This contract is part of the process under which all the PET-CT scanning in England has been put out to tender. The process has taken place in two phases - I and II. InHealth has won part of the phase II tender - lot 4 - which covers Oxfordshire and Buckinghamshire. The contract is for seven years. The contract would have meant that InHealth would have replaced the service provided at the Churchill Hospital, Oxford. InHealth planned to move the scanners elsewhere. After a backlash from campaigners and NHS staff, the contract was changed so that the two scanners will remain at the Churchill Hospital and continue to be operated by NHS staff.
In the same month, InHealth was awarded a place on a framework contract for remote teleradiology - the remote assessment of diagnostic images - and a contract to provide diagnostics services to prisons in the north of England. The latter contract is worth over £4 million.
In February 2019, InHealth was awarded a place on an AQP (any qualified provider) contract for adult audiology services in Hammersmith & Fulham, Central London, and West London.
In January 2019, InHealth was awarded a place on a framework contract to provide remote teleradiology services to hospital trusts over much of the north of England. The latter framework is valued at £100 million with nine suppliers listed on the framework contract. In the same month, the company was listed on an AQP contract for a community physiotherapy service as part of musculoskeletal services in North East Lincolnshire.
Contracts awarded in 2018, include a contract from North Kirklees CCG to provide community pain management services, a contract for Audiology services from Bristol, North Somerset and South Gloucestershire CCG, a community gastroenterology service in Ipswich and North Suffolk, a diagnostics service in Ealing, and radiology services for Brent CCG.
Other recent contracts include new diagnostic service contracts across the country, including radiology contracts in Croydon, Kingston and Walsall, major breast screening contracts in Outer North-East London and Surrey and adult ENT and audiology services in Southampton.
In January 2017 InHealth took over Care UK's Manchester CATS service.
In early 2016 InHealth was awarded a place on a framework for temporary and long term provision of mobile therapy units. Under this framework InHealth could provide mobile diagnostics.
Independent research organisation WeQ4U investigated call centre waiting times for a number of UK companies from various sectors. InHealth Netcare which is used by healthcare professionals to retrieve patients test results ranked as the worst company with delays of up to 74 minutes.
Oxfordshire PET contract
The decision to name InHealth as preferred provider to be awarded the PET-CT contract in Oxfordshire and Buckinghamshire was met with considerable opposition. Doctors stated that the contract award would damage patients’ health and disrupt treatment.
The scanning service was provided by Oxford University Hospitals (OUH) NHS trust’s Churchill hospital, which has an international reputation for cancer care. If InHealth had taken over, patients would have had to be transported away from the hospital for scans to diagnose and monitor their cancer, which doctors said would disrupt their treatment. Under InHealth’s plan, patients would have been taken to the GenesisCare private cancer clinic at Littlemore, four miles away on the outskirts of Oxford. There were also issues about what affects the contract award would have had on the world-class team at the Churchill Hospital.
Councillors on Oxfordshire county council's joint health overview and scrutiny committee (HOSC) put forward their concerns about coming away from a 'one team' approach and that this could have negative repercussions on patients' cancer treatment. Issues raised by the councillors include: that staff from InHealth will not be going to multidisciplinary team meetings of NHS staff; performing PET-CT scans in InHealth's mobile units to be set up in Swindon and Milton Keynes will give less accurate results than those from fixed scanners in hospitals such as the Churchill in Oxford and as a result produce a “two-tier service”; and NHS England’s alleged failure to fulfil its legal duty to consult the HOSC soon after it decided to put the PET-CT service out to tender.
As a result of the backlash from staff, campaigners and councillors, NHS England backtracked on some of the aspects of the contract. The scanners will now remain at the Churchill Hospital and be operated by NHS staff. Personnel from InHealth will have no role at the Churchill.
InHealth has taken five CCGs to court over the awarding of a contract for community diagnostics to another private company, Healthshare. InHealth had a number of contracts with the CCGs in North London - Brent, Central London, Ealing, Hammersmith and Fulham, and West London. The five CCGs decided to combine contracts and advertise one much larger five-year contract, £15.6m contract for community diagnostic services. This was advertised in 2019 and Healthshare was awarded the contract. InHealth claims that the five CCGs acted illegally in the tender process.
InHealth has told the High Court that the CCGs breaches included those requiring them to act transparently and to treat the bidders equally.
Other concerns of note
Questions have been raised over the extent to which preventive diagnostics, such as those carried out by InHealth’s subsidiary Preventicum, actually benefit patients with some arguing that in many cases they are unnecessary. Consumer group Which? has argued that some tests "are likely to cause more harm than good, some give widely inconsistent results and little useful information, and some detect disease when it's not really there.” They add that "false results cause worry, more investigations, and even unnecessary treatment - at a cost to the individual or the National Health Service”.