Medacs Global Group

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Medacs Healthcare Ltd is the UK arm of Medacs Global Group. The primary work of the company is the provision of healthcare and social care workers. In the UK, the company operates under several brand names - Medacs Healthcare, Global Medics, Doctors-on-call, Fast Response Healthcare, Litmus Workforce Solutions and ignosys.

Medacs work in the UK is the provision to the NHS, social care services and private healthcare providers of healthcare and social care staff, managed services, staff bank, occupational health, social care and home care services and eHealth solutions.

In March 2023, Impellam Group, the ultimate owners of Medacs, sold its regional staffing businesses in the UK (Tate, Blue Arrow Group, Chadwick Nott, Career Teachers) and its healthcare staffing business in the UK, Ireland and APAC (Asia Pacific Medacs Global Group) to Twenty20 Capital, a European specialist investment fund focussed on the human capital services sector, for £85 million.

Last updated: January 2024

Strategy

Medacs Healthcare is a healthcare staffing business supplying healthcare staff to the NHS and private companies for all areas of healthcare work in the community and hospitals. It also supplies staff for international vacancies. In March 2023 it was sold by its owners, Impellam Group, to Twenty20 Capital, a private equity company, which already owns HCRG Care (see profile on this website).

Medacs was established in 1990 in the UK as a supplier of healthcare locum staff. The company expanded through a series of company acquisitions and set up a homecare division in 2007, with the acquisition of Blue Arrow Nursing Care and Chrysalis Community Care.  In 2008 it was acquired by Impellam Group.

In March 2023, Impellam Group sold its regional staffing businesses in the UK (Tate, Blue Arrow Group, Chadwick Nott, Career Teachers) and its healthcare staffing business in the UK (Medacs Healthcare), Ireland and APAC (Medacs Global Group) to Twenty20 Capital, a European specialist investment fund focussed on the human capital services sector, for £85 million.

Medacs began operating outside the UK for the first time in 2000 in New Zealand and in 2009 began operations in Australia.

In 2015, Impellam acquired Global Group and it was combined with Medacs to form Medacs Global Group with operations in the UK, Ireland and Australasia. This acquisition gave the company the medical recruitment companies Global Medics and Doctors on Call, the Litmus platform, and a Global Medical Job Board, which allows doctors to view and apply for permanent and locum positions in the UK, Ireland, Canada, Australia, and New Zealand.

Medacs Global Group subsidiaries

Medacs Healthcare plc

A provider of locum, temporary and permanent doctors, nurses and allied health professionals in the UK and a managed healthcare business providing primary care. Now owned by Twenty20 Capital.

Global Medics

Global Medics provides permanent and locum doctor staffing solutions within the primary, acute and mental health markets in the UK, Ireland, Australia and New Zealand.

Doctors on Call

The company Doctors on Call provides a rapid response locum service to the NHS and private healthcare companies in the UK. It covers the full range of clinical specialties.

Litmus Workforce Solutions

Litmus Workforce Solutions has operations across Australia, New Zealand, Ireland and the UK and is involved in the provision of Staff Bank, Recruitment Process Optimisation (RPO), Direct Engagement, Workforce Analytics and eHealth.

Fast Response Healthcare

Fast Response Healthcare offers a  24/7, 365 days a year service to provide healthcare staff.

ignosys

ignosys is a global healthcare technology company that develops eHealth solutions for clients. The company is the newest in the Medacs Global Group founded in 2019.

 

Financials

The latest available finances for Medacs Healthcare Limited (Company No. 02518546) report revenue of £165.8 million for 2022 (£160.9 million in 2021), leading to a profit of £3.4 million (£1.5 million in 2021).

Medacs Healthcare Ltd is the UK medical employment arm of Medacs Global Group and it also provides primary care services.

Investors and political connections

In March 2023, Impellam Group sold its regional staffing businesses in the UK (Tate, Blue Arrow Group, Chadwick Nott, Career Teachers) and its healthcare staffing business in the UK, Ireland and APAC (Asia Pacific Medacs Global Group) to Twenty20 Capital, a European specialist investment fund focussed on the human capital services sector, for £104.3 million.

Prior to the sale to Twenty20 Capital, the ultimate parent group of Medacs Group plc was Impellam Group plc and in documents filed by the company with Companies House the ultimate controlling party for the company is given as Lord Ashcroft - in that he has more than 50% of the company's shares and voting rights, but less than 75%. As Lord Ashcroft is also Chairman of Impellam Group Plc, the company states that he has significant influence over the Group. In its annual report, Impellam reports that Lord Ashcroft has 4.75% share in the company, but the Lombard Trust owns 55% of the company. The Lombard Trust was set up in 2010 by Ashcroft in a tax haven with his children listed as beneficiaries. See Concerns below for details of Lord Ashcroft.

Baroness Stowell of Beeston, a non-aligned life peer, is also a non-executive director of Impellam Group plc.

Contracts

Medacs Healthcare

The company has numerous contracts with hospital trusts and with other NHS bodies. Medacs has been awarded a variety of contracts, including on-site managed service contracts, master vendor contracts and places on framework contracts. All these contracts put Medacs in position to be a large-scale supplier of healthcare staff to NHS trusts.

The contracts vary sometimes covering just doctors or nurses or in some cases all healthcare personnel (AHPs). This is a selection of just some of the contracts that Medacs has with the NHS.

Covid-19 contracts

In January 2021 it was revealed that Medacs had been awarded a £350 million contract for work on the Covid-19 vaccination programme, primarily large-scale recruitment of staff. Medacs is listed on numerous framework contracts (see below) and the awarding of this contract is what is known as a call-off  of one of these multi-disciplinary framework agreements. A framework agreement is a list of pre-qualified suppliers that can bid for work around a specific group of goods, services or works. A call-off agreement is when the buyer then awards an individual contract during the lifetime of the framework.

On-site managed service contracts include the following:

  • Doctors at Cardiff and Vale University Health Board, Lancashire Teaching Hospitals NHS Foundation Trust, Basildon and Thurrock University Hospitals NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Cwm Taf University Health Board, Hywel Dda University Health Board, bertawe Bro Morgannwg University Health Board, Betsi Cadwaladr University Health Board, NHS Highland and NHS Lothian
  • Community Nursing at Sussex Partnership NHS Foundation Trust
  • AHPs at Blackpool Teaching Hospitals NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust and London North West Healthcare NHS Trust
  • Nurses at Blackpool Teaching Hospitals NHS Foundation Trust

Master vendor contracts include the following:

  • Medical Locums at Barking, Havering and Redbridge University Hospitals NHS Trust and Royal United Hospitals Bath NHS Foundation Trust, The Royal Marsden NHS Foundation Trust and Burton Hospitals NHS Foundation Trust
  • Nurses in South Staffordshire and Shropshire Healthcare NHS Foundation Trust and North Staffordshire Combined Healthcare NHS Trust, Burton Hospitals NHS Foundation Trust
  • Psychiatrists and GPs to Cheshire and Wirral Partnership NHS Foundation Trust

Framework contracts, where Medacs is one of a list of companies, include the following:

  • NHS Wales – Nursing Framework
  • CCS Multi-Disciplinary Framework
  • H T E Nursing Framework
  • H T E Perms Framework
  • CPP Clinical Staffing Framework for all disciplines
  • H T E Total Workforce Solutions Framework including the Lots for Demand Management software, Staff Bank, Direct Engagement and Admin and Clerical.
  • National and International Permanent Recruitment Solutions
  • Framework Award Recruitment of International GPs 2018-2020

The following subsidiaries also provide services to the NHS

Doctors on Call

The company Doctors on Call provides a rapid response locum service to the NHS and private healthcare companies in the UK. It covers the full range of clinical specialties.

Litmus Workforce Solutions

Litmus Workforce Solutions has operations across Australia, New Zealand, Ireland and the UK and is involved in the provision of Staff Bank, Recruitment Process Optimisation (RPO), Direct Engagement, Workforce Analytics and eHealth.

Fast Response Healthcare

Fast Response Healthcare offers a  24/7, 365 days a year service to provide healthcare staff.

Social Care

Medacs also has numerous contracts with councils for the provision of social care staff and services and is listed on framework agreements for the provision of social care services.

Concerns

Lord Ashcroft and tax 

The original owner of Medacs Healthcare was Impellam Group, whose primary shareholder was Lord Ashcroft, one of the Conservative party’s biggest donors, an ardent supporter of brexit and an enthusiastic user of tax havens.

He was made a Conservative life peer in 2000 and sat on the Conservative benches of the House of Lords until 2015. However, his appointment was always controversial as he is not a resident of the UK, having become a resident of Belize to avoid tax many years ago.  He promised that he would take up permanent residence in the UK for tax purposes, but the Guardian reported that he had failed to comply with this request. He is what is known as a “non-dom” and does not pay tax in the UK on his earnings abroad. According to documents filed with Companies House, his nationality is listed as Belizean/British and his country of residence as Belize.

Lord Ashcroft is at the centre of the Conservative party. He is a former party treasurer and deputy chairman and has given millions to the party. Ashcroft is also influential in British politics via his polling company and the website ConservativeHome, a centre-right blog aimed at grassroots party activists. In 2012, he was appointed a member of the Privy Council and was made the Prime Minister’s Special Representative for Veterans’ Transition; he stepped down from this role in 2018.

The leak of the Paradise Papers in 2017 revealed that Lord Ashcroft had a previously unknown trust sheltering his vast wealth. Emails and financial statements exposed the Bermuda-based Punta Gorda Trust from its creation in 2000, just after Lord Ashcroft became a peer. The trust was set up with his children as beneficiaries, although the leaked emails and papers show that they were unaware of the trust. The value of the trust fluctuated, but a leaked financial statement recorded it as having assets of $450.4m (£341m) in 2006.

Quality of care

In January 2019, a Care Quality Commission report on a homecare service run by Medacs Healthcare rated it "inadequate". The CQC found the care that people received was not safe. The inspection found breaches of regulations in relation to staff training, the safety of care, staff deployment, person centred care, complaints, governance and statutory notifications.

The majority of people's care calls were not delivered at the time they were expected. Records relating to risks people faced were inconsistent and inaccurate. People's medicines records were not kept up to date and CQC identified instances where medicines records showed a potential overdose.

The CQC also noted that care plans lacked information about how to provide support to people in a way that responded appropriately to their needs. People and relatives told us their complaints were not responded to and inspectors saw that numerous concerns about staff punctuality and care delivery had not been picked up through monitoring.

Investigations into excessive charging of the NHS

An investigation by the Daily Mail into the amounts charged by staffing agencies to provide staff to the NHS found that one agency alone charged the NHS nearly £40 million for temporary nursing staff in 2015/16 and five of the major nursing agencies were paid £97 million. The figures were not complete, suggesting the true cost was far higher as the Daily Mail noted that about a third of trusts refused to divulge what they spent. Figures of £2000 for a single nurse shift were found in the investigation. The investigation found that Medacs Healthcare plc, had charged £11.4 million (for supplying 43 hospital trusts) in 2015/16, up from £9.2 million in 2014/15 (for 38 trusts).

The Daily Mail investigation followed media reports of the cost to Foundation Trusts of agency staff rising from 3.5% of total spend in 2004 to 7.2% in 2015, around £2 bn in spend. In late 2015 Monitor and the NHS Trust Development Authority issued “ceilings” to each provider on the proportion of nursing expenditure they can spend with temporary staffing agencies.

 

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