Nuffield Health is a registered charity that operates in the UK as a private healthcare provider. The organisation has a network of hospitals, medical clinics, health and well-being centres, and gyms around the country. A major source of income is from partnerships with employers to set up on-site gyms and health and well-being clubs.
Nuffield Health's strategy is determined by its board of governors, who are both directors of the organisation and the trustees of the organisation. The governors delegate day to day executive authority to the group chief executive.
In 2021, Nuffield Health reported that it had 31 hospitals, 113 fitness and wellbeing clubs, healthcare clinics, and over 200 workplace wellbeing services.
Nuffield Health introduced a 10 year plan in 2016, as part of this growth plan the charity began a partnership with Barts Health NHS Trust to lease the former pathology and residential staff quarters buildings. Nuffield Health will construct a new independent acute unit, specialising in Cardiology, Orthopaedics and General Surgery. In mid-2018 Nuffield Health began the renovation of the building and the plan is for it to open in 2021. The £60 million development will be the only independent hospital in the City of London, and will comprise a new acute unit specialising in cardiology, orthopaedics and general surgery.
Nuffield Health has partnerships with several companies, including in 2020 with SimplyHealth for physiotherapy services and with Health Partners to deliver occupational health services.
Nuffield Health believes that the increasing NHS waiting lists and the rationing of procedures, will lead to the continued growth of the self-pay market.
In the year to end December 2019, Nuffield Health reported that it had an income of £992.8 million, up from £945.8 million in 2018. Revenue from hospital services was £621.8 million, up £39.2 million over 2018. NHS referrals showed an increase of 1.1%, and diagnostic revenues grew by 4.4%, to deliver over £108.4 million for 2019. According to the company it had over 50,000 NHS referrals in 2019, but it is not reported exactly how much of its revenue comes from the NHS.
The wellbeing business generated £367.7 million revenue, up £8.6 million on 2018.
Nuffield Health works with the NHS, providing a range of services to NHS patients through local initiatives to reduce waiting lists for NHS treatment, the Patient Choice programme, and contracts for services.
In March 2020, Nuffield Health was part of the deal with the government for using all its premises and staff for NHS patients during the Covid-19 pandemic. NHS England block booked almost the entirety of the private hospital sector’s services, facilities and nearly 20,000 clinical staff for the foreseeable future to help cope with the surge of covid-19 patients. The agreement only covers England and added around 8,000 hospital beds, nearly 1,200 more ventilators, more than 10,000 nurses, 700 doctors and 8,000 other clinical staff. This deal, which means the NHS is paying all operating costs for the hospitals, has been a lifeline for the company, as the lockdown meant that no private work was possible.
In June 2020, a £5 billion deal to extend the March deal to help the NHS clear the backlog of work was agreed by NHS England and the private hospital companies, however this was blocked by the Treasury. The Treasury did not believe the deal represented good value for money and that the evidence was not substantial. The block-contract basis of contracts with private providers continued, however, as NHS England prepared a new four-year framework contract for increasing capacity. In November 2020, ContractFinder, the government tendering database, reported that Nuffield Health was one of 67 suppliers awarded a place on the NHS framework contract NHS Increasing Capacity worth in total £10 billion. The framework runs until November 2024.
In January 2022, Nuffield Health became one of ten independent providers which signed a contract to provide extra capacity for the NHS under a three-month deal if Omicron leads to unsustainable levels of hospitalisations or staff absences. The deal, agreed by Sajid Javid, the health secretary, will mean the providers are paid to be on standby, with the NHS ordered to pay the private hospitals up to £270m, even though they may not treat any NHS patients in return. Leaked letters showed that Amanda Pritchard, head of NHS England, raised grave doubts over the contract, which instructed the NHS to pay private hospitals £75m to £90m a month from NHS England funds for the next three months. The deal could mean the NHS has to pay independent hospitals up to £525m if they did end up treating any NHS patients.
The agreement also includes Practice Plus Group, Spire Healthcare, Circle Health Group, Ramsay Health Care UK, Healthcare Management Trust, One Healthcare, Horder Healthcare, Aspen Healthcare and KIMS Hospital.
Nuffield Health has also worked with the NHS to develop a specialist rehabilitation programme to support patients in their recovery after they have received medical treatment for COVID-19. The programme is being piloted in NHS trusts across the UK, before it is developed into a national programme.
The first pilot launched in September, with Royal Stoke University Hospital, part of University Hospitals of North Midlands NHS Trust, ran for 12 weeks. Patients will be referred onto the programme by the Trust, before being triaged, online, by a specially trained Nuffield Health physiotherapist. After pilots of the programme at four locations, the programme is being rolled out nationwide.
Over the 12 weeks, patients will work with a rehabilitation specialist to design their individual plan consisting of at home exercises, before moving to on to a Nuffield Health fitness and wellbeing club. Patients will also receive access to on-demand workouts, weekly emotional support calls and access to a community of participants where they can share their experiences.
In October 2020, the HSJ reported that Nuffield Health was the recipient of the fourth largest contract for staff and capacity from NHS England, according to a series of contract award notices, however the time period of 2020 this covered is unclear. The contract with Nuffield Health amounted to £165.2 million.
These block contracts have been criticised after leaks revealed that the capacity paid for by NHS England at companies, such as Nuffield Health, Ramsay and Spire, was very under-utilised. HSJ reported that two-thirds of the private sector capacity that was block-purchased by the NHS at a cost of an estimated £400 million a month went unused by the NHS over the summer, despite long waits for operations.
Over the years, Nuffield Health has not 'hit the headlines' due to problems. However, the organisation operates in an identical way to the other private hospital groups, despite being a registered charity. In May 2018, a CQC report found that two in five private hospitals are failing to meet safety standards. The private hospital sector was warned by Jeremy Hunt, the then Health Secretary, to put its house in order if it wished to partner with the NHS. Of major concern is that some private hospitals currently avoid liability by saying a clinician is not an employee if something goes wrong. In addition, a clearer process is needed for managing a patient if their health deteriorates in private care and they have to be transferred to the NHS in an emergency.