Practice Plus Group (PPG) services include GP practices, walk-in centres, out-of-hours GP support, and prison healthcare.
In October 2025, Indian company Narayana Health acquired PPG's secondary care business, its hospitals and surgical centres. Practice Plus Group’s secondary care business separated from the integrated urgent care business, including NHS 111 contact centres and out-of-hours GP services, and from its Health in Justice division.
This profile is on PPG - Health in Justice and Integrated Urgent Care. A separate profile for Narayana is available.
Last updated: June 2026
Strategy
Practice Plus Group, a private hospital and primary care healthcare company, was formed in 2020 when Bridgepoint, the owners of Care UK, split the company into two - putting the care home business in a separate company (see separate profile). The company is one of the largest providers of diagnostics services to the NHS.
In October 2025, Bridgepoint sold all PPG's hospitals and surgical centres to Indian company Narayana Healthcare for £188.8 million. At the time PPG's secondary care division had seven hospitals, three surgical centres, three musculoskeletal/diagnostic centres and one ophthalmology centre with 330-bed capacity. It had around 1,300 doctors and clinical staff. A profile for the new Narayana-owned business is available here.
PPG’s secondary care business has separated from its integrated urgent care business, including NHS 111 contact centres and out-of-hours GP services, and from its Health in Justice division, which provides healthcare throughout the justice pathway.
Former PPG CEO Jim Easton remains executive chair of the remaining PPG businesses, but also takes on a non-executive leadership role under Narayana Health. The new Narayana-owned business is now led in the UK by Ross Dowsett previously Practice Group’s deputy chief executive.
In March 2026, HSJ reported that PPG had left its diagnostics site in Havant, Hampshire, without giving formal notice and against the wishes of the commissioning ICB, Hampshire and the Isle of Wight ICB.
PPG were supplying X-ray, echocardiography and ultrasound services at Oak Park Community Clinic in Havant, in Hampshire, but left just before Christmas, after the site’s owners served notice on the company to cease using it. PPG relocated its diagnostics services to its Portsmouth Surgical Centre, but the ICB described the decision to leave the site as “hugely disappointing”. A spokesperson told HSJ: “Unfortunately, the decision to stop these diagnostic services at Oak Park was made by the provider, with no formal notice given during their contractual term.
Formation of Practice Plus Group
In October 2019, Care UK split its business into two separate companies, one covering care homes and the other covering all its healthcare businesses.
On 25 October 2019, Care UK Health & Social Care Holdings Ltd (the parent company) sold its shares in Care UK Healthcare Holdings Ltd to a new company Care UK Healthcare Bidco Ltd, which is outside the Care UK Group structure but still managed by Bridgepoint. Care UK Health & Social Care Holdings Ltd changed its name to Care UK Holdings Ltd.
In October 2020, Care UK Healthcare was rebranded as Practice Plus Group, containing primary care services, urgent care, prison healthcare, diagnostics, ophthalmology, hospital-based services and private healthcare.
For more information on Care UK and its history see the separate Care UK profile
Financials
The most recent financial reports available on Companies House are for the year ending 30 September 2025.
Practice Plus Group Topco Ltd (Company No: 12250218), the parent company for Practice Plus Group Ltd, reported finances for the year ending September 2025. The secondary care sector acquired by Narayana is reported as a discontinued activity with revenue for the year ending September 2025 of £250.3 million (2024: £229.4 million).
PPG's two continuing sectors are Health in Justice and integrated urgent care. Total revenue for the year to September 2025 was reported as £413 million (2024: £371 million). Revenue for sectors was Health in Justice area revenue of £293 million (2024: £247.5 million) and integrated urgent care revenue of just over £120.7 million (2024: £123.9 million). Profit for 2025 was £6.2 million (2024: £5.0 million.)
Practice Plus Group receives a high proportion of its annual revenue from the NHS. All income in the area of integrated urgent care and health in justice are from NHS contracts. In integrated urgent care, the company estimates that it has 14% of the NHS 111 market and 15% of the out-of-hours market.
Investors
In October 2025 Bridgepoint sold PPG's secondary care division to Narayana (India) for £188.8 million. Bridgepoint remains the controlling party of the remainder of PPG, the two divisions - Health in Justice and Integrated Urgent Care.
In March 2010 Care UK was acquired by Bridgepoint in a deal worth £432 million and Care UK was removed from the public markets.
After the formation of the two companies - Care UK and Practice Plus Group - Bridgepoint was still the ultimate parent company and controlling party of both companies. In October 2024, Bridgepoint, sold Care UK to an operating company owned by Care UK management. No financial details were disclosed.
Contracts
NHS contracts
Practice Plus Group has a large number of contracts with NHS commissioners and local councils.
Prison Healthcare Contracts
PPG is the leading independent provider of healthcare services in prisons and youth offender establishments. The company provides the following services to prisoners: primary care; substance misuse services; mental health services; dentistry; occupational therapy; physiotherapy; podiatry; and optometry.
The most recent award was in April 2026 for Healthcare Services to Norfolk prisons & L&D Norfolk & Suffolk and Primary Care to HMP Bure and HMP Wayland. The contract is worth £7.1 million for 12 months to April 2027; an extension of its current contract.
In March 2026, PPG was awarded a contract worth £49.9 million over a ten year period to provide gender-specific healthcare services for women in custody for HMP Askham Grange, HMP & YOI New Hall. The service will have a renewed and strengthened focus on improving mental health outcomes and tackling substance misuse issues for women in prisons that reflects the latest national policy and NICE clinical guidance.
In January 2026, PPG was awarded a contract to provide Primary Care Services (including Substance Misuse) and Mental Health Services (including Learning Disabilities and Autism) for South Yorkshire adult male prisons within His Majesty's Prison and Probation Service (HMPPS). The contract begins 1 September 2026. The contract term is for an initial period of 5 years and 7 months, with an option to extend for a further 3 years subject to satisfactory contractual and financial performance. The total value of the contract could be £141 million.
The South Yorkshire Prisons covered are; His Majesty's Prison (HMP) & Young Offenders Institute (YOI) Doncaster, HMP & YOI Moorland, HMP Lindholme and HMP & YOI Hatfield.
In April 2025 a contract was awarded for the provision of care and support services at HMP Wakefield or HMP New Hall.
In October 2024 a contract was awarded for Primary Care Services (including Substance Misuse) and Mental Health Services (including Learning Disabilities and Autism) for West Yorkshire adult male prisons. The contract is worth £132 million over 6 years, with effect from 1 April 2025, with the option to extend for a further 3 years.
In February 2024 Practice Plus was awarded a contract for integrated prison healthcare services for Leicestershire & Rutland Prison Cluster and Derbyshire Prison Cluster. The contract is worth £96 million over six years.
In March 2023 Practice Plus was listed on the contract for provision of Integrated Prison Healthcare Services, along with Oxleas NHS FT, for HMP Belmarsh, HMP Thameside, HMP Pentonville, HMP Wormwood Scrubs, and HMP/YOI Isis. The maximum annual contract value for the contract is just over £43.3 million per annum. Over the 7 years, if all contracts are extended to their full duration, the total maximum contract value will be £302.8 million.
In April 2022, PPG lost its contract for prison healthcare in the south west; the new 10 year contract was awarded to Oxleas NHS Foundation Trust. PPG only retained the contract for HMP Eastwood Park. worth £42.4 million.
PPG is took legal action against NHS England over the procurement in the South West. The contract was divided into four lots, runs for seven years from October 2022, and collectively is worth a total of more than £273m.
PPG had the contract at six of the sites. The legal challenge claims the NHSE was “manifestly wrong” in how it scored different sections of its bid, claiming it broke principles of equal treatment by apparently evaluating its bid in comparison to Oxleas FT.
In the 2016/17 year Care UK won a contract worth £135.6 million to provide healthcare at prisons and detention centres across the Thames Valley, Bristol, South Gloucestershire, Wiltshire and Gloucestershire. In the same year, Care UK was also awarded contracts for prisons in Devon and Dorset, worth £79.8 million, and Sudbury and Foston Hall, worth over £18.5 million.
In the 2017/18 year Care UK was awarded a £23 million contract for "Healthcare Provision for Women in Prisons across Yorkshire & Humber". It also received a £4.6 million contract for healthcare services at HMPYOI Feltham.
Integrated Urgent Care and NHS 111
Practice Plus Group runs a large number of NHS 111 services. The company states that it has designed and is delivering a new model of Integrated Urgent Healthcare. The model brings together out-of-hospital services and a hub of clinicians behind the existing NHS 111 number. This model is now being implemented in the West Midlands, for several CCGs and in an alliance with other local out of hours care providers.
The company has two urgent care centres, one in Southampton and one in Portsmouth.
In 2025, PPG reported that it has seven NHS 111 contracts across England which serve a total population of over 8.7 million residents. The company's main 111 call centres are based in Southall, Dorking, Bristol, Ipswich, and Stockton with two satellite centres in Worcester and Chippenham. The company's OOH services are delivered through eight contracts over 45 different facilities, provide a total population cover of over 8 million patients.
In the West country, the company runs Bristol, North Somerset and South Gloucestershire (BNSSG) 111, Gloucester 111 and Bath, North East Somerset, Swindon Wiltshire (BSW) 111, and Exeter and Plymouth IUC. In October 2024 a contract award notice was published for the contract to run an integrated urgent care service to NHS Devon Integrated Care Board, including 111 call handling services (NHS 111), clinical assessment of 111 calls through the Clinical Assessment Service (CAS), and out of hours GP provision (OOH). The contract is worth £163.1 million over eight years (if extensions happen).
Contracts
Out-of-hours services
Practice Plus Group provides OOH services through eight contracts over 45 different facilities for a total population cover of over 8 million patients. The areas covered are in North West London, South West London, North East Essex, Surrey, Warwickshire, Worcestershire, Coventry, Rugby, Gloucester, and Devon.
Recent contracts begun in 2022 include one with South West Integrated Urgent Care services in May 2022 and Devon Integrated Urgent Care services in September 2022.
In December 2025, Practice Plus was awarded a contract for Worcestershire for GP-Led Out of Hours services and Urgent Access Primary Care Service. The contract will be for a period of three years with the option to extend for a further two year period, plus one further year. The contracts begins July 2026. The total value of the contract if extension periods are included is £42.8 million.
GP services
The company has two walk-in clinics, one in Brighton and the other in Clapham Junction. In March 2026, PPG was awarded a place on NHS South West London Integrated Care Board (NHS SWL ICB) Primary Care at Scale Framework Agreement. The duration of the framework agreement will be from 1 April 2026 to 28 February 2029.
Practice Assist is a service provided by Practice Plus to GP surgeries designed to improve access for patients by providing additional remote capacity for practices. It provides registered patients with a full consultation by telephone or video on the same day with a GP, with full read and wrote access to the patient’s notes.
Patients call their local GP surgery as normal. Any patients with a clear requirement for a face-to-face appointment are booked in directly. Other calling for a GP appointment that can be managed over the phone are given a timed slot for a call back with a qualified Practice Assist GP, who will try to resolve their problems remotely. If required, the GP will then make any necessary onward referrals, either to the patient’s practice, or to other services.
Covid-19 contract
In March 2020, Practice Plus Group (as Care UK) 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 Practice Plus Group 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 October 2020, the HSJ reported that Practice Plus Group (as Care UK) was the recipient of the sixth 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 Care UK published in October 2020 amounted to £76.3 million. An similar earlier contract award published in June 2020 awarded Care UK £1.3 million.
These block contracts have been criticised after leaks revealed that the capacity paid for by NHS England at companies, such as Care UK, 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.
In January 2022, Practice Plus Group 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 then health secretary, meant that 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 have meant that the NHS had to pay independent hospitals up to £525m if they did end up treating any NHS patients.
The agreement also includes Circle Health, Nuffield Health, Spire Healthcare, Ramsay Health Care UK, Healthcare Management Trust, One Healthcare, Horder Healthcare, Aspen Healthcare and KIMS Hospital.
Concerns
Care Quality
In February 2023, the CQC found that the PPG-run out-of-hours service needed to improve its staffing to meet its legal obligations. The service was rated 'requires improvement' due to rota gaps.
The CQC also found that 73 patients who were classed as urgent over the weekend of its inspection were still waiting to speak to a clinician the following Monday morning.
Gloucestershire County Council's scrutiny committee has noted that the service had required improvement for more than five years.
Since 2009, there have been a number of high profile cases in the national media in which very poor standards of practice by Care UK have been exposed. This included a BBC Panorama investigation which uncovered instances of gross negligence in care homes operated by Care UK. Other incidents include in 2011 the 84 year old woman who was not visited by carers for four days as Care UK thought she was in hospital and in 2012 the lack of processing of 6,000 X-rays at a Care UK-run urgent care centre.
In Suffolk Harmoni’s OOH service was heavily criticised in 2011 then again in 2012, for excessive waiting times and cuts to the service. In 2012 Harmoni reorganised its Suffolk OOH service, including the closure of several bases, including in Newmarket and Aldeburgh. The closure of the bases was reported to be without any consultation with local people.
At the end of 2012, it became evident that things were going badly wrong in Harmoni's out-of-hours business in London. In December 2012, The Guardian exposed a catalogue of failings, noting that senior doctors have complained that the service is so short-staffed that it is routinely unsafe. Harmoni is also reported to have manipulated its performance data to cover up for delays in seeing patients and missed targets.
One of the most high profile cases was that of a seven-week-old baby boy who died while in the care of Harmoni's out-of-hours GP service. Harmoni's service was described as "wholly inadequate" by a coroner in February 2013. The coroner noted that Dr Muttu Shantikumar assessed the newborn baby, Axel Peanberg King, in a telephone call lasting just one minute a few hours before he collapsed in his mother's arms, and later made "wholly inadequate entries on the records that were clearly at odds with the evidence". When the baby's mother attended the Harmoni clinic three and a half hours later, she was made to wait with her baby in a queue with six patients ahead of her. The baby died shortly afterwards in the NHS A&E department next door to the clinic.
In May 2013, the Care Quality Commission produced a report on Harmoni noting that cost-cutting at the company may be harming patient care. The routine inspection by the CQC, which was carried out in March 2013, found that Harmoni did not respond quickly enough to calls from patients in north central London because it did not have enough doctors, putting patients “at risk”. The CQC report was highlighted by The Independent, which in its article noted that Harmoni won the contract to provide the out-of-hours service against rival bidder LCWUCC, a non-profit GP organisation in west London, by beating it on price despite scoring worse on quality.
In September 2016, Veritas produced a critical report on Care UK's urgent care contract in Ealing. The contract awarded by Ealing Primary Care Trust in 2011 was worth £3.9 million to run an urgent care centre in Ealing Hospital. The independent report by Veritas was triggered following complaints of poor care made to ITV reporters. The report noted that there was a gap in the assurance process carried out by the CCG as well as problems with the staffing model used by Care UK, which “took no account of predictable peaks in demand”.
The contract ran at a loss for Care UK, but when the company requested more funding from Ealing CCG in May 2013 it was refused. Furthermore, Ealing CCG would not allow Care UK to terminate the contract. The contract finally ended in April 2016, when Greenbrook Healthcare took over.
