Health department approves more than 100 private firms to run NHS services

BMJ 2013; 346 doi: (Published 09 January 2013) Cite this as: BMJ 2013;346:f156
  1. Gareth Iacobucci
  1. 1BMJ

More than 100 private firms have been given the green light to provide a host of NHS services in England under the government’s “any qualified provider” scheme.

Department of Health figures show that 105 private companies have been approved to run services such as physiotherapy, adult hearing services, and community diagnostics, alongside 140 NHS organisations.

Firms such as Care UK, Virgin Care, and BMI Healthcare are set to increase their share of NHS service provision through the new policy, which allows accredited private, NHS, and not for profit providers to operate a range of NHS community and mental health services without undergoing a full tendering process.

The policy is part of the government’s drive to offer patients more choice and control over their care by increasing the number of providers at a local level. But it has sparked concerns among doctors that the array of providers may lead to fragmentation of services.

The health department said that 87 providers were already up and running and providing services to patients under the scheme: 38 from the private sector, 26 NHS organisations, and 23 social enterprises or not for profit organisations.

A recent report suggested that social enterprises and charities were being squeezed out of the market to provide public services by a small number of private companies that dominate the sector.1

Among companies making inroads are Inhealth, which told the BMJ that it had won 36 contracts—mostly for adult hearing services and ultrasonography—and the high street chain Specsavers, which has won adult hearing contracts in 33 areas.

Care UK, which already provides primary care, diagnostic, and elective care services to more than 15 million patients in England, said that it had won around 35 new contracts under the scheme, more than half of which are for community based ultrasound diagnostic services.

Richard Branson’s Virgin Care has been accredited in 10 areas of the country where it has applied to run services, including dermatology, ophthalmology, ultrasonography, and musculoskeletal services.

Richard Vautrey, deputy chairman of the BMA’s General Practitioners Committee, said that the committee had “serious concerns” that the disparate spread of providers could fragment the care of patients.

He said, “The GPC does have serious concerns about the impact on patient care that AQP [any qualified provider] will lead to if the result is a more fragmented care system. With more and more organisations involved in a patient’s care, it becomes harder to ensure good communication, adds a greater amount of bureaucracy, and makes it more difficult to provide holistic care for patients with comorbidities.”

But the health minister Lord Howe said that such concerns were misplaced, as the policy would encourage greater innovation, improve performance in the health service, and drive up the quality of care.

“This is about offering patients more choice [and] control and driving up the quality of their care, and the idea that this will have a negative impact on healthcare and patients is nonsense,” he said.

“Patients have already had choice for non-urgent hospital treatments like joint replacements for several years, and this hasn’t destabilised services.”


Cite this as: BMJ 2013;346:f156