Intended for healthcare professionals


Subsidiary of US healthcare firm will run more than 50 GP practices after takeover deal

BMJ 2021; 372 doi: (Published 22 February 2021) Cite this as: BMJ 2021;372:n519
  1. Gareth Iacobucci
  1. The BMJ

A subsidiary of a large US healthcare company has taken over the running of one of England’s biggest NHS general practice providers in an expansion of its UK portfolio.

Operose Health1—a subsidiary of US company Centene2—has acquired AT Medics, which operates 37 GP practices across London, mostly under alternative provider medical services (APMS) contracts.

These will add to the 21 GP practices in England that Operose already runs, which were transferred to it last year when Centene Corporation brought together its UK subsidiaries The Practice Group and Simplify Health.3 Operose is owned by MH Services (UK), which is owned by MH Holdings International (UK).

The expansion will likely make Operose the largest primary care provider in England, with its 58 practices providing care to more than 500 000 patients.

Operose’s chief executive and president is Samantha Jones, the former director of NHS England’s new care models programme.4

Under the terms of APMS contracts, AT Medics and Operose were required to seek prior consent from NHS commissioners for the change of ownership. Board papers from Central London Clinical Commissioning Group (CCG),5 where AT Medics holds one GP contract, show that it notified 13 CCGs in London of its intention to transfer ownership of the contracts to Operose, and that due diligence carried out on behalf of all affected CCGs had shown no problems. As a result, local commissioners were recommended to approve the transfer, the board papers show.

The CCG papers said, “AT Medics Limited state that the new collaboration between AT Medics and Operose Health will combine the strengths of both organisations and that the benefits of this collaboration will include enhanced organisational resilience and accelerated technological capabilities leading to excellent patient access and high quality clinical outcomes. ATML also says that the new collaboration will bring together significant combined expertise in population health management.”

But the move has raised concern among campaigners opposed to private sector involvement in the NHS. Jackie Applebee, chair of Doctors in Unite and a GP in London, said, “We have been warning for years that US healthcare firms are circling to swoop on the NHS. Our fears are dismissed by politicians and senior NHS managers. The public are constantly told that the NHS is not being privatised. The advent of Centene onto the general practice landscape across London reveals, yet again, that this is a lie. In reality, the NHS is being parcelled up and sold off under the radar.”

A spokesperson for Operose said, “At the beginning of February, AT Medics and Operose Health created a new partnership which is committed to achieving high quality clinical outcomes and standards of care for our patients and communities. Day to day operations of our GP surgeries, the care that we deliver to our patients and the services accessed through our surgeries will not change. Patients will continue to consult with us in the same way that they do today. The practice teams will be the same and all the AT Medics leadership team are staying with the organisation as part of our new partnership.

“Covering approximately 530 000 patients, existing AT Medics and Operose Health patients at our 58 practices will continue to receive the same excellent standards of care, while benefitting from further digital access and staff training. We have followed all the required regulatory procedures, including obtaining consent from our CCGs.”

Liz Wise, director of primary care and public health commissioning at the NHS in London said, “The ownership of the holding company of AT Medics has been transferred after consent was given by the relevant commissioners. Patient care remains unaffected by this change.”


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