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NHS Changes Continue To Bear Gifts For The Private Sector

Since April 2013, £5 billion worth of NHS contracts have been awarded through the market. 67% of these clinical awards have been won by Non-NHS providers – a total of £2.4bn.

£13bn worth of contracts still remain in the pipeline.


This is probably an underestimate: around a third of tender adverts do not publicly reveal their value. However we estimate that non-NHS bodies stand to gain £6.6bn from the contracts still in the pipeline.

imageSo If they continue to win contracts at the current rate (50% of value), non-NHS companies will stand to gain £9bn of NHS money since the Health Act was passed.

This is a summary of our most recent investigation (October 2014) into the trends in NHS contract activity around clinical services. It covers the 18-month period since the Health and Social Care Act came into effect.

The data has been collected by recording the contract notices placed by NHS Commissioners, on the official contract websites (TED and supply2health). From our subsequent analysis we have identified what services are open to private providers, which providers are winning contracts and how much money is involved.

The full report can be downloaded here

Summary - NHS Clinical Contract Data (Apr 2013 - Oct 2014)

1. £18.3 billion worth of contracts to run or manage clinically related NHS services have been advertised in 865 notices in the 18 months since the Health and Social Care Act came in to effect.

2. £5 billion worth of contracts have been awarded through the market since April 2013.

3. 67% of these clinical awards have been won by Non-NHS providers – totalling £2.4bn in value. A further £760m was shared in 10 joint contracts.

4. £13bn remain in the pipeline. This is very likely an under estimate as around a third of tender adverts do not publicly reveal their contract value. However we estimate that non-NHS bodies stand to gain £6.6bn from the contracts still in the pipeline, if they continue to win contracts at the current rate (50% of the total value tendered).

5. The amount of NHS contracts being awarded through the market is rising significantly. In the first six months since the Health and Social Care Act came into effect (apr-sep 2013) over £400m of NHS contracts were awarded. A year later the number of awards in the same six-month period (apr-sep 2014) has doubled (72) and their value is over seven times higher, at £3bn.

image6. A huge range of services are involved in these contracts. Overall we have counted over 80 categories of NHS service covering every aspect of the patient journey including diagnosis, treatment and ongoing healthcare across every possible setting. In 2012 there were just 40 types of treatment covered by contract notices.

7. The value of clinical notices placed by CCGs since April 2013 is £8bn - 604 contracts (many containing multiple commissioners). Non NHS providers have so far won 56% of clinical awards from CCGs.

8. The most frequently advertised types of service (including Any Qualified Provider scheme) in terms of contract notices are Diagnostics (133 contracts), Mental Health (64) GP Services/Out of-hours/111 (59 contracts), , Pharmacy (51) and Community Care (39).

9. In terms of value of contract notices plus awards, Community Care services was of the greatest value at just over £1.9 billion, followed by Diagnostics at £1.2 million, then Elective Surgery at just over £1 billion, MSK on £785m, patient transport/ambulance£583m and pharmacy £558m.

10. There has been a trend towards the use of the Prime Provider contract model, which involves the appointment of a single provider, which will then appoint subcontractors to carry out some of the work. This has been most noticeable in the area of MSK services, where from April 2013 to the end of September 2014, £709 million worth of work has been awarded via prime provider contracts.

11. The largest contract for work within the NHS advertised since April 2013 is the ‘Framework for Commissioning Support Services’ with a value of £3 to £5 billion over a four year period.

Source: NHS Support Federation press release


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