NHS GP practice operator with 500,000 patients passes into hands of US health insurer

One of the UK’s biggest GP practice operators has quietly passed into the hands of the US health insurance group Centene Corporation, prompting calls for an official investigation into what campaigners claim is “privatisation of the NHS by stealth”.

Julia Kollewe www.theguardian.com 

The merger is expected to create the largest private supplier of GP services in the UK, with 58 practices covering half a million patients.

A coalition of doctors, campaigners and academics has voiced concerns in a letter sent this week to the health secretary, Matt Hancock, asking him to order an investigation by the Care Quality Commission.

Operose Health, a UK subsidiary of Centene, has recently taken over the privately owned AT Medics, which was set up in 2004 by six NHS GPs and runs 37 GP practices across 49 sites in London. Operose already operates 21 GP surgeries in England.

Objectors are concerned because they claim the change of control was approved for eight practices in the London boroughs of Camden, Islington and Haringey in a virtual meeting on 17 December that lasted less than nine minutes, during which no mention was made of Centene and not a single question was asked.

The approval was granted by the North Central London clinical commissioning group (NCL CCG), a local NHS body that purchases health services from GPs, hospitals and others using taxpayer funds.

The campaign group Keep Our NHS Public, Doctors in Unite, Allyson Pollock, a clinical professor of public health at Newcastle University, and others have written to Josephine Sauvage, the chair of NCL CCG, urging her to block the change of control at AT Medics, which has made £35m in profits over the last five years.

During the meeting on 17 December, AT Medics indicated there would be “no change to the board of directors,” according to the draft minutes of the event, which were approved last week.

However, despite this pledge, the change of control was effected when all six AT Medics directors resigned on 10 February, and three new directors were appointed, all of them also directors of Operose. The latter include Prof Nick Harding, who is Operose’s chief medical officer and a practising GP, and Samantha Jones, Operose’s chief executive and a former head of West Hertfordshire hospitals NHS trust.

The letter to Hancock said: “Whilst we imagine you will not be sympathetic to those of us who consider that US health insurers have no place in the provision of NHS services, we ask you to consider carefully the reasons for our request.

“Most of the CCGs have published nothing about this significant change, and held no meetings in public … This matter is an example of the privatisation of the NHS by stealth to which we have consistently drawn attention, and which you have, equally consistently, dismissed.”

Pollock told the Guardian: “What we’re really worried about is changes in the model of care and quality of service, especially in areas of high deprivation. Practices may employ fewer GPs – and they may bring in substitutes for GPs like pharmacists and nurses – there may be cuts in services and reduced access, for example, closures of branch surgeries.”

Operose confirmed the change of control, saying: “The care that we deliver to our patients and the services accessed through our surgeries will not change. We have followed all the required regulatory procedures, including obtaining consent from our CCGs. As a provider of NHS services, care remains free at the point of delivery. In addition, and as with all other GP services throughout the country, we will continue to be regulated and inspected by the Care Quality Commission.”

Operose said only those involved in delivering care had access to patients’ data, and that data would not be shared with with third parties unless obliged by UK law.

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

Frances O’Callaghan, North Central London CCG’s accountable officer, said there had been no legal or contractual basis for the CCG to reject the transfer of ownership, and doing so would have posed a risk to continuity of care.

“We followed a robust process to confirm that the transfer would not affect our patients, which included being assured regarding patient data protection. Twelve other London CCGs who commission AT Medics also considered and individually approved the transfer.”

The Department of Health and Social Care said the NHS had always involved a mixture of public and private provision, and it was not for sale to the private sector.

COVID-19 hotspots projected with new website

Owl has just come across this Covid-19 hotspot predictive web site produced by Imperial College. 

Exeter and to a lesser extent Mid-Devon are shown as lingering concentrations of local infection as we move into March

by Hayley Dunning, Dr Sabine L. van Elsland 03 September 2020 www.imperial.ac.uk

Screen shot

A new website uses reported cases and deaths to estimate the probability regions in England, Scotland and Wales will become COVID-19 ‘hotspots’.

The team behind the website, from Imperial College London, define a hotspot as a local authority where there are more than 50 cases of COVID-19 per 100,000 of the population per week.

COVID-19 is, unfortunately, very much still with us, but we hope this will be a useful tool for local and national governments trying to bring hotspots under control. Professor Axel Gandy

Using data on daily reported cases and weekly reported deaths and mathematical modelling, the team report the probability (%) that a local authority will become a hotspot in the following week.

The site also provides estimates for each local authority in England, Scotland and Wales on whether cases are likely to be increasing or decreasing in the following week and the probability of R(t) being greater than 1 in the following week.

The reproduction number R(t) indicates the number of people each infected person will pass the virus onto. An R(t) larger than 1 indicates the outbreak is not under control and cases will continue to increase.

Current hotspots

The site will be updated daily. 

The website was produced by the Department of Mathematics in collaboration with the WHO Collaborating Centre for Infectious Disease Modelling within the MRC Centre for Global Infectious Disease Analysis (GIDA), and Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA) at Imperial.

Lead researcher Professor Axel Gandy, from the Department of Mathematics at Imperial, said: “The model allows us to project where local hotspots of COVID-19 are likely to develop in England and Wales based on the trends that we’re seeing in those areas. COVID-19 is, unfortunately, very much still with us, but we hope this will be a useful tool for local and national governments trying to bring hotspots under control.”

Enabling swift action

The predictions assume no change in current interventions (lockdowns, school closures, and others) in a local authority beyond those already taken about a week before the end of observations. Each local authority is also treated independently of its neighbours in the modelling, i.e. the epidemic in one local authority does not affect or is not affected by the situation in any adjacent a local authority.

The team also note that an increase in cases in a local authority can be due to an increase in testing, which the model does not currently account for. The model also assumes all individuals within each local authority are equally likely to be infected, so demographic factors such as the age structure of the population are not considered.

Dr Swapnil Mishra, from the MRC Centre for Global Infectious Disease Analysis, said: “We provide weekly predictions of the evolution of COVID-19 at the local authority level in England and Wales. Our model helps to identify hotspots – probable local areas of concern. We hope that our estimates will enable swift action at the local level to control the spread of the epidemic.”

Doorstep campaigning for local elections to resume in England

Game on! – Owl

Door-to-door political campaigning will be allowed to resume in England from 8 March in the run-up to local elections in May, the government has announced.

Aubrey Allegretti www.theguardian.com

Activists will be permitted to stand on people’s doorsteps and canvass as long as they abide by the 2-metre social distancing rule.

They will not be able to enter people’s homes and should only access shared hallways in blocks of flats where “absolutely necessary”. The new advice also urges organisers to keep the number of campaigners to a minimum.

Campaign literature should be collected or dropped off without people meeting inside, and planning meetings should take place virtually.

From 29 March, when people will be allowed to gather in groups of six or two households outdoors, the same rules will apply to political campaigning.

When it comes to polling day on 6 May, the government said people must not share a car with anyone from outside their household or support bubble to be driven to vote.

Chloe Smith, the minister for the constitution, said: “Democracy should not be cancelled because of Covid. Voters appreciate being well-informed and campaigning is an important part of effective elections.”

She said the easing of restrictions would ensure free and fair elections that were also “Covid-secure”.

“I urge political campaigners to continue to show social responsibility, and for parties, agents and candidates to ensure that their campaigners understand the clear rules,” she said.

Public Health England advises campaigners to wash their hands or use hand sanitiser for at least 20 seconds on a regular basis and wear a face covering when meeting anyone they do not live with.

Given that the government expects many people to vote by post, it also encourages those who want a postal ballot to apply as early as possible to avoid a rush closer to polling day.

Elections will take place at the county, district and parish level, and mayors and police and crime commissioner will also be elected, including any polls pushed back from last spring because of the coronavirus pandemic.

Parliamentary elections will also take place in Wales and Scotland on 6 May, but the devolved administrations will make their own decisions about whether restrictions should be eased to allow for political campaigning.

Devon is building 30% more houses than required, including EDDC! – CPRE

Latest government figures show Devon is building a third more houses than ‘required’.


Devon’s Local Planning Authorities – with the exception of Torbay – have over-delivered on housing for the last five years, according to the government’s own figures.

Devon CPRE’s analysis of the Housing Delivery Test: 2020 measurement shows the county as a whole has delivered 30% more new homes than it was required to over a five-year period, in effect building 6,332 more houses than it had to. The government data substantiates what we’ve been saying for years – that Devon is building far more homes than required and the countryside is being ravaged as a result.

The Housing Delivery Test is a measurement published annually by the Ministry of Housing, Communities & Local Government. It compares the net homes ‘delivered’ to the homes ‘required’ to be built over the same period.

The 2020 Housing Delivery Test ‘required’ an average of 4,667 homes each year across Devon from 2017/18 to 2019/20. The number of homes ‘required’ is increasingly higher than the true number of homes needed because of the government’s aspiration to deliver 300,000 each year across England. There is no evidence that this number of homes is needed.

Analysis of the 2020 measurement reveals:

Exeter over-delivered by 45%, 25% and 90% over the past three years (average 53%); by 50% overall over the past five years (1,501 excess houses).

Plymouth, West Devon and the South Hams over-delivered by 108%, 5% and 28% over the past three years (average 44%); by 44% overall over the past five years (2,401 excess houses).

North Devon & Torridge over-delivered by 57%, 22% and 48% over the past three years (average 41%); and by 32% overall over the past five years (1,076 excess houses).

Mid Devon has over-delivered by 76%, 19% and 28% over the past three years (average 39%); by 30% overall over the past five years (473 excess houses).

East Devon has over-delivered by 37%, 5% and 28% over the past three years (average 22%); by 33% overall over the past five years (1,155 excess houses).

Teignbridge has over-delivered by 32%, 5% and -35% (under-delivery) over the past three years (average -2%), and over-delivered by 11% overall over the past five years (342 excess houses).

Devon CPRE Director Penny Mills says, “The government’s own figures vindicate what we have been saying for years. In 2018, Devon CPRE commissioned an independent report from specialists at Opinion Research Services to establish the true number of homes needed across the county. It showed that delivering 4,300 homes each year would meet all local needs, allowing for a continuation of past migration trends and a fall in average household sizes. In July 2020, a second report produced for us by ORS concluded that a total of 2.3 million homes are needed nationally over the decade 2020-30 to meet household growth and provide for past under-supply, an average of 230,000 each year, NOT the 300,000 which the government claim.”

Lets hope our local planning authorities, their officers and elected councillors will now start to put our countryside and green spaces first, before permitting any more unnecessary new housing developments.