Guys and St Thomas NHS Foundation Trust

Population 1,000,000
Beds 1,114
Income £1,136,426k
Comprehensive Surplus £5,368k
Operating Surplus £31,943k
PPI Cap 3.0%
PPI £23,081k
Public Members 4,160

Guy’s and St Thomas’ is part of King’s Health Partners, and it also has its own private practice, which it describes as [1]:

The Trust has a large commercial portfolio, and much of this income is subject to long term contracts.

The trust website [2] says that there are two private patient units [3], Westminster Unit (Howard Ward, 15 beds) and Lansdell Suite (6 beds, maternity) at St Thomas’:

Westminster Unit. The private patient wing at St Thomas’ is situated on the 12th floor of the North Wing. It has 15 single rooms all with en-suite facilities. All rooms are equipped with a nurse call system, direct dial telephone and television.

The Lansdell suite is a six-bedded private patient facility, based within the main maternity unit at St Thomas’ Hospital.

The Annual Report [4] lists the subsidiaries and joint ventures of the trust:

wholly owned subsidiaries GST Enterprises Limited, GTI Forces Healthcare Limited, Pathology Services Limited, joint ventures GSTS Pathology Limited Liability Partnership, SSAFA GSTT Care Limited Liability Partnership and an associate company SpOtOn Diagnostics Limited.

The trust makes it clear in its Forward Plan [1] that it is regards itself as a commercial organisation:

The Trust benefits from having one of the largest and most successful enterprise units in the NHS. The commercial directorate supports and develops a range of initiatives to diversify our income base and create additional financial Comprehensive Surpluses, which are used to invest in NHS patient care and our facilities and equipment.

On its commercial activities the trust says:

These include treating private and international patients at private patient facilities, commercial research and trials, commercialisation of intellectual property, consultancy services in the UK and internationally, both independently and in conjunction with leading consultancies, management of healthcare facilities for governments, military organisations and other healthcare organisations internationally, provision of support services to other NHS organisations, and partnerships with commercial organisations that have innovative products and services.

The Forward Plan has a large section indicating its planned commercial work

Commercial opportunities

In addition to estates related commercial opportunities, some of which are highlighted below, the Trust is engaged in other areas of commercial activity. The biggest external contract the Trust manages is the delivery of primary care and secondary care services for the British Forces in Germany. The current contract is due to expire in 2013 and the Trust is currently involved in the rebid for this contract which, if successful, would extend the contract until 2020.

The Trust is at an advanced stage of developing a partnership with a preferred bidder to run a private patient unit in the Cancer Treatment Centre which the Trust hopes to open in 2016. Contracts are due to be signed subject to approval by the Office of Fair Trading by the summer 2012. The Trust also plans to protect and enhance NHS maternity services through growing private maternity services at St Thomas’.

Other commercial opportunities and partnerships being pursued and expected to be finalised during 2012/13 by the Trust are:

  • Finalisation of a partnership with a commercial entity to deliver both community-based endoscopy and digestive diseases services;
  • Finalisation of a contract with a commercial partner to deliver community pharmacy services at both St Thomas’s and Guy’s Hospitals;
  • Finalisation of a contract with an existing dialysis company to carry on delivering services in satellite units;
  • Finalisation of a contract with a commercial partner to provide a satellite step down service for patients no longer requiring intensive respiratory support.
  • Finalisation of contracts to deliver a satellite radiotherapy services in outer South East London, with the preferred bidder to build and operate the centre;
  • Developing online and commercial training opportunities to enhance expertise within the Trust via a single delivery point

All of the above opportunities have been tendered via an OJEU process and therefore open competition with the market.

The trust says in its Annual Report that it is outsourcing some of its work:

Major initiatives this year have included:

  • securing a preferred bidder to work with us to deliver enhanced private patients services in a partnership that will form a key part of the new Cancer Treatment Centre at Guy’s;
  • agreement with a commercial partner to provide home healthcare, outpatient dispensing, and associated retail services that will improve services for patients, visitors and staff;

The Forward Plan says AQP will be an opportunity for the trust:

Lambeth, Southwark and Lewisham have indicated that they will move to AQP for adult hearing, children’s wheelchair and adult continence services. Other neighbouring boroughs are developing AQP for musculoskeletal physiotherapy and podiatry, and work is being undertaken to ensure we are ready to compete for business in our own and neighbouring boroughs.

Guy’s is part of the planned £145m King’s Health Integrated Cancer Centre [5] which is a collaboration between Guy’s and King’s. The ICC will have a private patients ward [6].

In addition to the ICC, the trust have an agreement with HCA to provide a private patient unit for cancer patients at Guy’s. In October the Office of Fair Trading [7] examined the lease of part of Guy’s Hospital to HCA:

The Trust intends to develop a new NHS cancer treatment centre (CTC) on the Guy’s Hospital site, to be opened in January 2016. The Trust and HCA will enter into a lease agreement for 25 years whereby HCA will operate and manage a private patient unit (PPU) on four floors within the CTC to provide inpatient and day care medical and surgical cancer patient services.

The agreement is that the trust will lease property and will provide limited services for HCA (for example waste removal). The trust will also continue to treat cancer patients at St Thomas’ and although these patients will not transfer to HCA the agreement between the trust and HCA include non-compete clauses that will limit the number of such patients the trust can treat. Significantly, under the agreement HCA will be allowed to use the name “Guy’s” in relation to the PPU.

The OFT decided that the agreement does not qualify for investigation under the mergers provision of the Enterprise Act 2002.

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[3] The Trust had provided private patient services from Nuffield House at Guy’s Hospital until April 2012.
[6] £145m cancer care revolution