Salisbury NHS Foundation Trust

Population 225,000
Beds 553
Income £184,525k
Comprehensive Surplus (£4,040k)
Operating Surplus £6,273k
EBITDA 8%
PPI Cap 1.2%
PPI £1,632k
Public Members 14,798

The private patient unit is called the Clarendon Suite [1]:

The Clarendon Suite is a designated department within Salisbury NHS Foundation Trust for private patients. It has its own private entrance leading to two outpatient consulting rooms, a lounge / waiting area and a ward with four inpatient bedrooms all of which have en-suite facilities.

The Annual Report [2] says that the trust owns a private company to sell medical devices:

The Trust has a strong tradition of creativity, high quality research and innovation and this continues to be reflected in the work carried out by clinical scientists at Odstock Medical Ltd – the company set up by the Trust to market worldwide its revolutionary Odstock Dropped Foot Stimulator.

Further, the Annual Report says:

Income generated by Odstock Medical Ltd (OML), is being used to further research and create new developments that help patients. The Trust owns 68% of OML. The Trust can report that OML made a profit and this is reflected in the consolidated accounts.

Board papers [3] show that OML paid £75,000 to the trust’s charity in 2011/12 and it paid rent to the trust of £158,000.

The trust also owns a separate company through which it treats private patients:

The Trust treats private patients through a partnership with Odstock Private Care Limited (OPCL). To support this, the Trust has a designated unit called the Clarendon Suite, where private patients can be treated on the Salisbury District Hospital site. While (OPCL) is contracted to provide private care on site, income generated is used to benefit NHS patients by supporting our services.

OPCL has a controversial past. The trust tried to have the company registered as a charity in 2007, but the Charity Commission refused the application [4] saying that:

Odstock is not established for exclusively charitable purposes and cannot be entered onto the Central Register of Charities.

The Commission said that the reason for rejecting the application was because there was a lack of public benefit:

8. The application was initially rejected on 26.01.2007 on grounds of lack of public benefit, the arguments against registration then being that:

a. the arrangements were to facilitate the practice of private medicine at the Hospital which would benefit medical practitioners, insurance companies and the Foundation Trust. Odstock seemed merely the administrative machinery whereby this was achieved.  In particular, the arrangements facilitated the practice of private medicine by a limited number of medical practitioners at the Hospital for the benefit of their own patients in some cases in conjunction with insurance companies

b. if the effect of charging is to exclude the less well off from benefit, then it cannot be for the public benefit.

Indeed, the company was originally set up to allow consultants an opportunity to carry out private work, the Charity Commission remarked:

A consideration in setting up Odstock had been to ensure that the needs of consultants in performing private patient work were met. Agreements with insurance companies would be entered into to enable private work to be undertaken for them.

The consultants were clearly benefitting from carrying out private work, so they were not contributing to charitable work.

In response to the Charity Commissions decision to refuse registering OPCL as a charity the trust then created a separate charity called Odstock Charitable Trust [5] and transferred ownership of OPCL to this new charity. That is, OPCL is the wholly-owned trading subsidiary of OCT, and OCT receives gift aided profits from OPCL. In 2011 OPCL paid OCT £95,607 (profit on a turnover of £816,051 [6]) and the charity made a donation of £83,750 to the Salisbury District Hospital Stars Appeal.

In the Forward Plan [7] the trust sees competition as an opportunity:

The Trust is seeing increasing competition for its services from a number of sources. Referrals to the local private sector provider have risen in the last 12 months, particularly from surgeries in the immediate catchment area and North Dorset which has been targeted by the private hospital. The number of services which are being put out to tender is increasing and this trend is likely to grow. To date the impact has been positive for the Trust.

The trust is ambivalent about AQP:

The Any Qualified Provider (AQP) initiative is being progressed in Hampshire and Dorset – it is not yet clear whether this will have a material impact on the Trust’s workload.

The trust did not report any future plans for OPCL in the Forward Plan.

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[1] www.salisbury.nhs.uk/InformationForPatients/Wards/clarendonsuite/Pages/ClarendonSuite.aspx
[2] www.monitor-nhsft.gov.uk/sites/all/modules/fckeditor/plugins/ktbrowser/_openTKFile.php?id=12841
[3] www.salisbury.nhs.uk/AboutUs/TrustBoard/AgendaBoardPapersAndMinutesTrustBoard/Documents/June 2012/3283 complete.pdf
[4] www.charitycommission.gov.uk/Library/start/odstockdecision.pdf
[5] www.civilsociety.co.uk/finance/news/content/3420/odstock_sets_up_trust_to_overcome_barrier_to_charitable_status
[6] www.charitycommission.gov.uk/Showcharity/RegisterOfCharities/CharityWithPartB.aspx?RegisteredCharityNumber=1123991&SubsidiaryNumber=0
[7] www.monitor-nhsft.gov.uk/sites/all/modules/fckeditor/plugins/ktbrowser/_openTKFile.php?id=11031