The CMA Order


In October 2014, the Competition and Markets Authority ("CMA") published the Private Healthcare Market Investigation Order 2014 (the "CMA Order"). The CMA Order requires private hospital operators (such as HCA UK) to disclose on their websites certain information relating to the way the private hospitals interact with referring clinicians; that is a clinician that has practising privileges and/or has the ability to refer patients for treatment or tests at a private hospital. 

Full details about the investigation and the Order can be found on the CMA web page: here.

It is important that HCA is transparent about our relationship with doctors and we therefore set out below some of the ways in which we work together.

We would welcome your feedback on the way this information has been presented. Please contact us by email using the link here.

Useful outcome statistics for all private healthcare operators can be found on the Private Healthcare Information Network website at www.phin.org.uk

 

This information disclosed on this page is supplied in accordance with the Private Healthcare Market Investigation Order 2014.

Expert medical advice and clinical quality

"Putting patients first" was the founding philosophy of the doctors who established HCA in 1968. Since then, we have worked closely with medical professionals to put the health and wellbeing of all patients at the centre of what we do. Working closely with doctors is integral to our delivery of excellent patient care across all our hospital facilities.

Our clinical quality processes are designed to ensure that we are able to manage complex services and facilitate the best possible care for patients. As in the NHS, senior doctors spend a proportion of their time overseeing audits and clinical governance procedures; reading and disseminating management guidelines and policies; serving on specialty advisory committees and Departmental Management Teams; carrying out hospital subcommittee duties; taking on Lead Clinician roles; updating unit documentation; dealing with complaints, clinical incident investigations and critical incident reviews; and, participating in local clinical governance committees and local and national guideline groups.

Our advisers are among the most respected and eminent consultants in the UK, and our patients benefit from the high-level clinical advice of doctors who are leaders in their fields.

As senior clinicians, our advisers are often sought to consult on health issues for governmental and intergovernmental organisations including the UK Trade and Investment department (UKTI), the Department of Health, the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO). We are extremely proud that these consultant doctors choose to work with HCA.

HCA is charged an hourly rate by consultant doctors in return for their expertise and advice on how to operate excellent hospital facilities. These hourly rates are calculated by an external party on a Fair Market Value basis (FMV).

The vast majority of doctors who provide advice to HCA also have practicing privileges to treat patients in our facilities, but are under absolutely no obligation to do so. They are free to treat patients at any other private facility.

HCA is passionate about ensuring that the advice we receive from consultants should in no way compromise their NHS commitments. HCA requires the doctors that provide us with medical advice to attest that they are not compromising their NHS commitments to do so.

Working with consultants

We are proud to work in partnership with our Consultants to ensure our patients receive the highest standards of care. 

The majority of Consultants working in HCA Healthcare UK’s hospitals and outpatient centres are self-employed independent practitioners and are not HCA UK employees. Many of them also work for the NHS and some also provide their services to other independent healthcare providers. 

All Consultants working in our hospitals must agree to our Practising Privileges Policy in order to provide independent medical services within our facilities. This policy includes the standards expected and assurance of their practice with us. 

All Consultants who are granted Practising Privileges at an HCA UK hospital have undergone a comprehensive application process to verify their clinical capabilities and this is regularly reviewed. All Consultants practising in our hospitals are registered with the GMC (General Medical Council) and hold a GMC licence to practice. They are required to have their own adequate medical indemnity cover and to operate according to HCA UK’s policies and procedures.  

While Consultants are responsible for clinical decision-making and the quality of care they provide, HCA UK is responsible for ensuring that there are systems and monitoring in place to ensure that they practise in line with their Practising Privileges agreement with HCA UK.

Invoicing

As a private patient, the care you receive at an HCA Healthcare UK hospital will involve separate arrangements with HCA UK and with your Consultant. You or your private medical insurer will receive an invoice from your Consultant for their fees. This will usually be separate to the invoice issued by the HCA UK hospital. 

Arrangements for emergency provision  

All HCA UK hospitals have 24-hour medical cover available on site and our large hospital inpatient facilities offer critical care. 

 

Services and Partnerships with doctors

  • Low-value services icon plus

    The following low-value services are provided free-of-charge to referring clinicians with practising privileges at HCA facilities:
    • General services to ensure appropriate clinical care (such as in-house training, chaperones)
    • Workplace amenities (e.g. free/subsidised tea and coffee including for patients, on-site meals, stationery)
    • General marketing (such as general promotional events, consultant directories and internet profiles)

    Flu jabs
    As is common practice at healthcare facilities, HCA provides flu jabs in winter at some of our sites. These jabs are available on a first-come, first served basis and doctors are not given priority over HCA staff.

    Physician Support Services
    Physician Support Services, part of HCA International Ltd, provides doctors with access to services which support their medical practice. By partnering with third party service providers, Physician Support Services facilitates doctors’ access to services including professional insurance, billing and collections, transcription services and practice management software. Doctors can use Physician Support Services as a one-stop service for outsourcing the non-medical and administrative elements of their practice.

    Basic Lifesaving Training
    HCA UK has allocated a budget that allows us to fund Basic Lifesaving training courses. These courses are run by an external company called A to E Training Solutions, and the cost to HCA UK currently is £474 per course. Typically, these courses have an attendance of six people. These courses are put on for GP practices to support their practice managers and doctors in their Continuing Professional Development (CPD). GP practices are free to approach us to provide this training. Our budget permits this course to run approximately 12 times in any year, and we intend to run a full complement of sessions in 2022.

    Awarding EPIC points
    HCA UK operates an internal reward system by which employees (including doctors that HCA UK employs) can be rewarded with points for meritorious reasons, both ad hoc and (sometimes) as a reward for length of service, birthdays, a milestone work anniversary, or in recognition of service. The recognition system used by HCA UK is known as the EPIC system (EPIC stands for Exceptional People In Care). Points can be redeemed to obtain gifts from a catalogue. These gifts are not lavish; and doctors are not favoured over other staff either in the frequency of awards to them or in the monetary value of these points.

    Car parking
    Some HCA UK facilities have (or have access to) car parking spaces. Where these spaces are made available to doctors, it is on a first-come, first-served basis. Where spaces are made available to staff and/or doctors, HCA does not charge for these.

  • Higher-value services icon plus

    Secretarial and administrative services
    HCA sometimes employs medical secretaries to liaise with patients, deal with correspondence, make appointments and handle patients’ enquiries on doctors’ behalf. Sometimes, medical secretaries work for more than one doctor. They help to manage complex processes such as payroll, making administration efficient both for doctors and – most importantly – our patients. Medical secretarial services are made available on a non-discriminatory basis and on equivalent terms in accordance with the CMA Order. We charge doctors for using this service at Fair Market Value (FMV).

    More details are provided at each hospital’s webpage (with links below on this page). 

    Consulting rooms
    HCA UK considers that doctors must be able to see our patients without delay, and in close proximity to our diagnostic and treatment facilities. In order to achieve this, we licence our consulting rooms to doctors at Fair Market Value on an hourly or sessional basis at market rates, which we determine by calculating the rent we pay to landlords plus overheads (including rates, services charges, utilities). Consulting rooms are made available on a non-discriminatory basis and on equivalent terms in accordance with the Order.

    More details are provided at each hospital’s How We Work With Doctors webpage. 

    Training
    Where appropriate, HCA contributes to the cost of training and professional development of doctors via external training and attendance at medical conferences.

  • Events icon plus

    HCA UK provides general corporate hospitality and social events (such as Christmas parties) for staff and doctors. Such hospitality is proportionate and reasonable and is not provided by HCA UK with the intention of inducing referrals or rewarding the referring clinician for making or having made referrals to HCA UK.

    Since 1 January 2021, HCA UK has hosted the following Events:

    • Event for consultants in Birmingham re Harborne development in July 2021 costing £43 per head
    • A networking event for doctors, allied healthcare professionals and GPs hosted by HCA UK’s Physician Services Group in November 2021 costing £112 per head.
    • A networking event in November 2021 with local doctors and GPs prior to HCA UK’s opening of the Harborne Hospital in Birmingham costing £71 per head.
    • A networking event for doctors, allied healthcare professionals and GPs hosted by HCA UK’s Physician Services Group in May 2022 costing £130 per head.
    • Haematology round table for Kuwait Health Office in June 2022 costing £130 per head
    • Hosting a group of doctors at the Epsom Derby in June 2022 costing £56 per head (the doctors paid for their entry tickets)
    • HCA UK Lower Limb Symposium in July 2022 costing £94 per head.

    (Please check Hospital pages below for details of events hosted by the Hospitals.)

  • Equity participation icon plus

    Some HCA hospitals and facilities operate partnerships with doctors, some of whom may be referring clinicians.

    More details are provided at each hospital’s How We Work With Doctors webpage.

    The Princess Grace Hospital, The Wellington Hospital and the London Bridge Hospital are the primary HCA facilities for the following joint venture in which doctors have an equity interest:

    The information here is regularly updated, and in this version is correct at 23 September 2022. Where a doctor’s name or a company name appears in italics, it means that discussions were taking place at the stated date regarding an exit from the investment.

    London Endoscopy Centre Ltd (Established 2021):

    Outpatient diagnostic Endoscopy units. Based at The Wellington Hospital, The Princess Grace Hospital and London Bridge Hospital.

    Name of referring clinician  Financial interest held
    Dr Ray Shidrawi  3.00%
    Dr Richard Marley  1.56%
    CF Medical Services Ltd (Dr Guy Chung-Faye)  1.40%
    M George Ltd (Mr Mark George)  1.40%
    Reffitt Associates Ltd (Dr David Reffitt)  1.25%
    Dr John Meenan  1.12%
    Prof James Lindsay  0.95%
    FZR Medical Ltd (Dr Farooq Rahman)  0.70%
    Dr Phillip Harrison  0.60%
    Piedmont Professional Ltd (Dr Sean Preston)  0.60%
    E Carapeti Ltd (Mr Emin Carapeti)  0.50%
    Dr John O'Donohue Ltd (Dr John O'Donohue)  0.40%
    Dr Voi Shim Wong  0.30%
    Prof Martyn Caplin  0.25%
    City Gastroenterology Ltd (Dr Bu'Hussain Hayee)  0.23%
    London Surgical Associates Ltd (Mr Auston Obichere)  0.20%
    Humphries Medical Ltd (Dr Adam Humpries)  0.20%
    Dr Michael Chapman  0.15%
    Dr Edward Seward  0.10%
    JS Silver Lining Ltd (Dr Deepak Joshi)  0.10%
    Stuart Bloom Ltd (Prof Stuart Bloom)  0.10%
    Dagitec Ltd (Dr Sebastian Zeki)  0.10%
    Mr Khaled Dawas  0.10%
    Dr Michael Mendall  0.10%
    Mr Al Mutaz Abulafi  0.10%
    SSJ Management Ltd (Dr Mayur Kumar)  0.10%
    Dr Rajab Kerwat  0.10%
    Prof Stephen Pereira  0.10%
    Mr Vivek Datta  0.10%
  • Referring clinicians who also hold other positions at HCA UK icon plus

    A number of doctors provide us with clinical guidance on how to deliver the best possible care to patients and run our hospitals safely and efficiently. We pay those doctors for this service at Fair Market Value (FMV) and we use an independent company to provide assurance around our FMV calculations.

    Many of these doctors work at more than one HCA facility. For ease of reference, therefore, you can find more information on any such medical advisory positions (including payments made by HCA to the doctor) on your doctor’s HCA biography webpage.

Working with doctors across our facilities

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The Christie Private Care

A private partnership with The Christie NHS Foundation Trust

About The Christie Private Care
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The Harley Street Clinic

Fast access to world-leading acute care

About The Harley Street Clinic
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HCA at University College Hospital

How we work with doctors
Leaders in Oncology Care (LOC)

LOC - Leaders in Oncology Care

Tailored Medicine, Individual Care

About LOC
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The Lister Hospital

Private care in the heart of Chelsea

About The Lister Hospital
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London Bridge Hospital

How we work with doctors
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The Portland Hospital

Leading care for Women and Children

About The Portland Hospital
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The Princess Grace Hospital

Latest innovative technology and pioneering treatments

About The Princess Grace Hospital
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The Wellington Hospital

How we work with doctors
The Wilmslow Hospital Main Entrance

The Wilmslow Hospital

How we work with doctors
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