Investigating private contracts with ICBs: new database

How much of our NHS budget goes to private companies in England via each of the 42 areas of England’s NHS now governed by separate Integrated Care Boards?

How widely have clinical services been outsourced?

Which companies are getting most ICB funding?

What is their track record of violating legislation including employment law and human rights?

These are some of the questions of use to campaigners at local level and nationally.

Outsourcing is not just for direct patient care, but includes many ancillary services, IT, data, management functions and consultancy services.  NHS England fast-tracks many companies to win contracts via the Health Systems Support Framework (HSSF).

KONP’s Integrated Care Systems (ICS) Working Group has produced databases for campaigners to explore NHS private sector contracts awarded through the ICBs, Trusts and Foundation Trusts.


The databases will help you to discover:
▪︎which companies are getting such contracts in England
▪︎how much they are being paid, and – importantly
▪︎their track record on law breaking and regulatory infringement using US and UK ‘Violation Tracker’ information. 

The first database uses data from the 42 Integrated Care Boards in England, currently covering the year since they started in July 2022. 

Data from individual Trusts is being added to a separate database; their spending on contracts is another route by which money flows from the ICS to the private sector.

The databases will enable you to investigate outsourcing in your local ICS and Trusts. You can use the findings to challenge commissioners and raise concerns publicly.

The detailed guide shows you how to interrogate the databases, use the Trackers and go further, as in the example below.

One Example of Violations by a Private Company

UnitedHealth, operating in England via its subsidiary Optum, has 366 violations listed on the US Violation Tracker. California is suing pharmaceutical companies and Pharmacy Benefit Managers including Optum, for rigging the price of insulin, making it unaffordable for many. Last year, Arkansas sued the same firms, alleging a conspiracy to sell insulins for $300-$700 when production costs were as little as $2. Despite this appalling record, the HSSF accredits Optum for 17 topics, including Shared or Integrated Care Records. This involves “sharing structured medications data across all care settings for a variety of uses such as population health management, risk stratification, patient assessment, medications reconciliation, and decision support.” Optum has contracts with 19 ICBs, and is hoping to merge with EMIS which has contracts with 30 ICBs.