Compliance with CMA Order 2014

In October 2014, the Competition and Markets Authority (the "CMA") published the Private Healthcare Market Investigation Order 2014 (the "Order") following its investigation into the private healthcare industry. The Order imposed requirements on private hospital operators to disclose certain information in relation to referring clinicians (as defined by the Order) for the benefit of patients. Full details about the investigation and the Order can be found on the CMA web page. The information provided by Spire Healthcare below is required by the Order.

"Higher value" services

The services provided at Spire Nottingham Hospital to referring clinicians and the amounts charged by Spire for those services are set out below:

  • Use of consulting rooms £18.20 per hour
  • Medical secretarial services £23.93 per hour (inclusive of VAT)
  • Office rental: £700 per month (inc VAT) divided equally between 10 referring clinicians

“Low value” services

The following “low-value” services are also provided to referring clinicians with practising privileges at this hospital: 

  • General services to ensure clinical safety (eg in-house training, chaperones)
  • Operational services such as patient bookings/admissions (including online booking and payment for consultations), access to a virtual consultation solution, administrative services and billing, and insurance/indemnity cover in respect of NHS patients
  • General marketing support, including production of consultant directories, promotional activities, web profiles etc
  • Basic workplace amenities such as teas/coffees/refreshments, subsidised meals, car parking (including EV charging) and stationery

Corporate hospitality events for referring clinicians

Spire group Medical Advisory Committee (MAC) Chairs conferences

Spire group Medical Advisory Committee (MAC) Chairs conferences are held twice a year, focusing on clinical safety and governance issues. MAC Chairs from all of Spire’s hospitals are invited to attend, with their partners, and are joined by members of Spire’s senior management.

  • In 2017, the conferences were held in Berlin and Aylesbury and the total cost of the events was approximately £85,000 and £25,000 respectively.
  • In 2018, a conference was held in Berlin and the total cost of the event was approximately £88,000.
  • In 2019, the conferences were held in Lisbon and Aylesbury and the total cost of the events was approximately £95,000 and £28,400. MAC Chairs were also invited to attend the Spire Healthcare Senior Management Conference in Birmingham in June 2019 (8 MAC Chairs attended at a cost of £845 per head).
  • No conferences were held in 2020.
  • In 2021, conferences were held virtually via Zoom as well as face to face in Aylesbury. The total cost of the events in 2021 was approximately £2,120 and £19,300 respectively. 
  • In 2022, the conferences were held in May at Spire’s head office in London and in November at Oulton Hall, Leeds. The total cost of the events in 2022 were approximately £6,463 and £20,338 respectively.
  • In 2023, the conferences were held in June at M Restaurant in London and in November at The Midland Hotel, Manchester. The total cost of the events in 2023 were approximately £2,931 and £20,389 respectively.

In 2019, Spire Healthcare held a series of 5 dinners with 70 consultants from across 5 Spire hospitals for the purpose of meeting various members of the Spire Executive team and listening to and engaging with consultants. The cost of the dinners ranged from £60 to £80 per head. No dinners were held in 2020, 2021, 2022 and 2023

Corporate hospitality events

Corporate hospitality events held by the hospital at no charge to referring clinicians are set out below, together with the cost of providing such events:

  • T20 hospitality - 18/08/2017: £152/head
  • England v West Indies Royal London One-Day International - 21/09/2017: £720/head
  • Consultant dinner - 06/09/2017: £50/head
  • Consultant dinner - 10/10/2017: £60/head
  • Consultant dinner - 12/06/2018: £82/head
  • Consultant dinner - 10/07/2018: £102/head
  • Consultant dinner - 07/08/2018: £46/head
  • Consultant dinner - 24/10/2018: £40/head
  • GP/Consultant dinner - 18/10/2018: £30/head
  • GP/Consultant wine tasting evening - 16/05/2019: £40/head
  • Consultant Cricket Day – 20/06/2019: £437.50/head
  • GP/Consultant wine tasting evening - 19/09/2019: £40/head
  • Medical Advisory Committee Christmas Dinner – 18/12/2019:£350 (10 people at £35/head)
  • Medical Advisory Committee Christmas Dinner - 08/12/2021: £687.72 (12 consultants at £57.31/head)
  • Planning meeting for new cardiac surgery services, followed by dinner, held on 15/11/22: 3 consultants attended at £37.34 per head
  • Consultant dinner - 27/04/2023: £30.27/head
  • Consultant dinner - 04/05/2023: £37.50/head
  • Consultant dinner - 24/08/2023: £56.36/head
  • Consultant dinner - 13/03/2024: 24 consultants and 6 Spire colleagues attended at £57.86 per head

Clinician financial interests in Spire Healthcare

Private hospital operators are required to disclose details of referring clinicians practising at their facilities, who have a share or financial interest in those facilities or any equipment used there. Some clinicians may own shares in Spire Healthcare Group plc, which were acquired either at the admission price or through trading on the main market of the London Stock Exchange. Where a referring clinician has an individual web page profile on this hospital website, relevant shares and/or financial interests are disclosed there. For referring clinicians who do not have an individual profile, their shares and/or financial interests are shown below.

  • Mr Bruce Braithwaithe holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Mr Yujay Ramakrishnan holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Mr Ahmed Vanker holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Mr Amar Alwitry owns 100% of the Zeiss software within the Callisto equipment used in theatre at Spire Nottingham Hospital

Clinician advisory services to Spire Healthcare

Private hospital operators are required to disclose details of certain paid services provided by referring clinicians to private hospitals operators in addition to exercising practising privileges at that hospital. This information can be found on the referring clinician’s individual web page profile on this hospital website.

  • Dr David Purnell – Histopathology £390 - £420 per month
  • Dr Hafiz Qureshi – Pathology £15,000 per annum
  • Dr PJ Prinsloo – Pathology £12,000 per annum
  • Dr Kris Inkpin - pre-operative anaesthetic assessments at £200 per hour. Fee paid: £17,400 (2019), £15,800 (2021), £14,475 (2022), £42,200 (2023)
  • Dr Pamela Wake - pre-operative anaesthetic assessments at £200 per hour. Fee paid: £8,850 (2019), £12,075 (2021), £14,550 (2022), £13.720 (2023)
  • Dr Qureshi and Dr Prinsloo oversee the pathology service, review abnormal patient results, oversee the quality of the service, provide advice to laboratory staff, provide clinical advice and attend the pathology meetings
  • Mr Tony Westbrook is Chair of the Medical Advisory Committee at Spire Nottingham Hospital. Their role is to provide senior professional advice to the Hospital Director and Director of Clinical Services in order to support effective medical governance and oversight. They are paid £14,000 per annum for this role and are also entitled to receive the following fees for the provision of additional ad hoc services: (i) £750 for chairing a Professional Review Committee; (ii) £200 per hour for attendance at regulatory or other national body meeting (capped at £500); (iii) £500 for each annual medical appraisal undertaken for a doctor designating to Spire for the purposes of revalidation; (iv) £1,000 per annum for undertaking the role of governance lead in addition to MAC Chair; and (v) £200 per hour for the preparation of an independent report (up to a maximum of £500 per report unless otherwise agreed due to complexity) upon request by the Medical Director or Chief Medical Officer.
  • Richard Sherman, Alan Feerick, Neil Hall, Steve Gill, Pulak Paul, Ndu Okonkwo, Paul Candler, Mark Elhers, Joel Swindin, Andrew Sharman, Zaid Alrifai, Steven Cantellow, Felix Fombon and Dan Harvey are Registered Officers of Critical Care Consulting Partners (CCCP) LLP which provide Intensivist Clinicians on site and on call services to the hospital for £300,000 per annum.