The selection process for a provider of primary care services for the Whitehawk surgery in East Brighton “was neither transparent nor fair”, according to the Independent Patient Choice and Procurement Panel (IPCPP).
The IPCPP, set up in 2024 to adjudicate disputes about commissioning NHS-funded healthcare services, has now told the Sussex Integrated Care Board (ICB) to re-run the procurement process for the primary care services contract.
In March 2025, Sussex NHS announced that One Medicare, a subsidiary of One Medical Group based in Leeds, had been awarded the seven year contract to run primary care services in Whitehawk, East Brighton, to begin 1 September 2025, with the option for a two year extension, worth around £10.4 million.
The incumbent providers Wellesbourne CIC, a not-for-profit organisation, referred the process to the IPCPP, raising concerns about the provider selection process and the way the ICB handled its request for information about the process.
The IPCPP identified several issues with the procurement process, including that Sussex ICB failed to provide bidders with adequate information, maintained insufficient records of its decisions, and incorrectly claimed that a losing bidder had not provided the required information.
One Medicare won the original tender by undercutting on price and proposing to add a walk-in centre. However, campaigners, including the GPs who work at the Wellesborne CIC, point out in an area such as Whitehawk, with very high levels of deprivation, a contract should be about more than just price.
Writing in Sussex Bylines in May 2025, Dr Posy Greany, GP at the Wellesbourne health centre, said that:
“this community needs hands-on, relationship-based care, delivered by people who know the area and are trusted by those who live here. And they need continuity: we know that being looked after by a GP who knows you leads to better outcomes and higher satisfaction rates, and is more likely to keep you out of hospital than any other factor.”
Whitehawk, the area where the surgery sits is one of the most deprived in Brighton, and in 2019 was ranked within the top 10% of England’s most deprived areas. Greany noted that:
“Over 10% of our patients have safeguarding concerns. Over 60% of our patients have more than one long-term condition, like diabetes or heart disease. Many live with serious mental illness, trauma, addiction, complex social needs, poor housing and financial problems.
Life expectancy in this area is 10% lower than the other side of the city. This is not a setting where care can be safely or effectively outsourced to a generic model.”
Wellesbourne CIC was established in 2018 in direct response to the failure of the private company, The Practice Group (now HCRG). The company abandoned the contract in 2016, along with four other contracts in Brighton & Hove, citing various reasons, but inability to make a profit due to funding issues was a major issue. Under The Practice Group, Whitehawk had no permanent GPs and services were poor.
Wellesbourne CIC has provided the Whitehawk area with stable primary care services since 2018 and has pioneered good practice in addressing health inequalities, for which it was featured in the Marmot Review in 2020.
When questioned by Poly Toynbee, columnist in The Guardian in March 2025, Sussex ICB claimed that it had to put the contract out to tender as it “had to follow an open procurement process, with the ability for all parties with interest in providing services to this community to submit an application”. Otherwise, its spokesperson said, private companies would challenge them in court.
Experts at the King’s Fund, contradicted this claim, however, telling Toynbee that there is no obligation for ICBs to tender out existing NHS services and that they can also reject cheaper bids in favour of best “social value”.
Sussex ICB now says that taking the IPCPP ruling and “the strong public feedback” into account it has decided to stop the current process.
The new Provider Selection Regime (PSR) for commissioning services, which the ICB is legally obliged to follow, came into place in January 2024, and was designed to reduce the need for commissioners to put contracts out to tender. Under the PSR, commissioners only legally need to put contracts out to tender if they cover new or radically re-designed services, if commissioners are seeking more providers for services where several providers can be used, for example for elective surgery or counselling services, or if a framework is being set up.
So why, when the ICB didn’t need to, did it start the process in the first place? Was it really as the ICB states to find “high quality, value for money GP services in Whitehawk that meets the needs of the local community.” Or is there more at play?
An answer might lie in the financial situation at Sussex ICB. Along with every other ICB in England, it has been told by NHS England to slash costs, and as a result, they are likely to be assessing all contracts as they come to an end and seeing if they can find a company who will do the contract for less to save money.
For ICBs seeking new providers for primary care services contracts, however, the pool of interested parties has been much reduced in recent years. The constant reorganisation of the NHS, plus the lack of sufficient funding and recruitment difficulties, have reduced the private sector’s interest in GP services considerably. It has also made it harder to run the contracts once they are awarded and make a profit. The addition of the ‘social value’ aspect of the criteria for selection may also have put companies off.
There has been consolidation of the market with mergers of companies and others leaving the market entirely. Nowadays the GP surgery contracts tend to make up only one part of the company’s business.
One Medical, the privately-owned company chosen by Sussex ICB, who undercut on price, is based in Leeds and has a number of GP surgery contracts as well as a property development business. Turnover in 2023, its latest available accounts, was £28.9 million, leading to a post-tax profit of £958,700.
One Medical has previously walked away from a GP contract in Reading, where it struggled to recruit permanent staff. The company also no longer runs the Shakespeare Medical Practice in Leeds following a whistleblower instigating a CQC inspection in 2023 that rated the surgery ‘requires improvement’.
The CQC lists the company as running nine GP services, including one co-located at Leeds General Hospital, two urgent care services in Corby and Derby, plus the Shakespeare Walk-in centre in Leeds and a health centre in St Neots. The latter received a damming report from the CQC recently with almost all categories receiving a ‘requires improvement’ rating.
The largest operator in the GP field Operose Health, now part of HCRG Care Group, is an example of how the industry has seen consolidation in recent years. Operose lists 54 GP surgeries on its website. Thirty-four of these surgeries are in London and operated by the subsidiary AT Medics. Operose Health and AT Medics both became part of HCRG Care in 2023 when the US company Centene, which owned Operose and subsidiary AT Medics, left the UK market. Operose itself was formed in 2020 by a merger between The Practice Group and Simplify Health. HCRG Care, which was Virgin Care, has large contracts for community services, which are a major part of the company’s business.
There are only three other companies of note operating in the GP surgery area. Malling Health, which for many years was just a GP surgery business, became part of PHL Group in 2025 and its eight surgeries are now a minor part of the overall business. IntraHealth in North East England has 13 GP surgeries listed on its website, but also has pharmacies and contracts for community services. Finally, SSP Health in North West England has maintained a business focused primarily on GP surgeries since it began over 20 years ago, with 40 GP surgeries across the area.
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