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 Little Aston Hospital to referring clinicians and the amounts charged by Spire for those services are set out below:

  • Use of consulting rooms: £22.48 per hour
  • Medical secretarial services: £17.70 per hour
  • Office rental: £300 per month
  • Physio cubical rental: £10 per hour

“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 the production of consultant directories, promotional activities, web profiles etc
  • Basic workplace amenities such as teas/coffees/refreshments, subsidised meals, car parking, stationery

Corporate Hospitality events for referring clinicians

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 39 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).

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.

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:

  • 06/02/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 20/03/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 10/04/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 22/05/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 26/06/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 25/09/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 16/10/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 20/11/2019 – Ophthalmologist – Spire Eye event – Chair fee given to an Optometrist to upload info £50
  • 02/04/2019 – 23 Practice Managers Afternoon/ networking at Swinfen Hall Tea £25 Per head
  • 04/04/2019 – GP education evening with a Haematologist consultant - 32 Attendees - £31.25 per head
  • 10/10/2019 – GP education evening with a Rheumatologist consultant - 25 Attendees - £24 per head
  • 02/05/2019 - Musculoskeletal education group Evening event - £200 Chair Fee
  • 06/11/2019 – Musculoskeletal education group evening event - £200 Chair Fee
  • 02/07/2019 - Cricket Match hospitality @ Edgbaston Cricket Ground - 10 Attendees £500 per head
  • 16/07/2019 and 19/11/2019 – Patient Event at Great Barr Golf Club (venue hire available due to sponsorship arrangement with Spire Little Aston)
  • 17/07/2019 - Walmley Golf Club, patient event - £100 total cost of snacks
  • 14/10/2019 - Lichfield Golf & Country Club, patient event – £100 total cost for snacks

Clinician Financial Interests in Spire

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:

  • Dr Deep Chand, Radiologist - Holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Dr Paul Crowe, Radiologist - Holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Dr Brendan O’Connor, Anaesthetist - Holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Dr Arumugam Jagadeeswaran, Anaesthetist – Holds less than 0.1% of the shares in Spire Healthcare Group plc

Clinician Advisory services to Spire

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.

Mr Gunaratnam Shyalmalan is Chair of the Medical Advisory Committee at Spire Little Aston 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 £12,000 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) £500 for each annual medical appraisal undertaken for a doctor designating to Spire for the purposes of revalidation; and (iii) £200 per hour for the preparation of an independent report (up to a maximum of £500 per report) upon request by the Medical Director or Chief Medical Officer.

Dr Raja Lakshmanan has been appointed as a pre-operative lead anaesthetist to run and improve pre-operative assessment clinics at the hospital.

Duties include;

  • Running a weekly anaesthetic clinic which consists of face to face appointments and note reviews to ensure our patients are medically fit for anaesthesia, and meet the hospital admission criteria based on Level 1 care
  • Liaise/communicate with Consultant anaesthetists/consultants re findings if required
  • Assist in the development of local guidelines for use in Pre-Operative Assessment
  • Provide teaching and mentorship to the POA nurses

Dr Raja Lakshmanan is paid £650 per 4-hour session to provide these services to the hospital.