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: £23.45 per hour
  • Office rental: £300 per month
  • Physio cubicle 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 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.


  • Optometrist education events, £300 fee to Mr A Dhanani for CET/CPD accreditation for Optometrists - 6 events throughout 2023
  • Charity Golf Tournament held at Little Aston Golf Club, total cost £550, 4 attendees (3 consultants)
  • Edgbaston Cricket Club, total cost £2,960, for cricket game and hospitality. 9 consultant attendees. Fee split with Spire Parkway Hospital
  • Aston Villa Season tickets, cost of £135 each per game (face value but free to hospital) Consultants and staff attended
  • Aston Villa Football Club, total cost £2,500, orthopaedic masterclass which was sponsored by L'Oréal, Dermal, LEO Pharma, Arthrex, and Reckitt Benckiser. 84 GPs attended and 5 consultants involved
  • Medical Advisory Committee, Christmas gifts, £55 per person, provided to 16 clinicians

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:

  • Dr Paul Crowe - Holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Dr Jayant Gupta - 100% owns equipment - Echo machine (Used in every clinic where necessary) 
  • Dr Ali Hamaad - 100% owns equipment - ECG machine that works via an iPad (Used in every clinic where necessary) 
  • Professor Francisco Leyva-Leon - 100% owns equipment - Echo cardiogram machine (Used in every clinic where necessary) 
  • Dr NS Mytheen - 100% owns equipment - Nerve conduction program run from Laptop (Used in every clinic where necessary) 
  • Mr Paul Super - Holds less than 0.1% of the shares in Spire Healthcare Group plc
  • Mr David East - 100% owns equipment - used in Audiology

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 Mark Cox 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 £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.
  • Dr Raja Lakshmanan has been appointed as a pre-operative lead anaesthetist to run and improve pre-operative assessment clinics at the hospital. Dr Raja Lakshmanan is paid £650 per 4-hour session to provide these services to 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 Nikunj Mahida Microbiologist appointed for an annual fee of £6,000. His services include:
    • Telephone clinical interpretation including advice where required for any microbiology queries during a 24 hour period
    • Liaise with the local consulting staff and promote the appropriate use of the pathology service, to include choice of examinations and sample requirements. (Not an onsite requirement)
    • Participate as consultant advisor for discipline groups where appropriate – this would be the IPC committee group 4 x a year. Physical attendance would be required with dates set in advance. If Spire changes the date with no notice, physical attendance may be changed by the microbiologist to phone dial in if the new date of the meeting can’t be attended in person. A minimum of two face to face attendances is required per year.
  • Dr Vinit Kundra is Spire Healthcare’s Lead General Practice Advisor and Vinit is paid a maximum of £10,000 per year to act in this role. The role includes providing advice in relation to regulatory compliance and clinical governance of GP services providing at Spire facilities; providing support to Spire’s Group Medical Director, Responsible Officer and Chief Nursing Officer (for example in relation to clinical incidents and complaints relating to GP services); undertaking clinical audits of Spire GP services; and acting as a member Spire’s national Medical Advisory Panel.
  • Dr Vinayak Tandon and Dr Matthew Lumley are each paid a monthly fee of £766.50 to provide advice and support to the hospital regarding its Haematology services