The London GP company that’s just been swallowed up by the UK subsidiary of the notorious USA Centene Corporation has ignored a request to explain claims made in a recent letter to medical colleagues about its “exciting new partnership” with Operose Health.
Operose Health is part of a UK group of Centene Corporation subsidiary companies. The Group has set its sights on “cost reductions and improved profitability”, as its 2019 Report makes plain.
On 10th February AT Medics Ltd sent its medical colleagues an “Exciting New Partnership” letter that failed to explain all the Directors had resigned
The same day that AT Medics told medical colleagues they were now part of an “exciting new partnership” with Operose Health Ltd, its directors resigned their positions as “persons with significant control” at AT Medics LLP holding company.
AT Medics did not mention this to their medical colleagues, or say that they’d been replaced by Operose Health Ltd and another subsidiary of Centene Corporation, MH Services International (UK) Limited – where the Operose Health Ltd CEO, Samantha Jones, had been appointed a director on 14th January 2021.
On 14th January 2021 Samantha Jones, who was previously NHS England’s Director of New Care Models, was also appointed as a director of MH Services International Holdings (UK) Ltd. AT Medics Ltd didn’t tell their medical colleagues about that either.
The holding company’s 2019 Annual Group Report for itself, its subsidiaries and associated companies (‘the Group’) states that the Group’s
principle activities comprise the provision of primary healthcare services, healthcare integration consultancy services and behavioural health services to NHS clinical commissioning groups and other NHS commissioning bodies.
The MH Services International Holdings (UK) Ltd Group continues to focus on
“developing a profitable and sustainable business model as a strategic partner to the NHS…”
“The Group’s strategy is entirely consistent with the widely documented need for the NHS to achieve efficiencies, adopt new ways of working and partner with innovative organisations (both public and independent sector organisations) to achieve the NHS strategy set out in its ‘Five Year Forward View.’”
Its 2019 Annual Report is rife with examples of NHS contracts the Group has ditched as unprofitable, and of the reorganisation of NHS contracts between Group trading entities in order to cut costs and improve profitability.
It mentions that strategic investments in 2020 are
“intended to lay the foundations of the Group’s longer term growth…and lead to significantly improved financial performance of the Group in future years.”
The Annual Report mentions £13m “support” from “the Company’s parent undertaking” – ie Centene Corporation – during 2020.
AT Medics Ltd didn’t tell their medical colleagues anything of that.
Nor did they tell their medical colleagues that on 10th February the AT Medics Ltd directors had also resigned from their positions as Directors of AT Medics Ltd.
Nor that they had done this this after gaining the Clinical Commissioning Groups’ consent to their Change of Control request on the explicit basis that the GP Contract for all the AT Medics Ltd surgeries would remain with the AT Medics Ltd Board of Directors whose members would not change.
The Minutes of the 19th December 2021 North Central London Primary Care Commissioning Committee record that during the due diligence process, At Medics Ltd told them that the change of control would only apply to AT Medics Holdings LLP, where control would pass to Operose Health.
But the AT Medics Ltd directors have now been replaced by the Operose Health CEO, Chief Medical Officer and Chief Financial Officer. Presumably the purchase of AT Medics Ltd is one of MH Services International Holdings (UK) Ltd Group “strategic investments”.
And control of AT Medics Holdings LLP has passed not only to Operose Health Ltd but also to another subsidiary of Centene Corporation called MH Services International (UK) Limited – where the Operose Health Ltd CEO, Samantha Jones, had been appointed a director on 14th January 2021.
What will the Primary Care Commissioning Meeting decide on 18th February, when they have to face the fact that they consented to AT Medics Change of Control request on the basis of a false assurance given to them during the due diligence process, that the company’s filing history on Companies House has exposed?
So much for the government’s spin that the new Health and Care Bill will stop further NHS privatisation by repealing the Health and Social Care Act 2012 section 75 on competitive tendering
It will just make it easier for private companies to get NHS contracts without having to go through even the limited process of transparency and accountability that competitive tendering requires.
In our naivete we hadn’t thought that one way this would happen would be for a local UK subsidiary of a US company to acquire NHS contracts, simply by buying UK companies that already have contracts. Like Operose Health Ltd has done with AT Medics Ltd. Really we should have seen it coming, since this was how Virgin and Care UK got their claws into the NHS. And we’ve been warning for years of the imminent takeover of GP, primary and community health services by super practices and private companies.
Plus, it turns out that as of January 2020, Centene Corporation in the USA also now has “significant influence” over BMI hospitals – the UK’s largest chain of private hospitals. This is the result of MH Services International Holdings (UK) Ltd Group’s January 2020 purchase of 20.1% of voting shares in Circle, plus some preferential shares, at a cost of approximately £67.3m. This investment brought Centene Corporation/ MH Services International Holdings (UK) Ltd Group’s voting interest in Circle to 40%.
Centene Corporation/MH Services International Holdings (UK) Ltd Group “became invested” in BMI hospitals because Circle acquired BMI Healthcare at the same time as MH Services International Holdings (UK) Ltd Group bought the 20.1% of voting shares in Circle, with Centene Corporation’s money,
Are Circle and Centene Corporation and MH Services International Holdings (UK) Ltd Group in cahoots?
What with Operose Health Ltd’s galloping purchase of GP companies, this gives new meaning to “integrated care”. They have control over large numbers of GP Practices and patients, they have control over many Clinicial Commissioning Groups as a result of being an approved supplier (listed as Centene UK) on NHS England’s Health Systems Support Framework, and now their GP practices and NHS Commissioners will be able to send Operose patients to BMI and Circle hospitals and rehab services. Soon the whole health service apart from non-profitable stuff like A&E and acute care will be run by these private companies. All acting in cahoots and without even competitive tendering to force their activities into the open.
So here we are. Apparently with the full collusion of the sell-out UK companies, the Clinical Commissioning Groups who have failed to show due diligence in approving AT Medics Ltd request for change of control , and NHS England who came up with the plan in the first place with the Five Year Forward View, as well as the GP Forward View and the Sustainability and Transformation Partnerships and Integrated Care Systems that were set up to carry out the 5 year plan. And then proceeded to seed its key directors far and wide among private companies through the revolving door.
AT Medics Ltd “Exciting New Partnership” letter to medical colleagues begs many questions
The 10th February letter from AT Medics Ltd letter claims that no employee terms and conditions will change as a result of the “partnership” with Operose Health Ltd; the Transfer of Undertakings (Protection of Employment) Regulations 2006 do not apply; and there is no need to tell patients about the change of ownership or to answer any questions about it, in order to “avoid misquotes and confusion.”
Instead the letter directs AT Medics Ltd medical colleagues to tell patients with any questions to email firstname.lastname@example.org.
The 10th February letter also states that the AT Medics Ltd Directors (who ceased to exist on that day) have merged with the Operose Health Ltd executive team to form the Executive Team of the Group of Companies.
My questions were sent to AT Medics Ltd but the (empty) reply came from Operose Health
I sent some questions to AT Medics Ltd at the email@example.com email address.
AT Medics Ltd did not reply. Instead, the Operose Health comms team replied with a piece of corporate spin, ignoring my questions. I’d asked:
- What is meant by the statement that the AT Medics Ltd GP Directors and the Managing Director of Primary Care and Services and the Chief Information Officer will merge with the Operose Health Ltd executive team to form the Executive Team of the Group of Companies? Specifically, how is this possible when none of those AT Medics people are now Directors of AT Medics Ltd, or persons with significant control at AT Medics LLP, and have not been made directors of Operose Health Ltd or Operose Health (Group) Ltd?
- Without any status as Directors, how will the GP Directors “continue with their existing leadership responsibilities”, as the letter to colleagues claims?
- And without any status as a Director, how will the Managing Director of Primary Care and Services take on “the added leadership responsibility for the new practices and services of Operose Health?”
- Is Operose Health planning to appoint the former AT Medics Ltd GP directors and the former Managing Director of Primary Care and Services as Directors of Operose Health, or one of its related companies?
- Since there has clearly been a transfer of ownership, why are AT Medics Ltd asking their colleagues to believe their terms and conditions will continue unchanged and there is no need for TUPE?
- What role did AT Medics Ltd medical colleagues’ Trade Unions have in the merger/takeover?
- How much money has changed hands between Operose Health Ltd/Operose Health (Group)Ltd and AT Medics Ltd/ AT Medics LLP in the course of this takeover/merger?
Operose Health Ltd’s Communications Team might just as well not have bothered to send this ridiculous spin:
AT Medics and Operose Health have formed a partnership in order to create the leading provider of NHS primary care services in the UK. The new partnership is committed to achieving high quality clinical outcomes and standards of care for patients and communities across the UK, and support and enable integrated care for patients.
There will be no changes to the day to day operations of our GP surgeries, including the care that we deliver to our patients and the services accessed through our surgeries. Patients will continue to consult with us in the same way that they do today. Our practice teams will be the same and all of the AT Medics Leadership Team are staying with the organisation as part of our new partnership.
The organisation will still be called AT Medics. Patient care, quality outcomes and improving the lives of those we serve always has been and will always remain our highest priority.
The AT Medics Managing Director has sent an identical empty reply to a patient rep
Omar Din is apparently limited to being a mouthpiece for the Operose Health Comms Team, despite being identified in the “Exciting New Partnership” letter as Managing Director Primary Care and Services, with a place on the Executive Team of the Group of Companies. (Which Group of Companies? There are so many.)
He sent the exact same Operose Health Comms Team email to a patient rep who’d asked him for information about Operose Health Ltd’s takeover of AT Medics Ltd. Except the email came from his own email address and was signed by him.
When is a Director not a Director?
Update 18 Feb 2021: A reliable source has clarified some of the questions that Operose Health Communications Team ignored
AT Medics Ltd “Directors” identified in the “Exciting New Partnership” letter are not statutory Directors of AT Medics Ltd. In other words, they are not on the Board of Directors. But they hold an executive level role in the business. Only Operose Health Ltd Directors are Statutory Directors of AT Medics Ltd.
AT Medics Ltd executive directors and Operose Health Statutory Directors make up the Senior Executive Team of the Group of Companies.
The Group of Companies consists of:
- AT Medics Holdings LLP – the holding company for the Group. The holding company is now owned by Operose Health Ltd and Operose Health Ltd’s parent company, MH Services International Holdings (UK) Ltd – also a subsidiary of Centene Corporation. MH Services International Holdings (UK) Ltd holds a minority interest because an LLP organisation needs two members.
- AT Medics Ltd (with the Board made up of Operose Health Ltd Directors) – the company that holds the APMS contracts for the GP surgeries
- AT Technology Services Ltd (with the Board made up of Operose Health Ltd Directors)
- AT Learning Ltd (with the Board made up of Operose Health Ltd Directors)
- Primary Care Partners Ltd (with the Board made up of Operose Health Ltd Directors)
All the APMS contracts remain with AT Medics Ltd – despite the fact that AT Medics Ltd is now run by a Board of Directors entirely made up of Operose Health Ltd Directors. This apparently breaches the terms of the Clinical Commissioning Groups’ consent to the Change of Control request. According to the North Central London Primary Care Commissioning Committee, Clinical Commissioning Groups agreed to the Change of Control request that allowed the contracts to stay with AT Medics Ltd, on the basis that its statutory directors remained in full control of the AT Medics Ltd Board.
Regardless, AT Medics Ltd executives claim that they have followed all the required regulatory procedures, including obtaining consent from all the Clinical Commissioning Groups following a due diligence process, for their change of control in their Limited Liability Partnership.
You can read AT Medics Ltd “Exciting New Partnership” letter to medical colleagues here:
Updated 17.2.21 to correct the date of AT Medics Ltd Directors’ termination of appointment and their replacement on the Board by 3 Operose Health Ltd Directors, from 11th February to 10th February.