Whether it be via direct partnerships or the acquisition of well-placed British groups, US health companies see plenty of upside in ‘supporting’ the NHS



The patriotically named Hospital Corporation of America (HCA) has seen a big opportunity in working with the NHS since 2006. The company has formed what it calls HCA NHS Ventures, which are partnerships with NHS trusts to provide clinics and hospitals. Though a part of the NHS, these facilities serve only private patients.

HCA has built several state-of-the-art cancer facilities through the partnership such as Harley Street at University College hospital and the Christie clinic. While real estate selling points are normally not part of NHS treatment, Harley Street at University College London boasts that the cancer ward offers “stunning panoramic views across London”. The company also has a number of strictly private hospitals in London, such as the Princess Grace hospital and the Portland hospital.



HCA, with a market capitalisation of more than $28bn, is known as one of the biggest healthcare facility companies in the US. The company’s UK arm is part of the Private Hospitals Alliance, a lobbying group that supports the role of private company participation in NHS services.



Instead of directly partnering with the NHS, some US companies have entered the UK through acquisitions, hoping to build relationships through existing British companies. To that end, the US hospital and clinic operator Tenet Healthcare in 2015 acquired Aspen Healthcare, an operator of private hospitals and clinics in the UK. Tenet said at the time of the acquisition that it hoped that owning Aspen would provide “increasing opportunities to work with and support the National Health Service”. Tenet also noted to investors that “privatisation of UK marketplace, given market inefficiencies and pressures on the National Health Service, should create organic and de novo opportunities” for the US company. The publicly traded Tenet employs more than 130,000 people and operates more than 470 outpatient centres, 84 acute care hospitals and 20 short stay hospitals in the US.

It’s not just US companies focused on hospitals and clinics that partner with the NHS. Optum, the health management arm of the US health insurance giant UnitedHealth Group, works with the NHS to provide services such as contract negotiations and medication management. Optum is one of a few for-profit companies that have won contracts to provide the services to the NHS.

Facebook Twitter Pinterest Simon Stevens, NHS England’s chief executive, who held executive positions at UnitedHealth. Photograph: Felix Clay/The Guardian

Optum’s connection to the NHS is also personal – Simon Stevens, the NHS chief, formerly held a number of different executive positions with UnitedHealth. Optum says it “supports the NHS by giving commissioners and providers the information they need to make the right decision for patients”, and calls the NHS its “partners”. UnitedHealth Group made profits of more than $8.4bn last year.

The US insurance-based healthcare system is often cited for its high expenses, its unnecessary procedures and its failure to provide healthcare to all of its citizens, but that hasn’t stopped one US insurance company, Kaiser Permanente, from crossing the pond to advise the NHS how to run itself better.



As a non-profit that focuses on managing patients with chronic conditions, Kaiser is known for its high quality of care and for preventing unnecessary admissions to hospital for very sick patients. The California-based Kaiser is often held up as a gold standard of fiscally responsible quality care in the US, and a number of studies, with titles such as Making the NHS more like Kaiser Permanente, have touted its good care. But it has also been accused of patient dumping - passing homeless uninsured patients to other agencies – and has clashed with staff unions. Kaiser has said a 2006 patient dumping incident was an “isolated case”.

The NHS is seen as a goldmine by US tech companies. IBM provides electronic staff records services to the NHS, which include things such as payroll, pensions and other human resources functions. The company took over after another US company, the drug distributor and healthcare services company McKesson, decided to shift its focus away from the UK market. IBM’s service covers about 1.4m employees at the NHS. IBM has promised to modernise the electronic staff records and make them easily accessible from mobile devices. IBM holds a five-year contract with the NHS to administer the records.