The Practice plc

Founded in 2005 by Dr Ajit Kadirgamar and Dr Jeremy Rose, both GPs, plus Peter Watts, a businessman.

Primary care, community care and secure health. The Practice Plc has a network of surgeries, including walk-in centres, plus contracts to run community services in the area of ophthalmology, dermatology, sexual health, and ear, nose and throat (ENT) services, and health services at four prisons and an immigration removal centre. The business is an unlisted limited company with three divisions covering surgeries, properties and services (1).

In the outset, The Practice’s strategy was to offer to take over the running of the infrastructure of existing GP practices including the premises. It offered 100% purchase or a partial equity release scheme for GP premises and then employed the GPs as medical staff with the possibility of share options in The Practice plc. The company has targeted GPs selling their premises, down-sizing for retirement or needing expansion funding (3,4). By mid-2010 The Practice had 16 contracts with GP surgeries. The Practice then underwent a phase of rapid expansion through the acquisition of other companies. In November 2010 it acquired the surgery business of Chilvers McCrea (over 30 surgeries) and in April 2011 the surgery business of United Health UK (six surgeries). In October 2011, The Practice provided GP services to around 180,000 patients at 60 surgeries, including eight walk-in centres, and more than 100 community-based outpatient NHS clinics per week. The Practice also had 800 employees, including 220 clinicians. (1,5,6)

In other areas The Practice has tendered for contracts with PCTs, although the acquisition of the company Drummonds in March 2010 expanded the company’s business in the area of secure health, adding contracts in two immigration removal centres. (1)

The most recent accounts available for The Practice Plc at Companies House are for the 15 month period to the end of March 2011. The company made a loss in this period of £2.5 million and as of March 2011 had debt of £3.3 million. The company paid £88,300 in tax.

The Practice’s major investor is the venture capital fund MMC Ventures Ltd. The initial investment of £865,000 was in 2006. This was followed by a further £1.4 million in October 2007 and £1.1 million in July 2007 (5,7). According to ex-CEO Peter Watts in 2010 The Practice has only just begun to break even (8). According to The Practice Plc’s accounts to the end of March 2011, in this financial period the company received shareholder loans of £1.29 million. Since the end of March 2011 the company has received at least another £3 million in investment by shareholders and loan conversions of £1.33 million.(2)

MMC is a fund manager that has been backing fast-growing early-stage companies since 2000. The company seeks investment opportunities in high growth sectors - financial services, business support services, digital media, and consumer internet. Thomas Hopkins is a director of MMC Ventures Ltd and of The Practice plc. (7) 

June 2013: Contract to provide a community ophthalmology service from Salford CCG

January 2012: Contract to provide a pilot service for cataract treatment in Croydon

July 2011: Primary care ophthalmology service in Weymouth and Bournemouth, commissioned by NHS Dorset 

July 2011: Contract to provide an expansion of The Practice’s primary care Ear, Nose and Throat (ENT) services in London. The additional clinic will be in Croydon.

November 2010: Contract to provide community-based ophthalmology services for Solihull NHS Care trust. The contract is for five years.

August 2010: Contract to provide a community-based ophthalmology service for NHS Worcestershire

May 2010: Contract with NHS Harrow to provide primary care ENT services in West London.

2009: Contracts to provide primary medical services for HMP Winchester and HMP Kingston 

Care Quality

Through its acquisition strategy The Practice has grown to a substantial size in just seven years. In the main, The Practice does not have a policy of ownership or partnerships for GPs, but employs salaried GPs at its practices. Of the problems that have been reported in the media, a major component has been the excessive use of locums because the company is unable to find permanent salaried GPs with potential for a reduction in quality of care for patients.

In June 2012 The Practice relinquished a contract to run the Brandon Street surgery (also known as Belgrave Health Centre) in Leicester. The Practice had failed to recruit permanent GPs for the surgery and a succession of locums was used. Patient complaints to the PCT noted difficulties in getting through on the phone and making appointments, rude staff, and the use of locums which meant medical history had to be gone over again and again in the limited appointment time allowed. The Practice took over the running of this surgery and three others in Leicester in 2010 for five years under a £5 million contract. (9,10,11,12)

In April 2012 The Practice closed its Camden Road surgery in London, which it had bought from United Health, when its lease ran out. There was an outcry from patients who had been given very little notice of the decision. Both United Health and The Practice were accused of running down the surgery and there was considerable use of locums. The closure triggered a public enquiry by Camden Council. Neither UnitedHealth nor The Practice produced any evidence at the public enquiry. The process by which The Practice acquired United Health’s surgeries was severely criticised by the enquiry, which noted that a loophole in APMS contracts needed to be closed. A third scrutiny committee meeting to discuss the closure of the surgery had to be abandoned when both United Health and The Practice, refused to attend (15,16,17,18,19).

In 2011 The Practice was given notice to terminate its contract for the St James medical practice in Handsworth, Birmingham, in December 2011. The Practice Plc noted that “The type of contract we have is a ten-year fixed term and the PCT have the option to terminate at the mid-point which they have chosen to do. This coincides with the unexpected termination of our lease by Vitality which means we will have no premises to practice from after December 31.” The Vitality Partnership is a GP partnership across five practices in Birmingham. (13,14)


  1. The Practice Plc accounts for the year ending March 2011 obtained from Companies House
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