Privatisation in the diagnostics/pathology sector has been ongoing for more than a decade and several companies are now well established with large long-term contracts. In pathology the leading company is Synlab and in diagnostics the leading companies are Inhealth and Alliance Medical. This section is a quick overview of some of the major companies involved in the sector.
The Covid-19 pandemic has resulted in a massive increase in the need for testing capacity and an increase in the number of private companies involved. In addition, from February 2021 onwards NHS England awarded places on the NHS Increasing Capacity Framework contract to a large number of small and medium sized companies involved in diagnostics and pathology, plus the large private hospital groups and major private diagnostics companies. Full profiles are available for the larger companies.
Last updated: August 2024
Companies
Synlab/Integrated Pathology Partnerships (separate profile available)
Synlab is the company most embedded in the pathology system within the NHS. Originally Synlab set up Integrated Pathology Partnerships (iPP) in 2010 to work in partnership with the NHS to deliver pathology testing services in the UK, and iPP now conducts more than 24 million tests per annum and employs over 600 staff across seven sites in the UK. More recently Synlab has entered partnerships with the NHS under its global name, Synlab.
Synlab, a German company, operates in more than 35 countries across four continents, employing more than 19,000 members of staff and conducting over 500 million tests per annum. Synlab as it is today was created by the private equity company Cinven in August 2015, when it combined Labco with synlab. The company was launched on the Frankfurt Stock Exchange in May 2021.
As iPP the company offers a full range of diagnostic tests and services ranging from phlebotomy, routine and urgent tests. Since 2010, iPP has formed joint venture (JV) partnerships with five NHS Foundation Trusts in Taunton, Yeovil, Southend, Basildon and the Christie in Manchester. In addition, the company works with CCGs in community testing, point of care testing and phlebotomy. Details of the partnerships can be found on the Synlab page.
The company has three operating companies: iPP Limited and iPP Analytics provide a fully-fledged testing service in Somerset and Essex respectively. iPP Facilities manages the laboratory facilities, equipment and logistics at all of the iPP laboratory locations.
In November 2020, Synlab and Guy’s & St Thomas’ NHS Foundation Trust and King's College Hospital NHS Foundation Trust signed an agreement to act as a joint venture in respect of the South East London Pathology Procurement. The new 15 year long joint venture began on 1 April 2021.
The contract covers the provision of pathology services to South London and Maudsley FT, Oxleas FT, the Royal Brompton and Harefield FT, and to Guy’s and King’s FTs, the two trusts who jointly owned Viapath.
In 2012 Synlab was excluded from the procurement process to provide pathology services to Royal Free London FT and UCLH as the company lied - the company said it was in the process of developing a laboratory close to the trusts’ sites which would meet the requirements of the tender but this was not true.
Alliance Medical (separate profile available)
Alliance Medical is an independent provider of medical imaging services to health organisations across Europe. In the UK, the company provides a wide range of scanning techniques, including MRI and PET-CT, at 37 static sites and in 45 mobile units. The company has a 10 year contract for PET-CT scanning in NW England. The company is listed on the framework contract for the provision of community diagnostic centres and by mid-2024, it listed involvement in eight active CDCs on its website, but only notes the location of four active CDCs - Oldham, South Tyneside, Taunton and the Turner CDC at Colchester Hospital. In October 2023, Alliance Medical was sold in a deal worth £910m to private equity entities owned by iCON Infrastructure Partners VI, a fund advised by iCON Infrastructure LLP, registered in Guernsey. For a full overview of this company see our Private Providers section.
Inhealth (separate profile available)
Inhealth is the largest private supplier of diagnostic procedures in the UK and works for almost all hospital trusts. The company has a large number of individual contracts with CCGs and hospital trusts, as well as being listed on several central framework agreements for screening services (NHS Supply Chain and NHS Shared Business Services National Procurement Frameworks), such as for interventional cardiology. InHealth is closely involved with the development of Community Diagnostic Centres (CDCs), including, five CDCs in the South West; in Salford a CDC in association with the Northern Care Alliance NHS Foundation Trust (NCA), and in October 2023, InHealth, Operose Health and Healthshare Ltd were awarded the contract for Community Diagnostics Services in North East London.
For a full overview of this company see our Private Providers section.
Medica (separate profile available)
Medica Group is a provider of remote diagnostics services in the UK and Ireland. The company works with around 100 NHS hospital trusts to provide a number of diagnostics services. Medica specialise in teleradiology, the secure electronic transmission of radiological patient images, including plain film (X-Rays), computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans, from one location to another, for the purposes of diagnostic interpretation and reporting. Medica is owned by private equity company IK Partners. For a full overview of this company see our Private Providers section.
Everlight Radiology (formerly Radiology Reporting Online Ltd)
Everlight Radiology is an Australian company established in 2006. The company first entered the UK market in 2010 as Radiology Reporting Online – a partnership with University College London Hospitals NHS Foundation Trust (UCLH). The company has had numerous contracts with hospital trusts, some of short duration as the company is contracted in to clear a backlog of images that need analysis. For example, the company has had many short contracts with the Queen Elizabeth Hospital King's Lynn NHS Foundation Trust for remote radiology reporting services.
Other contracts are more long-term, for example in April 2018 Everlight Radiology was awarded the teleradiology tender for three Trusts across Mid and South Essex. The contract comprises urgent after hours emergency and routine radiology reporting services for Mid Essex Hospital Services NHS Trust, Basildon and Thurrock Hospitals NHS Foundation Trust and Southend University Hospitals NHS Foundation Trust. The company is also listed on the NHS England Increasing Capacity Framework Agreement - Refresh in August 2022. Everlight Radiology is owned by private equity firm LivingBridge, which acquired it in 2021.
Sonic Healthcare UK/The Doctors Laboratory Ltd (TDL)
Sonic Healthcare UK, which incorporates the The Doctors Laboratory (TDL) Group of laboratories and services, is part of the Sonic Healthcare Ltd group, an Australian clinical diagnostic organisation employing over 22,000 people. Sonic is one of the world's largest providers of clinical diagnostics, and offers extensive laboratory pathology services to the medical community in Australia, New Zealand, South East Asia, Germany, Belgium, Switzerland, Ireland, UK and the USA. Its bases in the UK are in London and Manchester. The TDL Group of companies comprises: The Doctors Laboratory, TDL Trials, Health Services Laboratories (see NHS partnerships), Cervical Screening London (CSL), and HSL Advanced Diagnostics. All the companies work privately and have contracts with NHS trusts, community and acute, for pathology services.
CSL provides a comprehensive fully integrated single site HPV primary screening service for the NHS Cervical Screening Programme in London.
HSL-Advanced Diagnostics (HSL-AD) is a specialist clinical and research referral laboratory and is part of Health Services Laboratories. It developed from the UCLH Department of Pathology's Immunohistochemistry Unit. HSL-AD now stands as the immunohistochemistry, in situ and molecular tissue diagnostics service arm of Health Services Laboratories.
In the UK, TDL has a major partnership with London acute trusts known as HSL (see below) and in January 2024 entered another public-private partnership with Whittington Health Trust worth £105 million.
Mediscan Diagnostics Services Ltd
Mediscan Diagnostic Services is a provider of ultrasound diagnostic services at clinics across the UK. They also provide audiology, dermatology, ophthalmology, physiotherapy, MRI, and endoscopy services across 30 clinics. In several areas, Mediscan has been awarded several contracts by NHS organisations in previous years, including a musculoskeletal (MSK) pain assessment and treatment service for Lincolnshire CCGs and Walsall AQP non-obstetric ultrasound service.
Most recently in 2021, Mediscan was awarded a place on an AQP contract for Adult Hearing for Greater Manchester CCGs and on a contract for Community Audiology Services AQP in Coventry & Warwickshire . In February 2021, Mediscan was awarded a place on the NHS Increasing Capacity contract.
Spire Healthcare (separate profile available)
The private hospital company, Spire Healthcare, has considerable diagnostic and pathology capabilities. Its website reports that it has one of the largest independent networks of pathology labs and it works with the independent sector, NHS hospitals, GPs, pharmaceutical companies, research centres and the UK's largest health screening organisation. Spire Healthcare has been awarded a place on NHS England's four year Increasing Capacity Framework contract, which covers diagnostic work as well as elective surgery.
Small Companies
Other smaller companies that are listed on the NHS Increasing Capacity Framework contract include Medical Imaging Partnership Ltd, Cellular Pathology Services, Medneo Diagnostics, Diagnostics World Ltd, Newmedica, and Real Imaging Ltd. A listing on the framework means that these companies can be chosen by NHS organisations to carry out work without a further tender process, only a call-off contract is needed.
NHS/Private Partnerships
Health Services Laboratories (HSL)
HSL describes itself as 'a progressive partnership' between the Australian company TDL (The Doctors Laboratory), UCLH (University College London Hospitals NHS Foundation Trust), The Royal Free London NHS Foundation Trust and North Middlesex University Hospital . It carries out all the routine and specialist pathology departments from these NHS Trusts as well as Cambridgeshire Community Services Trust and North Central London Integrated Care System. Companies house lists Sonic Healthcare as the ultimate controlling party of HSL. In January 2024 the Whittington Health trust signed an agreement with HSL worth £105 million, which means that HSL supplies its pathology services to the Whittington for 10 years from April 2024.
Synlab, Guy’s & St Thomas’ NHS Foundation Trust and King's College
The joint venture between Synlab, a German company, Guy's and St Thomas FT, and King's College Hospital FT began 1 April 2021 and will last 15 years. The joint venture took over from Viapath, a joint venture between Serco and Guy's and St Thomas' Hospital Trust and King's College Hospital, that was for several years the largest pathology service provider in the UK, processing more than 22 million tests a year in London and Bedford.
Viapath was established in 2009 as a joint venture between Guy’s and St Thomas’ and Serco. King’s College Hospital joined them in 2010. In early 2020, Viapath lost the contract for covering a large swathe of south and east London and as a result Serco decided to withdraw from the venture. In June 2020 it was announced that King’s College Hospital FT and Guy’s and St Thomas’ FT will pay an undisclosed sum to Serco for its share of Viapath. In April 2021 it was reported in the HSJ that Serco received £15 million from Guy’s and St Thomas’ and King’s College Hospitals foundation trusts to leave the Viapath joint venture.
South West Pathology Services (SPS)
Southwest Pathology Services is a joint venture between Taunton and Somerset NHS Foundation Trust, Yeovil District Hospital NHS Foundation Trust and private sector partner – Integrated Pathology Partnerships (iPP), a subsidiary of Synlab. The joint venture was established in June 2012, serving a population of 500,000 and over 100 GP practices.
Pathology First
A collaboration between Basildon and Thurrock University Hospitals FT and Southend University Hospital FT and the private laboratory Integrated Pathology Partnerships (iPP), a subsidiary of Synlab, which provides pathology services across south Essex. It was launched in October 2014. Major problems were found with this service during a quality assurance visit in 2017. This led to smear test samples from 2,500 women having to be re-examined.
Christie Pathology Partnership
In 2014, the Christie Pathology Partnership (CPP) was set up as a joint venture between Synlab and The Christie NHS Foundation Trust. Synlab operates from within on-site pathology laboratories and serves a population of more than 3.2 million. The laboratories also provide testing, screening and assay development to support The Christie’s early phase clinical trials, with around 200 trials underway at any one time. Over 1 million tests are reported to be carried out per year, including: breast tumour receptor testing; blood sciences (biochemistry, haematology, blood Transfusion, stem cell processing); haematological malignancy diagnostic services; histopathology; oncology cytogenetics; and specialist oncology biochemistry.
