This is a list of many of the subsidiary companies, which were set up from 2013 onwards. Their development was reduced considerably by opposition from unions and the introduction of guidance in November 2018, by the NHSI (now NHS England) that it would have to look over a business case for the formation of a subsidiary company and then decide whether to give approval; NHSI could stop a subsidiary company being formed if it thinks it is a risky plan.
The guidance was changed in February 2024, to take a more hands-off approach by NHS England, and this move coupled with the transition CEO Jim MacKey telling healthcare leaders that all trusts should be setting up subsidiary companies, is likely to see a new wave of these companies being set up.
Trusts with Subsidiary Companies
Airedale Foundation Trust – AGH Solutions Ltd (2017)
The trust's estates and procurement is run by AGH Solutions Ltd, which began operations 1 March 2018. For the year ending March 2024 the business had a turnover of £33.1 million and made £1.4 million in profit.
Barnsley Hospital FT – Barnsley Facilities Services (2017)
Barnsley Facilities Services was incorporated in 2012, but staff were not transferred over until 2017. In the year to March 2024 the company had a turnover of almost £59.2 million and profit of £668,000.
Birmingham Women and Children’s FT – BWC Management Services Limited (2017)
According to 2023 accounts the company had a turnover of £40.3 million in that year and a profit of £44,000. The company had 246 employees. As well as facilities and estates management, BWC Management Services Ltd has been responsible for the design and construction of a new clinical facility - Waterfall House - and is now responsible for running this facility.
Birmingham and Solihull Mental Health FT – Summerhill Supplies Limited (2012)
In the year to March 2024, this subsidiary had a turnover of £29.4 million and reported a loss of £427,000. The company had 329 staff.
Blackpool Teaching Hospitals FT – Atlas BFW Management Ltd (2016)
The subsidiary had 162 staff in 2024, a turnover of £101.6 million and profit of 1.02 million.
Bolton FT – Integrated Facilities Management Bolton Ltd (2016)
Incorporated in July 2016, Integrated Facilities Management Bolton Ltd employed 703 staff in 2024 in cleaning, maintenance, administration and portering. For the year to March 2024, the company reported a turnover of £53.1 million and a loss of £43,000.
Calderdale and Huddersfield FT - Calderdale and Huddersfield Solutions Ltd (2018)
In August 2018, almost 400 facilities employees - porters, cleaners, gardeners, etc. - at Huddersfield Royal Infirmary were transferred to employment with the new wholly owned subsidiary, Calderdale and Huddersfield Solutions Ltd. For the year to March 2024, the company had a turnover of almost £101 million, a profit of £97,000 and 366 employees.
Central and North West London FT – Quality Trusted Solutions LLP (2017)
The trust set up Quality Trusted Solutions as a limited liability partnership in 2017. The organisation is wholly owned by the trust, but as well as working for the trust, the organisation takes on work from others in the area of estate management and maintenance. For the year to March 2024 turnover was £39.9 million, profit was £1.0 million and had 62 employees.
County Durham and Darlington FT - Synchronicity Care Ltd (2015)
Set up to provide estates management and procurement services under two 25 year agreements with the trust. In the year to March 2024, the company had a turnover of £43.5 million and profit of £12,000. It had a staff of 544 in 2024.
City Hospitals Sunderland FT – City Hospitals Sunderland Independent Commercial Enterprises Limited (2017)
The subsidiary has a ten-year lease agreement with the trust. On 1 February 2017 the company acquired the leasehold of the three main hospital sites - Sunderland Royal Hospital, the Children's Centre and Sunderland Eye Infirmary, and it now provides services to the sites. The company also operates an independent outpatient pharmacy service at Sunderland Royal Hospital. In the year to March 2024, the company had revenue of £124.5 million, a post-tax profit of £3.1 million. The company had 762 employees.
East Kent Hospitals University Foundation Trust - 2gether Support Solutions (2018)
In May 2018, the Trust announced that it was setting up a NHS-owned subsidiary company to employ around 1,100 staff. The vast majority, 850 cleaning, catering, switchboard and portering staff, were employed by Serco under contract with the Trust; Serco is due to leave the contract a year early.
The subsidiary employs estates, procurement and facilities transferred from the Trust. The transfer of 850 staff took place in August 2018, with a further 250 NHS staff, who are responsible for maintenance of hospital buildings and grounds and include carpenters, joiners, plumbers, electricians and gardeners, took place 1 October 2018.
For the year to March 2024, the company had turnover of £159.9 million, a profit of £2.1 million, and 1,469 employees.
The company is a social enterprise company known as 2gether Support Solutions.
Gateshead Health FT– QE Facilities Ltd (2014)
This subsidiary reported revenue of £73.9 million and a post-tax profit of £4.1 million in the year to March 2024 and employed 804 staff.
Gloucestershire Hospitals FT – Gloucestershire Hospitals Subsidiary Company Ltd (2017)
In April 2018, 675 Gloucestershire NHS staff were transferred into new subsidiary company. For the year to March 2024, turnover was £95.2 million, with a profit of £919,000, and 714 employees.
Guy’s and St Thomas’ FT – Lexica Health and Life Sciences Consultancy Ltd (previously Essentia Trading Ltd) (2013)
Provides consultancy services on strategy and estate development and had 100 staff in the year to March 2024, turnover of £14.8 million and profit of £961,095. The trust’s facilities and estates function, which includes around 1,500 staff, continues to be managed and operated in-house.
Hampshire Hospitals FT – Hampshire Hospitals Contract Services Limited (2013)
In the year to March 2024 had a turnover of £16.2 million, profit of £227,000 and 12 employees.
Harrogate District FT – Harrogate Healthcare Facilities Management Ltd (2017)
Around 300 staff were transferred to the subsidiary - Harrogate Healthcare Facilities Management - on 1 March 2018. Income is from managed healthcare facilities, car parking, staff accommodation rent, sterile services, and catering. Revenue for the year ending March 2024 was £26.9 million with a loss of £68,000.
King’s College Hospital FT – KCH Interventional Facilities Management LLP (2016)
The company is a limited liability partnership (LLP) set up in 2016 and owned by the trust and its subsidiary Kings Commercial Services Ltd. The LLP had 359 staff in the year to March 2024, with revenue of £188.9 million and profit of £10.5 million.
Northumbria Healthcare FT – Northumbria Healthcare Facilities Management Ltd (2012)
For the year to March 2024, turnover was £219.9 million and profit was £236,000. The company had 898 employees.
Northumberland, Tyne and Wear FT – NTW Solutions Ltd (2016)
This subsidiary was incorporated in 2016 and in the year to March 2024 had 669 staff, up from 594 in 2023. The company reported revenue of £58.4 million and a profit of £2.7 million for the 12 months to March 2024.
North Tees and Hartlepool NHS FT - North Tees and Hartlepool Solutions LLP (2017)
This subsidiary company is a partnership formed between North Tees and Hartlepool NHS Foundation Trust and the Northumbria
Healthcare Facilities Management Ltd (see above). North Tees and Hartlepool NHS FT is the majority partner and the partnership is a subsidiary of that Trust. The company's business is to design, finance, construct and operate healthcare facilities and provide facility management services to North Tees and Hartlepool NHS Foundation Trust. In the year to March 2023, the company had a turnover of £78 million and profit of £830,000, with 628 employees.
Royal Free FT - RFL Property Services (2017)
Established in 2017, RFL Property Services is responsible for planning, business case writing and review, hard and soft FM, property management, capital project delivery in all its forms, relocations and commissioning, healthcare and space planning services, and estates management. For the year to March 2024, revenue was £29.6 million and profit was £790,000, and the company had 142 employees.
Salisbury FT – Salisbury Trading Limited (2013)
Salisbury Trading Ltd began operations in 2013 (but was incorporated in 2009) and for the year to March 2024 had a turnover of £11.5 million and made a loss of £939,001. The company had 158 employees.
South Central Ambulance Service FT – South Central Fleet Services Ltd (2015)
Responsible for the delivery and maintenance of vehicles. In the year to March 2024, turnover was £10.6 million and profit was £188,000. The company had 49 employees.
South Warwickshire University NHS Foundation Trust - SWFT Clinical Services
Established in 2011 and registered as a social enterprise in 2013. The company is responsible for properties and estate management, energy and procurement management, consultancies, and outpatient pharmacy services. In 2023, turnover was just over £19.4 million, up from £18.6 million in 2022. In 2023, the company made a loss of £1.1 million, compared to £1.5 million in 2022.
The Clatterbridge Cancer Centre FT – Clatterbridge PropCare Services Ltd (2016)
Set up principally as a delivery vehicle for building projects and management of sites, including contracts with other NHS organisations that use them. In the year to March 2024, the company had a profit of £19.1 million and made a profit of £522,000.
University Hospitals Birmingham FT – UHB Facilities Ltd (2013)
The subsidiary provides fully managed renal hemodialysis healthcare facilities and corporate facilities building management services. The company has eight staff. In the year to March 2023, the company had revenue of £5.9 million and made a profit of £631,000.
University Hospital Southampton FT – UHS Estates Limited (2016)
The subsidiary was set up to develop and then provide a fully managed estates service. In the year to March 2024 the company had turnover of £77.9 million and made a loss of £37,000. The company had 49 employees.
Yeovil District Hospital FT – Simply Serve Ltd (2018)
Around 360 support staff, including cleaners and porters, were transferred to Simply Serve on 1 February 2018. In the year to March 2024, the company had turnover of £40.2 million and profit of £839,000 and the company had 278 employees.
York Teaching Hospitals Foundation Trust - York Teaching Hospitals Facilities Management LLP (2018)
York University Hospitals Trust set up a limited liability partnership that began operations in October 2018, known as York Teaching Hospitals Facilities Management LLP. In the year to March 2024, the company had turnover of £113.1 million and made £1.5 million profit. The company had 801 employees.
Trusts that have abandoned plans for subsidiary companies
Frimley Health Foundation Trust halts plans
In November 2019, plans for around 1,000 support staff at Frimley Health Foundation Trust’s three hospitals – Frimley Park, Heatherwood and Wexham Park – to be transferred out of the NHS into a new wholly-owned subsidiary (WOS) were halted by the threat of a planned coordinated 48-hour strike by all three major unions.
An agreement was secured over the weekend by UNISON, which represents the majority of porters, security guards, cleaners and catering staff employed by the Trust. The Trust gave a commitment not to continue with its existing plans while other options are pursued, including possible ways to keep the staff employed within the NHS. In view of this UNISON agreed to take no further action for the time being.
Bradford Teaching Hospitals FT - Bradford Healthcare Facilities Management Ltd
Around 300 staff are expected to transfer to the new company 1 October 2019. However, in July 2019, industrial action began against the move. Around 300 staff, including porters, security and catering staff, carried out a week of industrial action in July 2019 which was then followed by a two-week strike in August 2019. The transfer of staff was postponed until February 2020, then in November 2019 Mel Pickup, the new chief executive at Bradford Teaching Hospitals Foundation Trust, confirmed that the FT would not go ahead with plans to establish a subsidiary.
Wigan Wrightington Leigh FT: This foundation trust cancelled its plans to transfer more than 900 workers, including porters, cleaners and catering staff, into the wholly owned subsidiary, WWL Solutions. Staff had taken strike action over the plans, but Wigan Council has now offered the trust a one off payment of around £2m to cancel the plan.
Leeds Teaching Hospitals Trust: This trust was reported to have scrapped plans to transfer staff to a wholly-owned subsidiary.
Mid Yorkshire Hospitals Trust: This trust was reported to have scrapped plans to transfer staff to a wholly-owned subsidiary.
Royal United Bath Hospital Trust: This trust was investigating setting up a subsidiary company that would be wholly owned by the Royal United Hospitals Bath NHS Foundation Trust to employ about 500 of its support staff such as porters, catering staff, administration staff and trades people. In this case the trust in Bath is reported to be currently engaging with staff over the plans. In March 2018, Unison reported that the idea was on hold.
North Bristol Trust: In January 2018, Southmead Hospital in Bristol part of North Bristol Trust announced that it was considering setting up a spin-off company to employ the non-clinical staff in the hospital trust in an effort to save money. However, following a campaign by the unions and other campaign groups, plus a backlash from the staff themselves, the trust has dropped the plans.
