Here is some background about SWFT and its private company, SWFT Clinical Services. SWFT was one of the first Foundation Trusts in the country to set up a limited company as a subsidiary (sub-co). Since then, many other Foundation Trusts have set up similar Pharmacy businesses, and the model is now well established. Issues of concern: transparency, public accountability, staff terms and conditions.
South Warwickshire NHS Foundation Trust https://www.bloomberg.com/research/stocks/private/snapshot.asp?privcapId=31271224:
South Warwickshire NHS Foundation Trust operates hospitals. It provides adult in-hospital, adult out-of-hospital, children, and young people and family services. The company, through its subsidiary, provides outpatient pharmacy services; operates a private consulting and day surgery clinic; and provides online service that offers health information and recommended products to treat various common conditions. South Warwickshire NHS Foundation Trust was founded in 2010 and is based in Warwick, United Kingdom. It also has hospitals in Warwick, Stratford, and Shipston-on-Stour, United Kingdom.
SWFT Clinical Services Ltd
General background on NHS Sub-Co’s: (https://nhsprivate.wordpress.com/executive-summary/private-patient-services/commercial-companies/
‘One common scheme is to create a company to provide outpatient pharmacy services to exploit a VAT loophole (for example South Warwickshire, University Hospitals Birmingham, Birmingham Children’s Hospital). However, such companies are a potential vehicle for trusts to develop more commercial services, and possibly private patient services. For example South Warwickshire has a company called SWFT Clinical Services Ltd and in the trust’s Forward Plan  it says that the trust intends to “develop this model further”
SWFT CLINICAL SERVICES LTD. was set up in 2010 and incorporated at company house in 2011. (https://beta.companieshouse.gov.uk/company/07542436)
Formed in March 2010 SWFT Clinical Services Ltd. (SWFT–CS) is a wholly owned subsidiary of South Warwickshire NHS Foundation Trust. When South Warwickshire Trust was awarded Foundation Trust status in 2010, it was one of the first in the country to set up a limited company as a subsidiary. Since then, many other Foundation Trusts have set up similar Pharmacy businesses, and the model is now well established.
The company’s primary purpose is to develop income for the Trust through commercial activities. All profits made by the company’s trading activities are either reinvested in the business or returned to the Trust for reinvestment in health care services. In 2013 it was decided to formally register the company as a Social Enterprise. In January 2014 SWFT-CS received the Social Enterprise Mark. The mark is awarded to companies that are trading for the purposes of community and public benefit, and who commit to at least 50% of their profits being utilised for public benefits allied to the organisations purpose, or for reinvestment in growth of the organisation.
SWFT Clinical Services operates the Outpatient Pharmacy for the Trust based at Warwick and Stratford Hospitals. The pharmacy deals primarily with outpatient and A&E prescriptions as well as oral chemotherapy. Additionally the Outpatient Pharmacy also provides a continence service; providing an ordering and delivery service for continence products for both patients and care homes. To find out more about the services available at the Outpatient pharmacy click here (link to new pharmacy page).
The Beauchamp Suite at Warwick Hospital
The Beauchamp Suite offers NHS patients undergoing orthopaedic surgery the opportunity to pre-book a guaranteed individual en-suite room ahead of planned treatment.
The Stratford Clinic
The Stratford Clinic is a unique private consulting and day surgery clinic located in the heart of Stratford-upon Avon. Our experienced specialist Consultant Surgeons provide consultation, treatment and surgery for a range of conditions and are supported by our dedicated specialist nurse team.
- cosmetic surgery
- eye surgery
- hand and wrist surgery
- varicose veins
For more information about The Stratford Clinic or to book a consultation visit
Stratford Hospital – New Wing
Stratford Hospital comprises two buildings, the original building, now called ‘Building Two’, which is public NHS, and the new wing, Building One, which is owned by SWFT wholly owned sub-contract company, SWFT Clinical Services.
Building One is a new development which opened fully in August 2017. The building comprises of three floors;
The ground floor includes:
- Café Lomas, a health and wellbeing hub. Café Lomas provides information and advice on a range of health and wellbeing services in Stratford upon Avon and the surrounding areas
- Outpatient Pharmacy
- Some diagnostic services will be introduced
The first floor is an Ophthalmology Unit and includes:
- Eight outpatient consulting rooms
- Three treatment rooms with associated investigation rooms
- State of the art operating theatre
The Rigby Unit, known as the Rigby Cancer Unit, on the second and includes:
- 12 chemotherapy treatment chairs
- Macmillan Information and Support Centre
- A range of facilities to support patients such as a complimentary therapy room
It is owned by SWFT Clinical Services, a wholly owned subsidiary of SWFT.
SWFT clinical services:
From above website:
‘SWFT Clinical Services Ltd. is a wholly owned subsidiary of South Warwickshire NHS Foundation Trust.
When South Warwickshire Trust was awarded Foundation Trust status in 2010, it was one of the first in the country to set up a limited company as a subsidiary. Since then, many other Foundation Trusts have set up similar Pharmacy businesses, and the model is now well established. The company commenced operating in March 2011. The company operates the outpatient pharmacy for the Trust based at Warwick Hospital, a private patient day surgery clinic in Stratford-upon-Avon (www.thestratfordclinic.co.uk), and most recently has developed a facilities and estates management service, under which it manages the Stratford-upon-Avon hospital on behalf of South Warwickshire NHS Foundation Trust.
The company’s primary purpose is to develop income for the Trust through commercial activities. All profits made by the company’s trading activities are either reinvested in the business or returned to the Trust for reinvestment in health care services’.
The new wing’s services are not on the main Stratford Hospital website via SWFT:
History of the New Wing.
SWFT borrowed £23 million from the Foundation Trust Finance Facility (https://www.gov.uk/government/groups/independent-trust-financing-facility, https://www.gov.uk/government/publications/guidance-on-financing-available-to-nhs-trusts-and-foundation-trusts) to build the new wing.
It then ‘lent’ this to SWFT Clinical Services to build the new wing. This financing avoided VAT, with a £3 million saving. The transaction and financing had to take place before the new wing opened in August 2017 for the VAT advantages to apply.
The new wing belongs to SWFT Clinical Services, and maintenance and new acquisitions also avoid VAT, so saving SWFT money. This is the same VAT model as PFI maintenance, except in this case the ‘lender’ is a sub wholly owned by SWFT.
In addition, charities contributed to the new wing for cancer chairs etc. https://www.swft.nhs.uk/news/stratfords-one-million-hospital.
- Stratford Hospital website must be updated to make clear this ownership structure.
- Can FOI’s be put to wholly owned sub?
Other Risks of the wholly owned subsidiary model
- The wing could be sold off. But under the Health and Social Care Act 2012, this would be considered a ‘significant transaction’ and because it is a sub of SWFT would have to be approved by the SWFT Council of Governors.
- Staff at the new wing do not have to be employed under NHS terms and conditions, including NHS pay scales (http://www.nhsemployers.org/your-workforce/pay-and-reward/agenda-for-change/pay-scales/annual). However, UNISON at SWFT is well organized, and I understand that NHS terms and conditions have been negotiated for the staff at Stratford Hospital. However, there is no guarantee that this could not be changed.
- There is a general public accountability deficit problem with the new wing as a wholly owned SWFT subsidiary. There are fuzzy edges around finance. How does the sub relate to the main hospital, which is public NHS? It now appears that SWFT Clinical Services runs all estates and facilities management for Stratford Hospital.