UK’s Largest GP Chain Putting Profits Before Patients

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Kate McCue

Medical Negligence Associate Solicitor

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In June 2022, BBC Panorama revealed the shocking findings of its undercover investigation into Operose Health – the UK’s largest GP chain with 600,000 NHS patients in its care. The findings were reported by Rahil Sheikh, Charlie Mole and Sam Holder of BBC Panorama. 

The company is owned by the US healthcare giant, Centene Corporation, and now owns 70 general practice surgeries across England. The BBC sent an undercover reporter, Jacqui Wakefield, to work in one of these surgeries as a receptionist for a total of six weeks. The surgery she worked at during this time is one of 51 surgeries run by the company in London alone.

In the short time she was employed at the surgery, the reporter was told by a GP working at the practice that the practice was short of 8 doctors. When speaking about this, the practice manager at the surgery said that they tended to hire less qualified medical staff called physician associates (PAs) because they were “cheaper” than hiring GPs.

Physician associates were first introduced by the NHS in 2003, so that doctors could deal with more complex patient needs. Their introduction was based on a US model and has been adopted in various other countries. PAs are healthcare professionals who have completed two years of postgraduate studies on top of a science degree, as opposed to 10 years education and training for GPs. They support GPs in the diagnosis and management of patients but should always have oversight from a doctor.

It was the reporter's impression from what she saw and was told her manager that there seemed to be an emphasis on hiring cheaper PAs to save on costs throughout their practices in their UK. Although a physician assistant’s role is somewhat self-explanatory, it must be emphasized that they should only assist GPs and help them to manage their patients.

Despite this, Operose appear to be using PAs in place of qualified GPs, usually with no supervision. Indeed, this was something which many of the PAs commented on to the undercover reporting, saying that they would ordinarily see all sorts of patients, sometimes without any clinical supervision. They said that the practice treated them as the equivalent to a GP. Operose Health have denied this, stating that a clinical lead is on site “most of the time” to help answer questions from PAs.

Although Operose firmly deny any over reliance on PAs, they continue to employ six times as many PAs as the NHS national average based on data from the NHS. In addition to the findings already reported on, the undercover reporter experienced numerous calls from desperate patients who had been waiting to see a doctor for up to six months. She also spoke to stressed GPs and admin staff who were concerned their excessive workload would lead to harmful mistakes being made.

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Analysis of NHS Data

NHS data analysed by Panorama shows that for every 2,000 registered patients, Operose has just over 0.6 full time equivalent GPs employed – this is half of the national NHS average. BBC Panorama has also spoken to a dozen former employees from across the Operose group to obtain their comments on their experiences working for the company.

One GP, who wished to remain anonymous, said she had witnessed the way PAs had been used where she worked. "They were fantastic colleagues and trained to do certain roles, but not trained to basically do as much work as a GP. They were doing the same job as us, with less experience, less qualifications and earning less money," she said.

Since the NHS's inception, GP practices have been run as private businesses, owned and managed by doctors known as "partners", providing services to the NHS, rather than being directly employed by it. But in 2007, the Labour government at the time changed the rules which allowed larger businesses to buy up practices in England, in an effort to drive competition and innovation.

Since 2016, Operose Health has spent tens of millions of pounds buying GP surgeries. In 2020, it bought 32 practices from London based AT Medics for a reported £50 million. It now runs 70 in total across England, making it the largest supplier of GP services to the NHS.

This data, along with the findings of the BBC’s recent investigation, is deeply concerning. In this article, we’ll explore what the implications are for patient care as well as what you can do if you’ve suffered medical negligence from your GP.

How Does This Affect Patients?

One of the main concerns that came out of the BBC’s investigation was the way PAs were being used at the practice. The majority of these staff members were inexperienced and felt they were being expected to do the same job as a qualified GP.

This situation was picked up on by one GP at the surgery who, recognising the importance of regular communication between GPs and PAs, asked to take time out of his daily shifts to talk through cases with the’ official supervisor for the PAs. But this was refused by management as they wanted to “squeeze” the most GP appointments out of him for patients.

Both the PAs and admin staff who featured in the undercover footage expressed concerns about important information being missed or mistakes being made that could compromise patient safety.

The investigation found that the central admin team in particular were faced with up to 200 medical documents to process each day. While it’s not unusual for admin staff to deal with these files, they would usually have the support of medical professionals. But at this particular practice, communication between GPs and admin staff was extremely lacking - one staff member even admitted to using Google to help her prioritise patients’ files.

When admin staff raised their concerns, they were repeatedly told by managers to prioritise hitting their targets. This has led to patients’ medication requests being ignored for months and in the worst cases, people with serious illnesses – including cancer - experiencing significant delays in being seen by a GP.

The Care Quality Commission has said it will be following up the concerns raised by the investigation “as appropriate” and we hope urgent action will take place to improve the standards of care being provided by Operose Health.

One of our expert Medical Negligence Solicitors, stated:

“This investigation highlights concerns that patients have about the access to and quality of GP care, and raises important questions about a company providing GP care whilst looking to deliver profit.”

How Can a Medical Negligence Lawyer Help?

If you think you’ve been treated negligently by your GP, you could be entitled to take legal action. When you get in touch with us, the first thing we’ll do is provide a free claims assessment where we’ll talk through your situation and let you know if we think you have a valid claim.

If we can take on your case, you’ll be assigned an expert Medical Negligence Lawyer who will keep you up to date and informed throughout your claim. We’ll arrange a review of the treatment you received with a specialist Medical Expert who will let us know if they think you were treated negligently.

We understand the thought of taking legal action can feel daunting and by working with NHS Resolution to settle your claim amicably and early, we aim to reduce the stress involved for our clients.

We’ll work hard to get you the compensation you deserve, but we know your claim may not just be about the money. We can help you make a formal complaint to the NHS and will review any outcome. There is no doubt that there is a UK-wide shortage of GPs at the moment throughout the NHS and that the healthcare system as a whole in the UK has faced unprecedented levels of demand, with resources being stretched thin. However, this is unacceptable for patients who put their lives, quite literally, into the hands of doctors, nurses and PAs who may be unable to cope with such a huge demand. 

There is never an excuse for negligence. For more information please see Hospital Negligence Claims or Medical Negligence Case Studies. Further information on our case studies generally in addition to legal articles and legal news can be found on our website too by clicking here.

Additionally, if you have found yourself in a situation where you feel that you may have a claim for negligence against a medical professional, General Practitioner or a hospital generally in relation to treatment you may have received or a procedure that didn’t quite go the way it was expected to, you can contact our friendly team of expert Medical Negligence Solicitors by calling us today on 0808 239 6043. You can alternatively request a call back from one of our friendly team members.


Simpson Millar Solicitors. (n.d.). "Medical Negligence Solicitors." Retrieved from (Accessed December 11, 2023)

Simpson Millar Solicitors. (n.d.). "Hospital Negligence Claims." Retrieved from (Accessed December 11, 2023)

BBC News. (2023, June 19). [UK’s biggest GP chain replacing doctors with less qualified staff]. Retrieved from (Accessed December 11, 2023).

BBC News. (2023, June 19). [Operose Health: What I saw working undercover at a GP surgery]. Retrieved from (Accessed December 11, 2023).

Simpson Millar Solicitors. (n.d.). GP Negligence Claims. Retrieved from (Accessed December 11, 2023).

Kate McCue

Medical Negligence Associate Solicitor

Areas of Expertise:
Medical Negligence

Kate joined the Clinical Negligence department at Simpson Millar in January 2023 after previously working at Chris Kallis Solicitors in Plymouth. Kate qualified as a solicitor in 2004 and has developed extensive experience in both Personal Injury and Medical Negligence.   

Initially Kate started working as a Defendant Solicitor for firms such as Bond Pearce LLP and DAC Beachcroft Claims Ltd. This has allowed Kate to develop a tactical advantage to her cases, using the experience of how a claim is dealt with from a Defendant’s perspective. 

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