PPU roundtable 2: Advancing private patient units

Browne Jacobson recently hosted its second private patient unit (‘PPU’) roundtable, 'Private Patient Units: Exploring expanding through partnership', at its London office, bringing together NHS PPU managers, commercial directors, and other sector experts and stakeholders for a lively and insightful discussion. 

The event featured engaging conversations and valuable networking opportunities. Key themes included: 

1. Exploring NHS PPU partnership models  

The event outlined five main types of partnerships available for PPU expansion, including: 

• Contractual arrangements: This model involves a management services agreement where a partner is brought in to run the private patient operations. It allows NHS trusts to leverage external expertise while maintaining overall control.
• Corporate joint ventures: In this model, a trust may create a new entity to expand its private patient business. This could involve utilising existing facilities or adopting a phased approach to development. The joint venture model fosters a deeper collaboration and shared risk, potentially leading to more innovative solutions and shared financial investment.
• Brand new ventures: Another form of joint venture discussed was the establishment of entirely new PPUs. Working in partnership to develop a private patient business. This could be on or off trust land.
• Land transactions: Inspired by successful implementations like The Harbone Hospital (Birmingham), this structure involves a headlease granted by the trust of a parcel of its land to a developer, followed by a series of underleases. This model supports the operation and management of the private patient business and can lead to substantial infrastructure development without capital investment by the trust.
• Acquisitions: Some trusts might consider acquiring a current private hospital business to expand their PPU operations. This approach can be direct, without partners, although partnerships can still be formed to enhance the business scope and scale.

The group touched on the challenges and hurdles associated with each partnership model, acknowledging that the choice of model depends heavily on the specific goals, resources and constraints of the NHS trust involved. 

Participants discussed the importance of aligning the chosen partnership model with the trust’s strategic objectives to ensure that any partnership not only fosters growth and improves patient care, but also integrates seamlessly with existing NHS services.

The overall consensus was there is a growing demand for PPU expansion in NHS hospitals. 

2. Utilising NHS resources for growth

A key topic at the roundtable was the strategic use of NHS resources. The focus was on expanding business opportunities while also reducing the pressures on NHS waiting lists. 

The discussion emphasised the need to understand the economic conditions of local areas to ensure new developments support, rather than harm, economically deprived communities. 

This approach highlights a thoughtful consideration of both growth and social responsibility in managing NHS resources.

3. Importance of board engagement and support 

Participants discussed the importance of board engagement and buy-in for PPU expansion, and how this is critical for the successful expansion and management of PPUs. The session addressed the challenges and strategies relating to gaining buy-in from key stakeholders, and identified that there needs to be a clear goal and strategy identified from the outset with a clear articulation of what the “prize” is (i.e. more money to be reinvested in NHS services or departments). 

It was felt there is more buy-in from boards to pursuing PPU expansion than there may have been previously (along with looking at other commercialisation options) in order to try and plug the funding gap that is opening up.

4. PPU financial models and investment 

Financial sustainability was a key topic at the roundtable, with participants sharing their insights on various financial strategies and investment approaches. This discussion highlighted the diverse ways to ensure the financial health of PPUs while aligning with NHS goals.

Participants discussed how investing in technology and better infrastructure can make operations more efficient and attract more patients, while safeguarding investments and securing funding for new projects or expansions. A key takeaway was the importance of balancing financial goals with ethical healthcare practices in expanding PPUs. 

5. Navigating PPU regulatory challenges  

Participants discussed the complex regulatory landscape that PPUs face, focusing on the Competition and Markets Authority (CMA) regulations and the Procurement Act 2023, which was implemented in February 2025. These discussions were essential for preparing participants to handle the legal and operational challenges of running PPUs.

Participants discussed how CMA regulations that protect fair competition will affect PPUs, especially when forming partnerships with private entities. Emphasis was placed on the need for clear, compliant business cases to avoid legal issues and promote fair competition in healthcare.

The Procurement Act updates the processes used by NHS trusts when procuring goods and services, with the aim of making these more transparent and competitive. Participants explored how these changes might impact their contracting and partnership strategies, highlighting the importance of understanding and adapting to these legal requirements to achieve the best possible outcome.

5. Next steps

Browne Jacobson is excited to announce we will host our third PPU event in autumn 2025. This aims to consider some of the issues affecting PPU expansion further, including in relation to procurement considerations, and also to consider the views and insights from a private healthcare provider and their perspectives on to how they view partnerships with NHS trusts to expand PPUs. 

We have also launched a PPU toolkit webpage, featuring guidance and thought leadership articles. 

Please contact us if you would like to be involved in our autumn 2025 event.