Methodology & Data Sources
Transparent analysis. Verified data. Explicit assumptions. Every claim in this proposal is traceable to a primary source.
Data Verification Standards
Verified
Confirmed via official source, direct quote, or published data
Estimated
Derived from multiple sources or calculated from verified inputs
Unverified
Industry intelligence requiring further validation
Competitor Pricing Intelligence
| Provider | Circumcision | Cystoscopy | Varicocele | Status | Source |
|---|---|---|---|---|---|
| Cleveland Clinic London | From £3,605 | From £2,030 | From £4,625 | ✅ Verified | Website → |
| St John & St Elizabeth | £2,100 | £1,935 | £3,960 | ✅ Verified | Website → |
| International Andrology | — | — | From £3,500 | ✅ Verified | Website → |
| IMC Circumcision Clinic | From £550 | — | — | ✅ Verified | Website → |
| HCA Healthcare | Not published | Not published | Not published | ✅ Confirmed absence | Direct review |
| C&W Private (Target) | £1,950 | £2,250 | £4,500 | 💎 All-Inclusive | Fixed Bundle |
Critical Pricing Methodology Note
Competitor prices above are "hospital packages" only and typically exclude:
- • Consultant surgeon fee (£500–1,200)
- • Anaesthetist fee (£400–600)
- • Pathology/consumables (variable)
When professional fees are added, total patient spend at Cleveland Clinic or St John & St Elizabeth typically reaches £4,000–5,500 for procedures quoted at £2,000–3,500.
Our proposed bundles are genuinely all-inclusive: single payment covers hospital, surgeon, anaesthetist, medications, and follow-up.
NHS Trust Precedents
Royal Marsden NHS FT
Guy's & St Thomas' NHS FT
Imperial Private Healthcare
NHS PPU Failure Analysis (LaingBuisson / HSJ)
9 of 41 NHS trusts made losses on private patients (2010-2016)
Revenue per bed in PPUs runs "generally half or less" than private hospitals
Only 26 of 73 NHS PPUs held contracts with all four major insurers
Many PPUs "misprice their services" — HSJ Research
UK Private Healthcare Market Data
Overall Market (2026)
London Exception
London self-pay admissions Q1 2026
+1,000 → 15,000
All other English regions
Declined
London is the sole English region where self-pay admissions grew in 2026.
NHS Waiting List Context
7.4m
Total NHS pathways
62%
Treated <18 weeks (vs 92% target)
158
Weeks wait (NHS Grampian urology)
52%
Cite "speed" as primary motivation
Governance & Regulatory Framework
| Regulation / Guidance | Detail | Status |
|---|---|---|
| Health and Social Care Act 2012 | Foundation Trusts may earn up to 49% income from private patients | ✅ Verified |
| NHS England Position (FOI) | "Does not hold any recorded information" demonstrating PPUs provide net benefit to NHS | ✅ Verified |
| BMA Consultant Guidance | 11 PAs before private work; cannot initiate private discussions with NHS patients | ✅ Verified |
| Post-2004 Consultant Cap | 6 PAs maximum for private practice on part-time contracts | ✅ Verified |
| Public Satisfaction with NHS (2026) | Historic low of 21% — intensifies scrutiny on any two-tier perception | ✅ Verified |
Political Context (2026-27)
Health Secretary Wes Streeting champions private sector involvement. Labour manifesto removed "NHS is not for sale" phrase. However, proposals to cap PPU income growth remain a legislative possibility.
Internal Cost Estimation
Source Declaration
Primary source: Mr Giangiacomo Ollandini (Lead Consultant, GGO Med Ltd)
Basis: Current private practice costs at Nuffield Health Highgate and
comparable NHS trust tariffs
Validation required: C&W Private Care finance team confirmation
| Bundle | Target Price | Est. Cost Base | Gross Margin | Status |
|---|---|---|---|---|
| ED Diagnostic Suite | £950 | £540 | 43% | ⚠️ Estimated |
| Haematuria One-Stop | £2,250 | £1,130 | 50% | ⚠️ Estimated |
| LUTS Assessment | £650 | £315 | 51% | ⚠️ Estimated |
| Adult Circumcision | £1,950 | £1,568 | 20% | ⚠️ Estimated |
| Frenuloplasty | £1,750 | £1,387 | 21% | ⚠️ Estimated |
| Varicocele Repair | £4,500 | £3,500 | 22% | ⚠️ Estimated |
| MicroTESE | £7,500 | £5,550 | 26% | ⚠️ Estimated |
Modular Cost Base Assumptions
Anaesthetist Fee: £400-600 per case. Model assumes independent contractor billing. (Verification: Finance Audit required).
Theatre Time: £350-500/hr (GA), £250-350/hr (LA). Based on NHS Trust internal transfer pricing.
Imaging/Pathology: Marginal cost pricing (NHS internal). CT Urogram negotiated target: £550-650.
Consumables: Itemized by case (e.g., £168 for Circumcision, £200 for Varicocele microsurgery).
ROI & Investment Methodology
Tier 2B: Li-ESWT Protocol
Tier 3: MIST Surgical Conversion
Volume Logic
Projections utilize a 0.02% - 0.3% market penetration of the local private-pay demographic (Westminster/RBKC). This ultra-conservative approach ensures benchmarks are achievable even with minimal initial GP referral activity.
Key Sources Bibliography
Market Research
- • LaingBuisson. UK Healthcare Market Review (2026)
- • LaingBuisson. Private Acute Healthcare UK Market Report (2026)
- • LaingBuisson. Self-Pay Market Analysis (Q1 2026)
NHS Data
- • NHS England. Referral to Treatment Waiting Times (2026)
- • NHS Scotland. Waiting Times Statistics (2026)
- • British Social Attitudes Survey (2026)
Trust Reports
- • Royal Marsden NHS FT. Annual Report 2023-24
- • Guy's and St Thomas' NHS FT. Annual Report 2023-24
- • Imperial College Healthcare NHS Trust. CQC Report 2023
Policy & Governance
- • CHPI. Is treating private patients a net benefit to NHS Trusts? (2026)
- • HSJ. The Profitability of Private Patients (2023)
- • GIRFT. Urology National Report (2023)
Document Control
Version 1.0 | January 2026 | Mr Giangiacomo Ollandini
Prepared for Executive Review