Almost one third of NHS estate and hotel service costs are now provided through contracts with the private sector, latest figures show.
Data released by the NHS Information Centre on Tuesday shows trusts outsourced £1.98bn worth of these services in 2009-10, from a total of £6.6bn running costs.
With estates and hotel services coming to £3.8bn and £2.8bn respectively, the category is one of the largest areas of NHS expenditure.
The proportion of services outsourced increased from 26 per cent in 2007-08 to 30 per cent in 2009-10.
Most large hotel services contracts - for functions such as cleaning and catering - were undertaken by one of the “big seven” companies: ISS Mediclean, Compass Medirest, Sodexo, Mitie, Interserve, Serco and OCS.
Three quarters of the total £1.98bn contracts are with acute providers and one third are with NHS organisations in the capital.
In London alone the total value of outsourced contracts was £628m in 2009-10, an increase of 45 per cent since 2007-08. That was a faster increase than the hospital trust sector overall, whose outsourced contracts rose by 18 per cent over the same period.
Hospital cleaning is one of the biggest hotel service costs and a Department of Health study published alongside the data found costs had risen more than 9 per cent since 2008-09 to £897m.
Management consultant Rachel Dick from the firm EC Harris said some of the overall increase could be linked to Agenda for Change.
“The bulk of soft facilities management costs are staff so the annual uplift from that is a factor” she said. “Also, large teaching trusts or acutes with private finance initiative [deals] will have an annual uplift built into their contracts.”
She said London’s total could be partly explained by the inner London weighting in Agenda for Change and the number of PFI projects.
The figures show only 18 trusts across the whole NHS kept all their services in-house, with 29 contracting out the entirety.
The information is taken from the estates returns information collection system, which showed that three large London acutes contracted out 100 per cent of their estate and hotel services. These were Barking, Havering and Redbridge University Hospitals, Barts and the London and Barnet and Chase Farm Hospitals trusts.
HSJ’s conference Procurement and Outsourcing in the New NHS is in London on 9 November, www.hsj-procurement.com