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Aneurin Bevan University Health Board (ABUHB) failed to sufficiently scrutinise the finances and business plans of a GP partnership linked to a Leicestershire-based healthcare management company before awarding it contracts to run several surgeries, a damning report by Audit Wales has found.

Doctors Jalil Ahmed and Jonathan Allinson were awarded the contracts to run eight GP practices in the health board area – including two in Caerphilly County Borough.

The management and back-office functions of the practices were managed by eHarley Street – a company owned by the two doctors.

Lliswerry Medical Practice in Newport was the first to come under the doctors’ control in November 2022, when they joined an existing partnership.

ABUHB then awarded six contracts to Ahmed and Allinson between October 2023 and April 2024. These were for Brynmawr Medical Practice, Bryntirion Surgery in Bargoed, Aberbeeg Medical Practice in Abertillery, Blaenavon Medical Practice, Tredegar Health Centre and Pontypool Medical Centre.

In April 2024, the partnership also joined the contract for Meddygfa Gelligaer Surgery, independent of the health board’s involvement.

By this point, the partnership was responsible for eight GP practices across Gwent, with contracts worth around £10.1 million annually.

During 2024, concerns began emerging over the financial sustainability and management of the practices.

According to Audit Wales, concerns were raised over underpayment of NHS pension contributions, underpayments to HMRC and unpaid invoices to locum doctors, but said NHS Counter Fraud found “no evidence of fraud” relating to pension underpayments.

Health board’s failings

However, Audit Wales said the health board “did not fully assess the risk” of allowing a single partnership to take control of so many surgeries in such a short period of time and should have had a greater appreciation of it.

It also noted the contracts awarded to the partnership, through the vacant practice process, totalled £8.1m – more than eight times the £1m threshold that would normally require Welsh ministerial approval for a single NHS contract.

The health board had failed to carry out sufficient financial stress testing or background checks into the wider business interests of those involved – including basic Companies House checks.

Auditors also criticised the level of scrutiny applied to the partnership’s business plans and financial forecasts.

One business case reviewed by Audit Wales proposed reducing locum doctor costs by around £1 million, while increasing substantive GP salary costs by just £16,607, without explaining how the savings would be achieved.

The report also found there was “no evidence” the health board had carried out financial stress testing on the partnership’s plans or background checks into the wider business interests of those involved.

Despite receiving more than £1.2 million in Welsh Government sustainability funding during 2024/25, the partnership began handing contracts back to the health board within 15 months after concluding several practices were not financially sustainable.

The collapse of the arrangements forced the health board to take several surgeries back under direct management at short notice in order to safeguard GP services for thousands of patients across Gwent.

The first practices to be returned were Brynmawr, Aberbeeg and Blaenavon, followed by Bryntirion Surgery and Tredegar Health Centre.

In February this year, the partnership formally notified the health board that it intended to hand back its remaining contracts for Gelligaer Surgery, Pontypool Medical Centre and Lliswerry Medical Centre.

The company, through its solicitors, has previously denied allegations of mismanagement and blamed locum agencies of “driving up prices to unsustainable levels“.

A spokesperson for Aneurin Bevan University Health Board said: “We welcome the Auditor General’s report and have accepted all of its recommendations, which are already being put in place.

“Our priority throughout has been to keep GP services running safely and consistently for patients, particularly during a period of significant pressure on general practice. Where practices have changed hands, we have acted quickly to maintain care and protect patient safety.

“The health board acknowledges the report’s findings that, while contracts were awarded in line with existing policy and national regulations, there is learning to be taken and that further scrutiny could have been applied to financial and workforce plans, and the cumulative risks associated with awarding multiple contracts to a single GP partnership.

“We remain committed to working with our contracted GPs, practice staff, and partners to provide stable, high-quality services for communities across Gwent.”