The biggest healthcare companies in the UK started with a single site. Operose Health, AT Medics, Modality Partnership — all began with one GP practice and expanded. Ashgrove is your first site. Prove the model, refine your operations, then replicate across multiple locations. NHS England actively supports larger provider networks that deliver consistent, high-quality primary care.
Ashgrove is not just a single practice. It is a proven operational model you can replicate across multiple sites.
NHS England is actively consolidating primary care. Integrated Care Boards prefer working with larger provider networks that can deliver consistent care across multiple sites. A well-run primary care group is exactly what the system wants. You are building with the current, not against it.
Start with one. Add a second in Year 2. A third in Year 3. Here is what the combined group looks like.
| Site 1 (Ashgrove) — Year 3 Revenue | £846,646 |
| Site 2 — Year 2 Revenue | £804,924 |
| Site 3 — Year 1 Revenue | £567,845 |
| Combined Revenue (Year 3 of group) | £2,219,415 |
| Combined Profit (3 sites) | £400,000+ |
| Total Patient List (3 sites) | ~12,400 |
| Average Margin Per Site | ~20% |
These projections assume each new site follows the same growth trajectory as Ashgrove. In practice, subsequent sites often perform better because you have refined your operational model, built relationships with local ICBs, and can share back-office functions across sites. Shared practice managers, group purchasing, and centralised compliance reduce per-site costs and improve margins.
Site 1 is funded like any startup. Sites 2 and 3 are funded from a position of strength.
The first practice is always the hardest to fund. After that, you have trading accounts, NHS contract history, and proven profitability. Lenders compete for your business.
The 313 documents you receive with Ashgrove are not site-specific. Your clinical governance framework, HR policies, financial templates, and operational procedures transfer directly to additional sites. You do not need to buy them again. You do not need to write them again. This alone saves £15,000–25,000 per additional site in consultant and setup fees.
You are not swimming against the current. Multi-site primary care is where NHS England is heading.
NHS England has been encouraging practice consolidation for years. Primary Care Networks (PCNs) were introduced specifically to get practices working together at scale. Integrated Care Boards (ICBs) prefer contracting with organisations that can deliver consistent, high-quality care across multiple sites.
A multi-site primary care group offers benefits that single practices cannot:
The direction of travel is clear. NHS England wants fewer, larger, more capable primary care providers. A well-run three-site group with 12,000+ patients is exactly the kind of organisation that ICBs want to commission. You are building what the system needs.
From a single practice to a primary care group.
Your flagship site. The company, all 313 documents, financial models, website, email, phone, and CQC & NHS Application-Ready pack are yours. Secure funding, recruit staff, and open your patient list.
Run Ashgrove for 12–18 months. Build your patient list from 2,000 to 3,500+. Achieve profitability. Develop your operational playbook. Build relationships with your local ICB. Generate your first set of annual accounts.
With trading accounts and a proven model, secure funding for a second site. Either acquire an existing practice (using your governance framework) or apply for a new NHS contract in a nearby area. Your documentation transfers directly to the new site.
By now you have two profitable sites, a growing reputation with your ICB, and the operational infrastructure to manage multiple locations. Add a third site. Your group now serves over 12,000 patients with combined revenue exceeding £2.2 million.
Highly scalable. The 313 documents included with Ashgrove are designed as organisational policies, not site-specific documents. Your clinical governance framework, HR policies, safeguarding procedures, information governance policies, and financial templates all apply at the company level. For each new site, you only need to add site-specific details: the premises address, local staff names, and any location-specific risk assessments. The core documentation — which represents 95% of the work — transfers directly.
Yes, actively. The NHS Long Term Plan and the introduction of Primary Care Networks explicitly encourage larger-scale primary care provision. ICBs regularly award new contracts to existing multi-site providers because they can demonstrate consistent quality, clinical resilience, and operational efficiency. Several of the largest primary care providers in England (Operose Health, AT Medics, Modality Partnership) grew from single practices to multi-site groups. The regulatory and commissioning environment supports this model.
A realistic timeline is 3–4 years from purchasing Ashgrove to operating three sites. Year 1: establish Ashgrove, build patient list, achieve profitability. Year 2: secure funding and open Site 2 (either by acquiring an existing practice or applying for a new contract). Year 3: open Site 3 using the same approach. This timeline assumes steady execution and may be faster or slower depending on your local ICB area, available premises, and funding speed. Some multi-site groups have grown faster by acquiring distressed practices that NHS England needs to rehome.
Yes. The documentation is designed at the organisational level. Your clinical governance framework, employment contracts, safeguarding policies, prescribing protocols, information governance procedures, and financial templates all apply company-wide. For each new site, you add a site-specific appendix covering local details (premises, staff, local risk assessments). This saves £15,000–25,000 per additional site compared to starting from scratch. It also ensures consistent quality across all your sites — which is exactly what CQC and NHS England want to see from multi-site providers.
Beyond 3 sites, you are a genuine primary care group. At this scale, new opportunities open up: APMS contracts (Alternative Provider Medical Services), enhanced community services, out-of-hours provision, and partnerships with hospitals and community trusts. Your group can also attract private equity investment, partner with other healthcare organisations, or bid for larger NHS contracts that single practices cannot access. Several primary care groups in the UK have grown to 20+ sites using exactly this model. The ceiling is determined by your ambition and execution, not by the model itself.
Ashgrove Medical Practice — your flagship site. The first step towards a multi-site primary care group.
