CMA provisionally clears US healthcare giant’s purchase of GP IT supplier EMIS

The Competition and Markets Authority (CMA) has provided provisional clearance of a £1.2bn deal which will see US healthcare giant UnitedHealth buy NHS GP IT supplier EMIS.

EMIS is the largest supplier of GP electronic patient records systems to the NHS, with its GP IT system EMIS Web holding a 58% share of the UK GP market.

The healthcare IT supplier also provides secondary care systems, including its Symphony suite, which is the most popular system used in NHS Accident and Emergency (A&E) departments, and its pharmacy system.

Potential buyer, UnitedHealth’s own GP system, Optum, which has been available in the UK market for 20 years, supplies GP prescribing software, as well as data analytics and advisory services used by the NHS to improve healthcare service provision. Optum and its competitors also use data that EMIS holds and integrate their software with EMIS systems to compete in other markets.

The CMA initially investigated the deal due to concerns that it could lead to worse outcomes for the NHS by reducing competition by not allowing other companies access to the EMIS data. However, the concerns were probed in more detail and the authority provisionally found that the merger did not raise competition concerns.

An independent panel found that the merged business would not be able to use EMIS to harm competition, primarily because the NHS would be able to use its role as overseer to prevent the business from “pursuing this kind of strategy”, the CMA said.

Kirstin Baker, chair of the independent inquiry panel carrying out the investigation, said that digital technology and analytics play a very important role in supporting high-quality healthcare in the NHS “so it’s important we investigate this deal thoroughly”.

“We want to ensure the NHS continues to benefit from innovation and efficiencies brought about by technology services competing for its business,” she said.

“After carefully considering a broad range of evidence, we have provisionally found that this deal is not expected to harm competition or adversely affect patients.”

In 2019, the NHS launched a new GP IT framework, replacing the old GP System of Choice (GPSoC) framework, aiming to create a competitive market for IT systems aimed at surgeries.

The old GPSoC framework only held four suppliers – EMIS, TPP, INPS and Microtest – while the GP IT Futures framework has opened up the GP IT market to a range of suppliers and systems, with the first iteration of the framework featuring more than 70 suppliers. However, EMIS, together with TPP still make up 98% of the market.

The CMA will issue its final report on the sale of EMIS on 5 October 2023, and is looking for responses from interested parties on its provisional decision until 1 September 2023.