Aneurin Bevan University Health Board awarded contracts worth £10.1m to run GP surgeries across south Wales without conducting adequate checks on the provider, Audit Wales has concluded. The findings point to significant failures in due diligence within NHS Wales primary care commissioning.

The contracts were awarded to E-Harley Street Primary Care Solutions, a Leicestershire-based provider, to manage eight GP surgeries serving communities across Blaenau Gwent, Torfaen, Caerphilly and Newport. The arrangement gave a single external provider operational control over a substantial portion of primary care in the region.

Audit Wales found the health board failed to properly assess the risks of concentrating multiple contracts in one provider. E-Harley Street had only two doctors attached to the partnership, neither of whom delivered care directly to patients. The model relied instead on recruiting locum and contracted staff to run services. The watchdog found no evidence that the health board had made any Companies House checks into the partners' wider business interests before the contracts were signed. When the provider ran into financial difficulties, the health board handed over £1.2m in sustainability funding. It was not enough. The surgeries were eventually handed back one by one, forcing the health board to step in at short notice.

Before that point, serious concerns had emerged on the ground. Locum doctors refused to work at E-Harley Street-managed practices, claiming they were owed £250,000 in unpaid wages. Clinicians raised alarms about staffing levels they described as dangerous and warned of supply shortages with potentially serious consequences for patients. Patients reported difficulty accessing appointments and, in some cases, obtaining treatment for serious conditions including terminal illness. eHarley Street denied all such claims at the time, attributing difficulties to chronic underfunding, outdated funding formulas and a burnt-out workforce across Wales. The company said it had spent personal and private funds to stabilise operations.

The political response has been pointed. Alun Davies, former MS for Blaenau Gwent, described the situation as involving failings at every step of the way and said serious lessons needed to be learned. He has said he will call on the Senedd Health Committee to launch a fresh inquiry into the failures surrounding these contracts and into the broader delivery of primary care services in Wales. Davies said he wanted accountability from both the health board and the Welsh Government, and that the experiences of his former constituents should not be ignored.

The health board has accepted all of Audit Wales's recommendations, stating that changes are already being put in place. In a public statement, it acknowledged that while contracts were awarded in line with existing policy and national regulations, further scrutiny could have been applied to financial and workforce plans and to the cumulative risks of awarding multiple contracts to a single partnership. The Welsh Government said it would review and update current guidance to better reflect what it described as the modern primary care landscape and evolving GP partnership models.

The systemic significance lies in E-Harley Street's business model, an external workforce partnership without directly employed doctors, which was already in use by NHS England. Welsh Government guidance from 2006 had not been updated to cover these arrangements, a gap Audit Wales noted, recommending revision before similar contracts. This raises questions about whether the health board could have identified the risks and if the regulatory framework was adequate.