Essex County Council - Provider Hub
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Market Context

The Integrated Community Equipment Loan Service (ICELS) provides, by way of loan, equipment to adults and children living in their own home to support them to maintain or increase their independence and support careers in their roles. Examples of community equipment include:

  • Toileting – commodes, shower seats, raised toilet seats
  • Mobility Equipment - mobile or fixed hoists, lifting aids and moving and handling equipment
  • Walking – walking frames, sticks, etc.
  • Beds – specialised beds, mattresses and accessories
  • Seating – standard and specialised chairs and seating
  • Hoists – including ceiling track hoists
  • Adaptations – including simple such as grab handles or rails, and complex such as door widening or concrete steps.
  • Medical/Surgical – disposable medical and surgical support equipment

Equipment can be provided to support an urgent and non-urgent hospital discharge or be provided following an assessment of need for someone in the community. Equipment is also provided to support children in education environments.

Essex County Council have established a contract for the provision of the equipment, with Medequip Assistive Technology, which commenced on 1st July 2023, and this includes the delivery, collection, cleaning, maintenance/testing and refurbishment of the equipment. The current contract runs to June 2028, with the option for an extension of up to 24 months.

This service is provided across ECC Adult Social Care, Family Ops and Education and through a number of Essex-based Health and Local Authority partners.

Market Rating

The community equipment market remains thin, with only a small number of capable providers. Medequip continued to secure most new contracts through 2024–2025, reinforcing concerns about limited competition. The situation shifted significantly after NRS Healthcare entered liquidation on 1 August 2025, removing one of the two major national providers and prompting many councils to hand urgent service transfers to Medequip.

Alongside this, Millbrook Healthcare has started to regain ground, picking up several contracts that needed rapid replacement following NRS’s collapse—including new awards in Brighton & Hove, Plymouth and Torbay. Millbrook Healthcare have recruited new staff for their community equipment service and therefore look to be attempting a full return to these services in the light of the demise of NRS.

Demand for equipment services will stay high due to demographic pressures, and although staffing remains largely stable, occupational therapy capacity continues to be a constraint. The supply chain for equipment remains mature, but the loss of NRS has exposed real concerns about market resilience and the risk of over‑reliance on a single dominant provider. Millbrook’s return to the market would assist in mitigating this risk, this will need to be monitored over the coming years.

Market Quality Market Supply ECC Demand
Good Low High
ECC Ambition Market Workforce Market Maturity
Increase Supply Good Mature/Established

ECC rating of the market, assessed on 14th January 2026.

The Community Equipment Service (CES) market in England continues to play a critical role in supporting independent living through the provision of essential equipment.

Essex County Council (ECC) remains contracted with Medequip, who reported a £40m increase in turnover between 2023 and 2024. While profit margins across the sector declined sharply in previous years—Medequip’s profit fell from £2.7m in 2022 to £0.5m in 2023—2024 saw a significant recovery, with profit after tax rising to £3.6m.

The Community Equipment Service market has shifted sharply going into 2026, largely due to the collapse of NRS Healthcare in August/September 2025, which forced councils across England—particularly in London—to take urgent action to maintain continuity. Medequip remains the dominant provider and continues to deliver the Essex contract, supported by strong financial recovery through 2024, but the post‑NRS landscape has opened the door for other providers to re‑establish themselves.

Millbrook Healthcare are regaining market share. They have picked up several former NRS contracts, including major arrangements in Plymouth, Torbay and other areas where councils needed immediate replacements. Their interest in new opportunities – such as Birmingham’s market engagement – shows they are not simply filling gaps but are preparing to compete more actively for future work.

Provide Community has also stepped into the market, particularly in London, where they were appointed as the new community equipment provider in Lambeth following NRS’s liquidation. They have also taken over services in Islington under urgent contract arrangements. Their presence is becoming more visible, especially where boroughs needed rapid mobilisation.

It remains to be seen for certain whether Provide Community will seek to expand market share further or are simply content with revenues gained from ex-NRS contracts. This will be closely monitored, alongside upcoming local authority opportunities in the ICELS market, to assess competitive dynamics and strategic risks.

At the same time, some London councils have chosen to bring elements of provision in‑house or through council‑owned companies. Tower Hamlets moved to an emergency council‑run service after NRS collapsed, with the borough directly delivering equipment while a new provider is procured. The City of London transferred its service to Enabled Living Healthcare, a company owned by Newham Council, effectively shifting to an in‑house local authority model. This marks a noticeable trend in parts of London toward greater local control, particularly where councils felt vulnerable to market instability.

The wave of emergency direct awards issued in late 2025—often for short terms with optional extensions—means many contracts will now end around the same time. Boroughs such as Haringey and Ealing awarded urgent one‑year or short-term contracts due to the abrupt collapse of NRS, with extension options built in to allow breathing room. As a result, the period between 2028 and 2029 is likely to be highly congested, with numerous councils re‑tendering simultaneously. This risks overstretching providers, reducing competition, and potentially driving up costs at a time when the market is already under pressure.

In early 2025, several acquisitions and sales occurred among key equipment suppliers to Medequip. Notably, Seating Matters acquired the shower chair division of Care & Independence, and GBUK acquired their sling division—both transactions completed in May 2025.

Due to the confidential nature of these deals, Medequip was informed post-completion, which is standard in such circumstances. However, these changes have prompted operational concerns, particularly regarding significant staff turnover and the potential for alterations in supply chain processes.

Medequip are actively engaging with the affected suppliers to assess any potential impact on the Essex service. Discussions are already scheduled to ensure continuity, address any emerging issues, and maintain service quality.

Essex Market  
Total Spend £15m per annum*
No. Providers 1
No. Adults/Children per month Adults and Children ≈6,700
Adults ≈6,400
Children ≈300
No. Items per month Delivered ≈10,600
Collected ≈6,250
No. Standard Items in Catalogue ≈370
Core NHS and LA Service Partners 4
EPUT, MSE, Thurrock Council, ESNEFT

The information shown in the table(s) above is correct as of 14th January 2026.

*It is anticipated that the above figures will be subject to change over the next 12-24 months.

The contract with Medequip is designed to move the service closer to the long‑term vision by setting out clear requirements, social value commitments, climate ambitions and expectations for continuous improvement. Medequip’s scale and sector expertise provide significant opportunities to modernise and enhance the service. Because this is the first time ECC and its partners have outsourced the model, there has been a steep learning curve. As the Council becomes more familiar with the market, new areas for improvement and innovation continue to emerge.

ECC and Medequip remain focused on delivering an equipment service that is centred on the needs of residents and grounded in best practice. The ICELS team plays a key role in ensuring that the provider understands and meets its obligations while also contributing its own expertise. The team maintains oversight across contractual, clinical and data functions, enabling joined‑up decision‑making and ensuring that the service direction aligns with the original vision and specification.

Over the past six to twelve months, ECC has taken meaningful steps to strengthen delivery of the service, including improving access to data and reporting. The ICELS team continues to work closely with Medequip and partners to identify savings, cost‑avoidance opportunities and efficiencies, and to drive continuous improvement and innovation across the contract.

The relationship between ECC and Medequip is collaborative, which allows issues to be addressed quickly when they arise. However, the recent market disruption caused by the liquidation of NRS Healthcare, and the large number of contracts transferred as a result, had placed considerable pressure on Medequip’s operational capacity. While ECC fully understood the national need to ensure continuity, the impact of this sudden expansion was  felt locally, with delays and reduced responsiveness prompting formal escalation. Medequip advised that the operational pressures should ease as newly acquired services stabilise and this has ben the case in recent months.

Current market risks:

  • Market stability continues to be fragile
    The collapse of NRS Healthcare has left the sector dependent on a very small number of providers. Although services have remained operational, the sudden loss of one of the main national contractors exposed how vulnerable the overall market is to disruption.
  • Operational strain on Medequip following rapid expansion
    Medequip has taken on a large volume of contracts at short notice, which stretched its operational capacity.
  • Uncertain competitive landscape as new entrants gain ground
    Millbrook Healthcare is seemingly re‑entering the market and has secured several significant contracts, indicating they plan to rebuild their presence. Provide Community has also taken on major responsibilities, particularly in London. Both strengthen provider diversity, but their long‑term capacity, investment plans and appetite for future growth remain uncertain.
  • Growth in in‑house and council‑owned delivery models
    Some London boroughs have taken equipment services back in‑house or shifted them to council‑owned companies. This reduces the number of contracts available on the open market and creates a more fragmented landscape, making future benchmarking and procurement more complex.
  • Increased monopolistic risk due to reduced competition
    With NRS gone and many urgent direct awards issued to Medequip, the market risks becoming overly dependent on one large provider. Reduced competitive tension could affect pricing, innovation and the leverage councils have during commercial discussions.
  • Congested procurement period expected in 2028–2029
    Many of the emergency contracts awarded in late 2025 are short‑term and will expire around the same time. This clustering of re‑procurements may overwhelm providers’ bidding capacity, reduce competition and lead to higher prices or weaker bids.
  • Ongoing supply chain uncertainty
    Recent supplier mergers, restructuring and staff turnover have created uncertainty within key parts of the supply chain. Although mitigations are being monitored, these changes may affect equipment availability, lead times or product consistency.
  • Financial pressure across remaining providers
    The sector continues to operate on tight margins, making providers more sensitive to cost pressures such as wage increases and national insurance changes. Ongoing financial monitoring remains essential to prevent further provider failure and ensure service continuity.
  • Contract rigidity increasing long‑term risk
    Many councils, rely on strict contract conditions that offer limited commercial flexibility. While this protects public funds, it can place additional strain on providers already operating with narrow margins. Over time, inflexible contractual arrangements may reduce providers’ ability to absorb cost pressures or adapt service models, increasing the risk of future instability or withdrawal from the market.

Our current areas of focus are:

  • Aligning Medequip performance with the specification of requirements, including KPI’s, approved assessor, adaptations and ceiling track hoist requirements.
  • Utilise contract extension information from the provider to create recommendations.
  • Escalating contract extension conversations with senior ECC stakeholder and ELS to understand direction and legal position.
  • Continue dialogue with Medequip with regards to contract extension.
  • Ensure that annual uplift principles within the contract are understood by Medequip.
  • Ensuring partners are up to date on the extension discussions and the impact on them and their governance.
  • Working closely with clinical lead to ensure that service is in line with expectation.
  • Working with Medequip to review and reduce permitted reason usage and understand the drivers.
  • Ensuring that charging mechanisms are accurately reflected on the invoicing.
  • Increased utilisation of recycled specials across the partnership.
  • Increasing collections across the partnership.
  • Review catalogue to identify rationalisation and savings.
  • Undertaking various tasks and projects under the umbrella of mutual action plan to benefit all parties, such as increased advertising of collection service, commencing drop off points at recycling centres and other locations and working with housing associations regarding void properties.
  • Working with the provider and the ECC Data and Intelligence Manager to produce clear data and reporting which can be used to understand the current service, decipher areas of concern and improvement and provide evidence where required.
  • Ensuring performance data and narrative is provided regularly to senior stakeholders.
  • Engagement with other health organisations and local government organisations to determine current solutions and pursue best practice and innovation.
  • Engaging with commissioning and Medequip to develop the lived experience offering.
  • Working towards innovations and continuous improvements such as savings calculators.
  • More collaborative work with commissioning and the new commissioning manager for this contract.
Last updated: 01/04/2026
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