SSP Health is the largest provider of primary care GP services in the North West of England, one of only three such organisations in England serving more than 140,000 patients. The company is run by Dr Shikha Pitalia, MBChB MRCGP, who has been a GP in family practice since 1991, and her husband, Dr Sanjay Pitalia, also a GP. In 2002, SSP Health pioneered 'federated General Practice', which the BMA British Medical Association has described as "increasingly being viewed as a vital part of the future of general practice". It took over 22 practices in Liverpool and Sefton in 2013, adding to the 17 practices it was already running. The contract was worth £26.7 million over three years. 5 of the contracts were renewed in 2016. The secretary of Liverpool Local Medical Committee described the contracts in May 2016 as “unworkable” and said they did not “stack up financially”. When the firm first took over the practices, many of them were already struggling due to poor management and funding previously. The firm was forced to employ some locus staff as they worked to rectify the problems inherited from the previous contract holders. SSP Health currently manages 37 GP surgeries aligned to 30 practices across 10 NHS Clinical Commissioning Groups in Greater Manchester, Lancashire, Cheshire, Merseyside and Cumbria. The company employs around 500 people and has a head office in Ashton-in-Makerfield, Wigan. It cares for approximately 150,000 patients. All practices inspected by the Care Quality Commission while part of SSP Health have received a rating of "Good" or "Outstanding". Since 2004, SSP Health has pioneered the role of Practice Champions to improve patient outcomes and quality of life. Each practice is required to have nominated Cancer Champion and Carer Champion. In 2006, Dr Shikha Pitalia devised an Acute Visiting Scheme for SSP Health, which won a number of awards. It was a much more efficient way to organise GP home visits. It has been used by its practices ever since and has now become a model for much of general practice in the UK. In 2009, Dr Shikha Pitalia - who is Secretary of the British International Doctors’ Association, Wigan division, supporting education and welfare for doctors from diverse backgrounds - co-founded SSP Health Charitable Trust with Dr Sanjay Pitalia, raising funds for local, national and international health-related charities. All her income for work done for Wigan's CCG and GP Alliance