The General Independent Sector Treatment Centre (ISTC) programme was initiated after a capacity review of NHS provision in the UK was completed in 2002. This review found that there were gaps in provision up and down the nation, which needed to be addressed. Following the capacity review some health economies, (‘Gaps’), entered the programme on their own and are known as Local Schemes. Other Gaps were clustered together to form what are known as a Chain Schemes. The Spine Chain is the largest of all the chains within the programme and is comprised of 11 Gaps that span the length of the country, from Cornwall up to Newcastle. The East Berkshire Gap is part of the Spine Chain, which is also known as ‘GC4’.