Foundation trusts have warned most decisions on allowing consultants to work for other providers will need to be decided individually, despite a co-operation and competition panel ruling last week that attempts to prevent such work were anti-competitive and undermined patient choice.

The panel said generally barring such work was acceptable only if there were patient safety concerns or a consultant held a “strategic management position” in more than one organisation providing NHS funded care.

But Foundation Trust Network director Sue Slipman this week said decisions would usually need to be made case by case.

She said the push for clinical leadership and the use of service line reporting implied many clinicians had a “strategic management” responsibility. This meant “casting the net quite widely” in identifying clinicians who would be captured by the two exceptions to the rule.

She said the panel report had implicitly recognised this by saying questions of employee fidelity “will depend on the facts in each case”.

But David Worskett, director of NHS Partners Network, an arm of the NHS Confederation representing private sector organisations working in the NHS, welcomed the prospect of more NHS consultants being able to move freely between rival providers.

He said: “The panel rightly acknowledges that all providers in the scope of this report are NHS providers, so there is no conflict of interest in terms of consultants working for competitors.”