NHS England has delayed the publication of its choice and competition framework amid a “paucity of evidence” of the benefit to patients.
Policy director Bill McCarthy made the announcement at a board meeting on Friday, highlighting the issue as a new risk for the central body.
The framework and supporting documents were originally slated for publication in July.
Mr McCarthy said: “We’re having [a discussion] with Monitor around choice and competition, and how best they can be applied in healthcare to improve outcomes for patients, including a better experience.
“That’s taken a bit longer than we hoped.
“We had hoped to be able to put out some guidance early in the summer – I think that probably reflects… it is one of the areas where there is a paucity of evidence.
“We’re committed to being a system that works on evidence and in this area, even taking from international experience, the direct evidence of where best competition and choice works to improve outcomes is fairly limited.”
NHS England chair Malcolm Grant added: “It is so important that we get away from ideological preconceptions and take a much more pragmatic focus around the needs of patients.”
Board papers for the meeting revealed that, while “good progress” has been made in developing supporting documents for a choice and competition framework, “Monitor is reconsidering the content and publication is being reviewed”. It added: “Publication is unlikely to be before late autumn 2013.”
NHS England’s risk register identified the issue as an amber red risk. It said the choice and competition framework “will set out guidance for how CCGs can use choice and competition as levers to improve standards of care”, including guidance related to any qualified provider.