Monitor is closely observing the decisions clinical commissioning groups are making about transforming community services contracts, its chief executive has told HSJ.
Community services contracts were let by primary care trusts in 2010-11 - the year when they were required to cease providing services directly - usually on terms of between three and five years.
However, very few CCGs have begun tendering the contracts and anecdotal evidence suggests many are looking to roll on the contracts or avoid tendering them all together.
Mr Bennett told HSJ Monitor was “anxious to understand better what’s going on”.
“Under section 75 regulations not every contract has to be competed but there needs to be a proper process to decide whether or not you want to tender a contract,” he said.
“I think you’re certainly hearing noise in the system about whether this is happening… we’re watching closely to satisfy whether CCGs are doing what they should do.”
Guidance on the implementation of the regulations to section 75 of the 2012 Health Act, published by Monitor just before Christmas, states commissioners do not have to tender a contract if it is in the best interest of patients not to do so.
CCGs must satisfy themselves the services currently being provided could not be improved and that there are not alternative providers that could deliver them. It may also be possible for CCGs to argue that an integrated system is better for patients and it would be difficult to create that through an open tender.
Mr Bennett said: “It won’t be the same in every place… Once the commissioner has assessed a population’s needs they should look at the quality of provision.
“You may have some areas where quality of community care isn’t good enough and there are alternative providers, that’s where you might expect them to tender. At the other end of the spectrum, if they’ve got lots of other problems to deal with and there are no particular issues [with community services] and perhaps there aren’t even any other providers interested, then it’s much easier to understand why they will roll this contract over.”
Asked whether organisations must already be operating in an area or providing the same kind of services to be considered an alternative provider, Mr Bennett said they must have a track record but it could be in another geography and proving similar but not identical services.
“They’ve got to be a credible; we don’t want commissioners being forced to go through a competitive tendering process because some ‘mom and pop’ business thinks they can run all care for the elderly in the whole of Cambridgeshire [for example].”