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Ever since the long-term plan was published, we have known of the intention to remove the NHS from the business-like obligation to tender contracts for clinical services.
But until now, it has been unclear what a new regime would look like.
As ministers officially announced their plans for a new Health and Care Bill, confirming those intentions, NHS England was launching a consultation on how providers should be selected or reappointed in future.
It set out the steps that new integrated care systems would have to take in three different scenarios.
In the first, where the commissioner wants to continue with the incumbent provider, the document says this should be “straightforward” to achieve where there is no viable alternative, or if the existing provider is “doing a good job and the service is not changing”.
A second scenario would arise where a new service is being established, services need to substantially change, or either party wants to cease an existing contract. In this case the commissioner would need to consider a set of “key criteria” after which it could award the contract to a provider it found most suitable, without a tender process.
These key criteria would include a need to “maximise the social value created by the arrangements, recognising the vital role the NHS plays in communities and its leadership role in achieving net zero emissions”. This would include considerations around local employment, economic growth, and community cohesion.
There would also need to be consideration of “the current stability and wider sustainability of services over time and/or in the wider locality”, such as the local NHS workforce, and around “integration and collaboration” between local services.
More familiar considerations include quality, value, and access.