A new EU procurement directive could see the NHS have to advertise all contracts over 500,000 Euros in the Official Journal of the European Union.

NHS bodies will have to give notice of the contracts and who has won them under the proposed new rules.

Elisabetta Zanon, director of the NHS Confederation’s European office, said the proposal would be “a significant change and we will have to fully consider its potential implications for the NHS”.

“But from both a procedural perspective and a cultural perspective, this legislation will impact the way commissioners routinely tender for services in the future,” she said.

The proposed directive allows more scope for negotiating with suppliers, she added.

The document, published today, also assuages fears that all medical services would be opened up to the full force of EU procurement law.

At the moment medical services, known as “part B services”, are subject only to limited public procurement rules and there had been concern they would be subject to the full procurement regime, known as “part A services”.

Althugh the distinction between part A and part B have now been removed there is still a recognition that health, education and social services need a less onerous set of procurement rules “given their limited cross-border interests”.

EU competition law is intended to ensure that member states do not unfairly privilege domestic companies over foreign competitors.

Article 11 of the proposed directive covers co-operation between public bodies and says the integration between public bodies fell outside the scope of the procurement laws, as long as “there is no private participation” in the integrated body.

Ms Zanon said the stringency of the co-operation rules could cause problems for the NHS.

There are also rules in article 44 about splitting large contracts into separate lots, in some circumstances.

The NHS Confederation said this was to encourage more small companies into the market but could lessen the savings from buying at scale.

If the proposal is agreed by the European Parliament and Council of Ministers the directive will be adopted in the autumn.