Monitor is to investigate a complaint that referrals to a private hospital dropped after two clinical commissioning groups entered into a block contract with a local NHS hospital.

The complaint – which has been angrily denied by one of the CCGs - could be a key test of the new competition requirements introduced this year.

Spire Fylde Coast Hospital saw a “considerable decrease” in the number of NHS referrals after CCGs were formed earlier this year, which led to Spire Healthcare complaining to Monitor.

Hospital director Liz Cousins said: “We believe this is largely due to the CCGs entering into a block contract with Blackpool Teaching Hospitals Foundation Trust and failing to promote patient choice.”

But the fall off in referrals led to the hospital raising the issue with the two CCGs in August. ”Whilst we’ve no evidence to suggest that the CCGs are telling GPs where to send patients, we have not seen a meaningful effort by either of the two CCGs to fulfil their obligation to ensure that patients are aware of their ability to choose their preferred provider of treatment for routine elective care,” Ms Cousins said.

But Amanda Doyle, chief clinical officer at Blackpool CCG, said: “We are extremely disappointed that Spire chose to refer their concerns to Monitor as their first line of action, rather than to have a conversation with us as commissioners.

“Although we are happy to work with Monitor to assist their investigation, there is not a shred of evidence to substantiate Spire’s supposition that we have told GPs to direct patients to any particular provider, and I, personally, deeply resent the accusation that either Blackpool CCG or its constituent GPs have acted in any way other than in the best interests of our patients.”

Monitor has confirmed it will examine the arrangements of both Blackpool CCG and Fylde and Wyre CCG to purchase planned care and to offer patients choice. It says it has not yet formed a view on whether there has been any breach of the rules and, if it found there had been, it would then have to look at whether patients’ interests were negatively affected.

Monitor is already investigating two complaints about commissioning behaviour, although these are around specialist services rather than more general non-elective treatment. Last month the chief executive of one of the UK’s largest private hospital groups warned there she could “almost guarantee” there would be more complaints to come. Jill Watts, of Ramsay Health Care UK, said the reforms had not produced uniform changes in commissioners’ attitudes to the private sector.