Monitor has stressed the need to avoid an overly restrictive approach to regulating competition issues affecting GP commissioners.

The NHS economic regulator’s chair David Bennett told HSJ a “sensible boundary” needed to be drawn between encouraging GPs to establish innovative services and preventing conflict of interest issues arising from their commissioning roles.

HSJ has previously reported how a “Monitor-proofed” list is to be drawn up of services practices could provide without having to be opened up to competition.

Asked whether the list was likely to include, at the very least, all local enhanced services, Mr Bennett said “At this stage we wouldn’t want to say it’s going to include all local enhanced services, we’ll need to look across the piece.”

Local enhanced services, which commonly include smoking cessation, minor injuries services and screening, have been cited by some as those most likely to require tougher competition regulation.

But Mr Bennett said: “If you try to prevent [GP commissioners] from using their own services completely, [and] have some arrangement with every single little thing that isn’t narrowly in the commissioning bucket… and project it to some competitive procurement that’s nonsense.

“The challenge is to work out what the sensible boundary is between things they can do versus the competitive process.”