• Proposed new procurement regime drawn up by NHS England
  • Government plans to take the NHS out of existing procurement rules
  • New regime would include requirement to consider “social value” of decisions
  • This appears to respond to concerns aired about a future trade deal with the USA, which campaigners have said could lead to an increase in privately provided services.

NHS commissioners seeking to procure services would need to consider the ‘social value’ of their decisions, under new proposals.

The requirement would be part of a proposed new procurement regime drawn up by NHS England, which outlines the options open to commissioners when selecting or continuing to work with providers.

As was widely expected, the government has today confirmed its planned legislation will take the NHS out of existing procurement rules, meaning commissioners will no longer be automatically obliged to put services out to tender.

The current rules have been frequently criticised for leading to fragmented services and adversarial relationships between local partners, as well as long-standing controversy around opening services up to private providers.

A consultation document published by NHS England proposes what the new regime should look like, outlining the steps that should be taken in three scenarios.

In the first scenario, where the commissioner wants to continue with the incumbent provider, the document saying 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.

The paper suggests commissioners would decide “if and how they prioritise and balance” the criteria for each decision they make under this regime, to best reflect their intentions.

In a third scenario, where the commissioner cannot identify a provider most suitable without running a competitive process, or wants to use a competitive process, it can proceed to tender the contract, the paper says.

David Hare, chief executive of the Independent Healthcare Providers Network, said: “We support the aims of ensuring that procurement is used when it benefits patients and taxpayers, and not just where it adds unnecessary bureaucracy.

“The requirement to consider service stability and social value sits alongside multiple other requirements in the consultation including quality, innovation, value and choice, all of which will need detailed consideration when assessing how services should be improved.”

The paper says patients will retain the legal right, which they currently have in some cases, to choose where they are treated under the “any qualified provider” framework.

Meanwhile, the document also proposes that future trade deals made by the UK with other countries should “support and reinforce” the new regime. It adds: “We…propose to work with government to ensure that the arranging (procuring and sub-contracting) of healthcare services by public bodies for the purposes of the health service in England is not to be included within the scope of any future trade agreements.”