Athene Medical Solutions
More NHS services set to go out for tender
May 17, 2008
"Entrepreneurial GPs likely to gain"
"EU rules coming more into play"
Written by Nicholas Timmins, Public Policy Editor
A big expansion in the range and type of NHS services put out to tender looks likely, with private sector operators, the voluntary sector, foundation trusts and more entrepreneurial GPs set to benefit.
The new guidance was published alongside an annual report on the state of the NHS from David Nicholson, its chief executive. It says the more contract-based nature of the NHS is increasingly bringing into play new European Union procurement rules, with their requirement for more services to be advertised.
The Department of Health said the guidance did not represent new policy. But leading commercial lawyers say its effect will be to require primary care trusts, which commission care on patients' behalf, to advertise significantly more services.
The guidance fits with recent statements by Mr Nicholson that "I cannot imagine an NHS service in 10 years' time that does not have significantly more private engagement at almost every level".
The guidance says: “There is no general policy requirement for NHS services to be subject to a formal procurement process".
However, it says the range of providers to the NHS is broadening, with private and voluntary providers already more involved and foundation trusts becoming freestanding businesses.
As a result, more care was now bought through legally binding contracts than old style NHS agreements. This meant EU procurement law became more applicable.
"Expectations of transparency, proportionality, fairness and non-discrimination (between providers) are rightly higher," the guidance says, "as is the likelihood of challenge [by disappointed suppliers) if these requirements are not met.”
Both UK and EU law "have become more relevant to the activities of NHS commissioners" and “there are now a range of circumstances in which a formal procurement process should be followed, and may actually be highly desirable in order to achieve best value for patients and taxpayers".
The greater the value of a contract and the larger the number of potential providers the more there is a case for advertising services and for following a formal EU procurement process, the guidance says.
In addition, primary care trusts would be required to explain if they decided not to tender "for new or significantly changed services".
A new NHS competition panel made up of economists, lawyers, procurement specialists and consumer advocates will act as a court of appeal where providers feel they have not been given a fair opportunity to bid.
Narrative by- Andrew Clarke, Commercial Director-First Echo Ultrasound Ltd
Both innovative Foundation Trusts who are seeking external expertise/partnership working are looking at new ways of working – this has spanned putting out to tender, the management of their private patient units, as a way of securing long-term contributions from rental and earnings growth from the independent sector partner ( UCLH NHS FT). There has also been discussion of Trusts making approaches to their Primary Care Trusts with a view to providing diagnostic and treatment services from community hospitals, which may be under the management of the PCT.
Primary Care Trusts have sought value for money and introduced the principle of contestability for services –but putting out to tender a wide range of services- initial outpatient appointments and follow-ups, dermatology services, sexual health services, GP out of hours provision to name a few.
Commercial organisations such as Virgin Health have taken significant stakes in Operating Companies formed by GP consortia to deliver a range of minor procedures, which historically would have been carried out within the Acute Hospital Setting or in an outpatient setting (Stockport PCT/Virgin Health)
This policy: Primary Care Trust Procurement Guide for Health Services, published 16/05/08 on the Department of Health Website: www.dh.gov.uk is set to change the competitive landscape further still
More NHS services set to go out for tender
May 17, 2008
A big expansion in the range and type of NHS services put out to tender looks likely, with private sector operators, the voluntary sector, foundation trusts and more entrepreneurial Gps set to benefit.
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