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Monitor to arbitrate private company complaints over commissioning of GP services

Private providers will be able to appeal to Monitor if they believe CCGs have unfairly excluded them from running GP services, under Government plans to prevent conflicts of interest.

A new Department of Health consultation, Securing the best value for patients, sets out how the Government expects CCGs to adhere to procurement rules and protect patient choice.

The guidance, designed to supplement primary legislation on managing conflicts of interest, says ‘interested parties’ who feel they have been denied the chance to provide a service ‘will be able to appeal to Monitor where they believe commissioners have failed to act transparently in the procurement of services or that private interests have affected their choices’.

The consultation pledges to ‘establish a requirement specifically prohibiting commissioners from awarding a contract to a provider where that decision is the result of an interest in the provider’, with CCGs also required to maintain records of how they have managed conflicts of interest in individual cases.

The NHS Commissioning Board will be responsible for contracting with GP practices to deliver core primary medical services from April 2013, but CCGs will be able to commission some additional community services from practices– including those previously contracted as local enhanced services.

The recently published draft code of conduct from the NHS Commissioning Board on avoiding conflicts of interest said CCGs should use any qualified provider or full tendering for services previously provided as LESs, as it adds ‘greater transparency’ and will help ‘reduce the scope for conflicts’.

But the GPC has raised fears this could lead to substantial sums of practice funding being lost, with the code of conduct stipulating that only enhanced services of ‘limited value’ or where GPs are the ‘only capable providers’ should be commissioned directly from practices.

The new guidance says commissioners would be required to ‘demonstrate how they had managed the potential conflict of interest and that the contract was awarded on the basis of objective, proportionate and non-discriminatory criteria’.

It adds: ‘Monitor will have powers to investigate the commissioner’s conduct and to take action in the event of a breach.’

The guidance comes after the head of the UK’s largest LMC warned opening up LESs to any qualified provider will destabilise practices and lead to mass redundancies of sessional GPs.