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More CCGs putting enhanced services out to competition



Exclusive GP practices face more competition for their local enhanced services, with rising numbers of CCGs using a full tender or Any Qualified Provider (AQP) when commissioning enhanced services, new data obtained by Pulse has revealed.

An FOI to 109 CCGs and 82 local authorities found that around one in five CCGs are using the ‘AQP’ route or putting services out to competition, compared with only 8% in 2013/14, when CCGs first began commissioning enhanced services.

It also revealed that one CCG had put all its enhanced services out to AQP since 2013/14.

However, the actual proportion of the value of the services being put out to competition remains fairly low.

GP leaders said that CCGs need to be more confident about not putting services out to costly and ‘onerous’ procurement processes.

CCGs and local authorities took responsibility for commissioning local enhanced services in April 2013, and were told that they would no longer be able to give them straight to GP practices.

The NHS reforms stated that services would have to be put out to competition unless it could be proved that there was only ‘a single potential provider’, leading to fears that GP practices would have to go through long and costly processes to provide enhanced services.

Pulse’s survey has revealed that more CCGs and local authorities are putting services out to tender, or through the AQP route.

In total, around 7% of all enhanced services funding by local authorities and CCGs was going to AQP and competition.

One CCG – NHS North Kirklees CCG – told Pulse it had put all its enhanced services out to AQP in 2013 under three-year contracts.

Elsewhere, NHS Nottingham City CCG, NHS Warwickshire North CCG and NHS East and North Hertfordshire CCG all put more than 50% of services to competition or AQP.

Dr Chaand Nagpaul, chair of the GPC, said that they had been long opposed to the ‘unnecessary competitive procurement of services that are sensibly provided by GP practices, which incurs huge bureaucracy and takes GPs and staff away from caring for patients’.

He added: ‘The tendering process is onerous, goes into disproportionate detail and requires huge amounts on info from practices.

‘CCGs need to be more confident of rules, so that they do not feel they have to put services out to tender.’

However, Dr James Kingsland, president of the National Association of Primary Care and an adviser to the Department of Health when it was devising the Any Willing Provider process, said he was happy to see more CCGs using AQP.

He said: ‘AQP was a way of reducing bureaucracy and costs. The idea was that if you were good enough, you would get services, but you weren’t guaranteed volume.

‘It should have been the norm by now anyway. The tendering process is complex and very costly, and ends up with a monopoly provider. AQP was a way of moving away from that.’