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GPs will be hit by legislation requiring CCGs to use competition, warns GPC



GPs will be forced to waste time and money defending their practice resources from competition under proposed legislation for the NHS that will require CCGs to put all services out to tender ‘as a default’, warns the GPC.

The claims come after the Government published its draft regulations for CCG procurement, giving Monitor new wide-ranging powers to reprimand CCGs that have not ‘considered the full range of options’ before commissioning services.

The GPC has branded the secondary legislation, titled ‘Procurement, Patient Choice and Competition’, a betrayal of Government promises that CCGs should be able to use competition only when it served ‘patient’s interests’.

It also said that they would have a large impact on GP practices, bidding for new local enhanced services, or defending existing services when they are put out to Any Qualified Provider.

The draft regulations do make one concession, that CCG procurement arrangements ‘must not include any restrictions on competition that are not necessary to achieve intended outcomes which are beneficial for patients’.

But GPC negotiator Dr Chaand Nagpaul said this ‘slight provision’ would still require CCGs to justify when they decided not to use competition and meant using AQP would be the norm for commissioning services.

He said: ‘These regulations are placing a compulsion on CCGs to use competition by default, with exceptions to this occuring in defined instances. I think that reneges on the commitment given by Government to CCGs at the passing of the bill.

‘An ideological requirement for competition will be bureaucratic and will force CCGs to commission with the private sector. The last thing CCGs need is to be spending all of their time putting out every service to tender. There is a huge bureaucracy and expense involved in processing tenders.

‘It will affect GPs because the last thing we want is for CCGs to be incurring expense, delay of going through tendering processes, but also we don’t want GPs as providers to be putting unnecessary time and expense into tendering for services either.’

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Writing to CCGs in February 2012, Mr Lansley said: ‘It is a fundamental principle of the bill that you as commissioners, not the Secretary of State and not regulators, should decide when and how competition should be used to serve your patients’ interests. The healthcare regulator, Monitor, would not have the power to force you to put services out to competition.’

CCGs will now have to publish details of all procurement decisions, after the Department of Health declined to implement a suggested minimum value of £10,000 before publication was required. This data will be open for scrutiny by Monitor and may also be collected in a central database, after the DH tasked Monitor to look into how best to put a suggestion from the private companies’ representative group, NHS Partners’ Network, into practice.

Monitor and the NHS Commissioning Board will now draft additional guidance to commissioners on how best to comply with regulations, to be drafted and consulted on in coming months. Dr Nagpaul said that it is vital that the regulations, which will apply to all local services including LESs going forwards, does not create huge bureaucracy with CCGs wasting money on tenders.

The DH said in its response: ‘Given the current fiscal situation, the NHS is facing one of the tightest funding settlements in its history. We therefore need to ensure that commissioners operate within a framework of rules so that they secure the best clinical services for patients and deliver best value.’

The consultation on competition regulation, entitled ‘Securing Best Value for NHS Patients’ ran from August to October last year and saw over 80 responses. This included submissions from the BMA and the RCGP as well as private companies such as Virgin Care and Weight Watchers.

Pulse Live: 30 April – 1 May, Birmingham

Pulse Live

Richard Apps, partner at RSM Tenon accountants, will be presenting a session on ‘Maximising your income and keeping an eye on your cashflow’ at Pulse Live, Pulse’s new two-day annual conference for GPs, practice managers and primary care managers.

Pulse Live offers practical advice on key clinical and practice business topics, as well as an opportunity to debate the future of the profession, and a top range of speakers includes NICE chair designate Professor David Haslam, GPC deputy chair Dr Richard Vautrey and the Rt Hon Stephen Dorrell MP, chair of the House of Commons health committee.

To find out more and book your place, please click here.